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Sample records for hip simulator study

  1. In-situ electrochemical study of interaction of tribology and corrosion in artificial hip prosthesis simulators.

    Science.gov (United States)

    Yan, Yu; Dowson, Duncan; Neville, Anne

    2013-02-01

    The second generation Metal-on-Metal (MoM) hip replacements have been considered as an alternative to commonly used Polyethylene-on-Metal (PoM) joint prostheses due to polyethylene wear debris induced osteolysis. However, the role of corrosion and the biofilm formed under tribological contact are still not fully understood. Enhanced metal ion concentrations have been reported widely from hair, blood and urine samples of patients who received metal hip replacements and in isolated cases when abnormally high levels have caused adverse local tissue reactions. An understanding of the origin of metal ions is really important in order to design alloys for reduced ion release. Reciprocating pin-on-plate wear tester is a standard instrument to assess the interaction of corrosion and wear. However, more realistic hip simulator can provide a better understanding of tribocorrosion process for hip implants. It is very important to instrument the conventional hip simulator to enable electrochemical measurements. In this study, simple reciprocating pin-on-plate wear tests and hip simulator tests were compared. It was found that metal ions originated from two sources: (a) a depassivation of the contacting surfaces due to tribology (rubbing) and (b) corrosion of nano-sized wear particles generated from the contacting surfaces. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Prior Generic Arthroscopic Volume Correlates with Hip Arthroscopic Proficiency: A Simulator Study.

    Science.gov (United States)

    Erturan, Gurhan; Alvand, Abtin; Judge, Andrew; Pollard, Thomas C B; Glyn-Jones, Sion; Rees, Jonathan L

    2018-01-03

    Changing trends in surgical education and patient expectation are leading to proficiency models of progression and the use of simulators. Hip arthroscopy is increasingly performed and has a steep learning curve mainly addressed during fellowship training. The aim of this study was to assess the impact of previous generic arthroscopic experience on performance at a simulated hip arthroscopy task to both estimate the minimum case numbers that correlate with expert proficiency levels and help to guide selection for hip arthroscopy fellowships. Fifty-two participants were recruited to a cross-sectional study. Four consultants (expert hip arthroscopists), 28 trainees (residents and fellows), and 20 novices (interns and medical students) performed a standardized bench-top simulated hip arthroscopy task. A validated global rating scale (GRS) score and motion analysis were used to assess surgical performance. Prior arthroscopic experience was recorded from surgical electronic logbooks. Receiver operating characteristic (ROC) curve analyses were conducted to identify optimum cut-points for task proficiency at both expert and competent GRS levels. There were significant differences (p arthroscopic ability of all experience groups based on GRS assessment and for all motion analysis metrics. There was a significant positive correlation between logbook numbers and GRS scores (p arthroscopic procedures were necessary to achieve an expert GRS score, and 78 prior arthroscopic procedures were necessary for a competent score. Performing a basic hip arthroscopy task competently requires substantial previous generic arthroscopic experience. The numbers identified in this study provide targets for residents. Program directors appointing to hip arthroscopy fellowship training posts may find these results useful as a guide during the selection process.

  3. The role of altered proximal femoral geometry in impaired pelvis stability and hip control during CP gait: A simulation study.

    Science.gov (United States)

    Bosmans, Lode; Jansen, Karen; Wesseling, Mariska; Molenaers, Guy; Scheys, Lennart; Jonkers, Ilse

    2016-02-01

    Children with cerebral palsy (CP) often present aberrant hip geometry, more specifically increased femoral anteversion and neck-shaft angle. Furthermore, altered gait patterns are present within this population. This study analyzed the effect of aberrant femoral geometry, as present in subjects with CP, on the ability of muscles to control hip and knee joint kinematics. Given the specific gait deficits observed during crouch gait, increased ability to abduct, externally rotate the hip and extend the knee and hip were denoted as beneficial effects. We ran dynamic simulations of CP and normal gait using two musculoskeletal models, one reflecting normal femoral geometry and one reflecting proximal femoral deformities. The results show that the combination of aberrant bone geometry and CP-specific gait characteristics beneficially increased the ability of gluteus medius and maximus to extend the hip and knee. In contrast, the potentials of the hamstrings to extend the hip decreased whereas the potentials to flex the knee increased. These changes closely followed the observed changes in the muscle moment arm lengths. In conclusion, this study emphasizes the concomitant effect of the presence of proximal femoral deformity and CP gait characteristics on the muscle control of hip and knee joint kinematics during single stance. Not accounting for subject-specific geometry will affect the calculated muscles' potential during gait. Therefore, the use of generic models to assess muscle function in the presence of femoral deformity and CP gait should be treated with caution. Copyright © 2015 Elsevier B.V. All rights reserved.

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

    OpenAIRE

    Groves, Dawn; Fisher, John; Williams, Sophie

    2017-01-01

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

  5. Efficient selection against categorically scored hip dysplasia in dogs is possible using best linear unbiased prediction and optimum contribution selection: a simulation study

    DEFF Research Database (Denmark)

    Malm, S; Sørensen, Anders Christian; Fikse, W F

    2013-01-01

    Breeding to reduce the prevalence of categorically scored hip dysplasia (HD), based on phenotypic assessment of radiographic hip status, has had limited success. The aim of this study was to evaluate two selection strategies for improved hip status: truncation selection based on phenotypic record...... versus best linear unbiased prediction (BLUP), using stochastic simulation and selection scenarios resembling those in real dog populations. In addition, optimum contribution selection (OCS) was evaluated. Two traits were considered: HD (as a categorical trait with five classes and a heritability of 0.......45 on the liability scale) and a continuous trait (with a heritability of 0.25) intended to represent other characteristics in the breeding goal. A population structure mimicking that in real dog populations was modelled. The categorical nature of HD caused a considerably lower genetic gain compared to simulating HD...

  6. Friction measurement in a hip wear simulator.

    Science.gov (United States)

    Saikko, Vesa

    2016-05-01

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

  7. Uncemented Total Hip Replacement Stem Loosening after Long Term Compressive Stress Application: A Simulated FEA Study of Cortical Bone Remodeling

    Science.gov (United States)

    Jung, Duk-Young; Tsutsumi, Sadami; Nakai, Ryusuke; Ikeuchi, Ken; Sekel, Ron

    The purpose of this study is to predict with the use of FEA, the differing predisposition to cortical bone resorption and subsequent distal migration of an un-cemented femoral hip replacement stem subjected to long term biomechanical high compressive stresses, while varying the load angles, the material properties of the stem, and the stem length. A two-dimensional hip model was constructed to estimate the minimum principle stresses (P3) and migration magnitudes. Bone remodeling at the interface between the bone and the prosthesis was performed by comparison of the local compressive stress to physiological stress values governing bone resorption. With respect to load angles, migrations of the hip prosthesis did not occur with load angles between 63° and 74° load angle in relation to the longitudinal axis of the bony femur, as the compressive stress generated on the cortical bone was under the criteria threshold for bone resorption (-50MPa). In addition, the magnitude of migration (17%decrease) was relatively more sensitive to changes in stem length than those (92%decrease) of changes of material properties. In conclusion, using an FEA model for bone remodeling, based on the high compressive stresses exerted on distal cortical bone, it is possible to estimate migration magnitudes of cementless hip prostheses in the long term. The load angles have been shown to be an important parameter affecting the migration magnitudes and furthermore, it can be demonstrated that the stiffer materials and reduction of stem length can decrease the migration of cementless hip prosthesis in the long term.

  8. Toxicology of wear particles of cobalt-chromium alloy metal-on-metal hip implants Part I: physicochemical properties in patient and simulator studies.

    Science.gov (United States)

    Madl, Amy K; Liong, Monty; Kovochich, Michael; Finley, Brent L; Paustenbach, Dennis J; Oberdörster, Günter

    2015-07-01

    The objective of Part I of this analysis was to identify the relevant physicochemical characteristics of wear particles from cobalt-chromium alloy (CoCr) metal-on-metal (MoM) hip implant patients and simulator systems. For well-functioning MoM hip implants, the volumetric wear rate is low (<1mm(3) per million cycles or per year) and the majority of the wear debris is composed of oxidized Cr nanoparticles (<100nm) with minimal or no Co content. For implants with surgical malpositioning, the volumetric wear rate is as high as 100mm(3) per million cycles or per year and the size distribution of wear debris can be skewed to larger sizes (up to 1000nm) and contain higher concentrations of Co. In order to obtain data suitable for a risk assessment of wear debris in MoM hip implant patients, future studies need to focus on particle characteristics relevant to those generated in patients or in properly conducted simulator studies. Metallic implants are very common in the field of orthopedics. Nonetheless, concerns have been raised about the implications of nano-sized particles generated from the wear of these implants. In this two-part review, the authors first attempted to identify and critically evaluate the relevant physicochemical characteristics of CoCr wear particles from hip implant patients and simulator systems. Then they evaluated in vitro and animal toxicology studies with respect to the physicochemistry and dose-relevance to metal-on-metal implant patients. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Groves, Dawn; Fisher, John; Williams, Sophie

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Dawn Groves

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

  11. Efficient selection against categorically scored hip dysplasia in dogs is possible using best linear unbiased prediction and optimum contribution selection: a simulation study.

    Science.gov (United States)

    Malm, S; Sørensen, A C; Fikse, W F; Strandberg, E

    2013-04-01

    Breeding to reduce the prevalence of categorically scored hip dysplasia (HD), based on phenotypic assessment of radiographic hip status, has had limited success. The aim of this study was to evaluate two selection strategies for improved hip status: truncation selection based on phenotypic record versus best linear unbiased prediction (BLUP), using stochastic simulation and selection scenarios resembling those in real dog populations. In addition, optimum contribution selection (OCS) was evaluated. Two traits were considered: HD (as a categorical trait with five classes and a heritability of 0.45 on the liability scale) and a continuous trait (with a heritability of 0.25) intended to represent other characteristics in the breeding goal. A population structure mimicking that in real dog populations was modelled. The categorical nature of HD caused a considerably lower genetic gain compared to simulating HD as a continuous trait. Genetic gain was larger for BLUP selection than for phenotypic selection in all scenarios. However, BLUP selection resulted in higher rates of inbreeding. By applying OCS, the rate of inbreeding was lowered to about the same level as phenotypic selection but with increased genetic improvement. For efficient selection against HD, use of BLUP breeding values should be prioritized. In small populations, BLUP should be used together with OCS or similar strategy to maintain genetic variation. © 2012 Blackwell Verlag GmbH.

  12. Design of biped hip simulator using SolidWorks

    Science.gov (United States)

    Zainudin, M. R.; Yahya, A.; Fazli, M. I. M.; Syahrom, A.; Harun, F. K. C.; Nazarudin, M. S.

    2017-10-01

    The increasing number of people who underwent both hip implant surgery based on World Health Organization (WHO) has received massive attention from researchers lately to develop various types of hip simulators in order to test the hip implant. Various number of hip simulator have been developed with different functions and capabilities. This paper presents the design development of biped hip simulator using SolidWorks software by taking into consideration some improvement and modifications. The finite element method is used to test the design whether it is safe to be used or not. The biped hip simulator has been successfully designed and ready to be fabricated as the endurance testing shown a positive results. The von Mises stress induced in the material is an alloy steel which is 2,975,862.3 N/m2 lower than the yield strength. Thus, the design is safe to be used as it obey the safety criterion.

  13. Three-dimensional friction measurement during hip simulation.

    Directory of Open Access Journals (Sweden)

    Robert Sonntag

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

  14. Hip-hop and urban studies

    NARCIS (Netherlands)

    Jaffe, R.

    2014-01-01

    How can urban studies research engage fruitfully with hip-hop? This contribution responds to the essays by David Beer and Martin Lamotte on ‘street music’, urban ethnography and ghettoized communities. It discusses how a social science engagement with hip-hop texts might differ from cultural studies

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

    Science.gov (United States)

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

    2002-08-01

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

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

    Science.gov (United States)

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

    2000-03-01

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

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

    OpenAIRE

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

    2007-01-01

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

  18. A simulation-based training system for hip fracture fixation for use within the hospital environment.

    Science.gov (United States)

    Blyth, P; Stott, N S; Anderson, I A

    2007-10-01

    We report development of a PC-based virtual reality training system for hip fracture fixation that comprises a surgical simulator and an assessment component. The simulator allows hip fracture fixation to be performed on a virtual hip model using two-dimensional radiographic images to guide fracture reduction and implant placement. Ten operative scenarios with increasing complexities of fracture type are available. The face validity of the simulator was tested using a 26 item feedback questionnaire, with answers on a 5 cm visual analogue scale from 'disagree strongly' to 'agree strongly'. Ten study participants, aged 20-50, and with variable levels of surgical skills, each performed six operative scenarios on the simulator before completing the questionnaire. The results showed that the simulator had good face validity, with the majority of subjects stating it provided a realistic view of the operating environment (median score 8.2/10) and that the three-dimensional view provided was all that was required (median score 7.8/10). The subjects considered the simulator was able to test problem solving ability (median score 8.0/10). These results confirm that this simulator achieves good face validity without computationally intensive touch feedback (haptics). Overall, this study demonstrates that non-haptic simulators have a larger role to play in virtual simulation than is currently recognised.

  19. Morphological Analysis of True Acetabulum in Hip Dysplasia (Crowe Classes I-IV) Via 3-D Implantation Simulation.

    Science.gov (United States)

    Yang, Yuhui; Zuo, Jianlin; Liu, Tong; Xiao, Jianlin; Liu, Shuanglu; Gao, Zhongli

    2017-09-06

    The purpose of this study was to investigate the 3-dimensional (3D) morphological features of the true acetabulum in patients with developmental dysplasia of the hip (DDH). Seventy-nine hips-53 in patients with developmental dysplasia of the hip (DDH) and 36 normal hips-were included in the present study. According to the Crowe classification, 26 hips were graded as Class I, 31 were Class II or III, and 22 were Class IV. The anterior pelvic plane was defined to standardize the measurements in the study. A selected virtual cup component was implanted into the true acetabulum of a 3D pelvic model of each hip. The acetabular anteversion angle, effective center-edge (CE) angle, effective Sharp angle, and thickness of the medial wall were measured to provide morphological indices of the true acetabulum. Acetabular sector angles and the component coverage ratio were measured to provide coverage indices. The acetabular anteversion angle increased with the severity of the DDH. Crowe-II/III hips had the smallest effective CE angle and the largest effective Sharp angle. The mean medial wall thickness was greatest in the Crowe-II/III hips (8.72 mm; 95% confidence interval [CI] = 7.52 to 9.92 mm), intermediate in the Crowe-I hips (7.17 mm; 95% CI = 6.24 to 8.11 mm), and smallest in the Crowe-IV hips (6.05 mm; 95% CI = 4.78 to 7.32 mm). The integrated coverage ratio of the Crowe-II/III hips was significantly less than that of the Crowe-I and IV hips. The morphological features of the true acetabulum in patients with DDH can be evaluated comprehensively by using 3D implantation simulation. Segmental bone deficiency was prevalent in the dysplastic hips, especially those in the Crowe-II/III group. Both the severity and the individual morphology of the acetabular dysplasia should be carefully considered in preoperative planning.

  20. 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.

  1. HipGISAXS: A Massively Parallel Code for GISAXS Simulation

    Science.gov (United States)

    Chourou, Slim; Sarje, Abhinav; Li, Xiaoye; Chan, Elaine; Hexemer, Alexander; Hipgisaxs Team

    2013-03-01

    Grazing Incidence Small-Angle Scattering (GISAXS) is a valuable experimental technique in probing nanostructures of relevance to polymer science. New high-performance computing algorithms, codes, and software tools have been implemented to analyze GISAXS images generated at synchrotron light sources. We have developed flexible massively parallel GISAXS simulation software ``HipGISAXS'' based on the Distorted Wave Born Approximation (DWBA). The software computes the diffraction pattern for any given superposition of custom shapes or morphologies in a user-defined region of the reciprocal space for all possible grazing incidence angles and sample rotations. This flexibility allows a straightforward study of a wide variety of possible polymer topologies and assemblies whether embedded in a thin film or a multilayered structure. Hence, this code enables guided investigations of the morphological and dynamical properties of relevance in various applications. The current parallel code is capable of computing GISAXS images for highly complex structures and with high resolutions and attaining speedups of 200x on a single-node GPU compared to the sequential code. Moreover, the multi-GPU (CPU) code achieved additional 900x (4000x) speedup on 930 GPU (6000 CPU) nodes. This work was supported by the Director, Office of Science, of the U.S. Department of Energy under Contract No. DE-AC02-05CH11231.

  2. Degeneration in dysplastic hips. A computer tomography study

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Rømer, Lone; Søballe, Kjeld

    2005-01-01

    with moderate to severe dysplasia, and 78 hips with normal morphology in the study cohort, whilst 111 hip joints were borderline dysplastic according to preset definitions. Comparative analyses of anatomy and distribution of degeneration between dysplastic and normal hips in the study cohort were performed......-referred younger patients with hip pain believed to be caused by hip dysplasia constituted the study cohort. The average age was 35.5 years (range, 15-61 years). They were examined by close-cut transverse pelvic and knee computed tomography and antero-posterior radiographs (CT). We identified 197 hips...... ranging from -0.8 to 0.7). Fifty-one hips were subluxated (24R/27L). There were no cases of complete dislocation. The formation of subchondral cysts or osteophytes in dysplastic hips was significantly associated with reduced minimum joint space width (p ranging from 0.005 to 0.02). However, in 67 hips...

  3. Evaluation of a new methodology to simulate damage and wear of polyethylene hip replacements subjected to edge loading in hip simulator testing.

    Science.gov (United States)

    Partridge, Susan; Tipper, Joanne L; Al-Hajjar, Mazen; Isaac, Graham H; Fisher, John; Williams, Sophie

    2017-06-29

    Wear and fatigue of polyethylene acetabular cups have been reported to play a role in the failure of total hip replacements. Hip simulator testing under a wide range of clinically relevant loading conditions is important. Edge loading of hip replacements can occur following impingement under extreme activities and can also occur during normal gait, where there is an offset deficiency and/or joint laxity. This study evaluated a hip simulator method that assessed wear and damage in polyethylene acetabular liners that were subjected to edge loading. The liners tested to evaluate the method were a currently manufactured crosslinked polyethylene acetabular liner and an aged conventional polyethylene acetabular liner. The acetabular liners were tested for 5 million standard walking cycles and following this 5 million walking cycles with edge loading. Edge loading conditions represented a separation of the centers of rotation of the femoral head and the acetabular liner during the swing phase, leading to loading of the liner rim on heel strike. Rim damage and cracking was observed in the aged conventional polyethylene liner. Steady-state wear rates assessed gravimetrically were lower under edge loading compared to standard loading. This study supports previous clinical findings that edge loading may cause rim cracking in liners, where component positioning is suboptimal or where material degradation is present. The simulation method developed has the potential to be used in the future to test the effect of aging and different levels of severity of edge loading on a range of cross-linked polyethylene materials. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2017. © 2017 Wiley Periodicals, Inc.

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

    NARCIS (Netherlands)

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

    1999-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-01-01

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

  6. Transfusion practice in hip arthroplasty - a nationwide study

    DEFF Research Database (Denmark)

    Jans, Øivind; Kehlet, H; Hussain, Zubair Butt

    2011-01-01

    Background and Objectives The optimal transfusion strategy in hip arthroplasty remains controversial despite existing guidelines. The aim of this study was to evaluate the transfusion practice in patients undergoing primary total hip arthroplasty (THA) or revision total hip arthroplasty (RTHA) in...

  7. Assessing risk factors for early hip osteoarthritis in activity-related hip pain: a Delphi study

    Science.gov (United States)

    Jackson, K A; Glyn-Jones, S; Batt, M E; Arden, N K; Newton, J L

    2015-01-01

    Objective Hip pain and injury as a result of activity can lead to the development of early hip osteoarthritis (OA) in susceptible individuals. Our understanding of the factors that increase susceptibility continues to evolve. The ability to clearly identify individuals (and cohorts) with activity-related hip pain who are at risk of early hip OA is currently lacking. The purpose of this study was to gain expert consensus on which key clinical measures might help predict the risk of early hip OA in individuals presenting with activity-related hip pain. The agreed measures would constitute a standardised approach to initial clinical assessment to help identify these individuals. Methods This Dephi study used online surveys to gain concordance of expert opinion in a structured process of ‘rounds’. In this study, we asked ‘What outcome measures are useful in predicting hip OA in activity-related hip pain?’ The Delphi panel consisted of experts from sport and exercise medicine, orthopaedics, rheumatology, physiotherapy and OA research. Results The study identified key clinical measures in the history, examination and investigations (plain anteroposterior radiograph and femoroacetabular impingement views) that the panel agreed would be useful in predicting future risk of hip OA when assessing activity-related hip pain. The panel also agreed that certain investigations and tests (eg, MR angiography) did not currently have a role in routine assessment. There was a lack of consensus regarding the role of MRI, patient-reported outcome measures (PROMs) and certain biomechanical and functional assessments. Conclusions We provide a standardised approach to the clinical assessment of patients with activity-related hip pain. Assessment measures rejected by the Delphi panel were newer, more expensive investigations that currently lack evidence. Assessment measures that did not reach consensus include MRI and PROMs. Their role remains ambiguous and would benefit from further

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

    Science.gov (United States)

    Higashi, Hideki; Barendregt, Jan J

    2011-01-01

    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. 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. 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.

  9. 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.

  10. Cost-Effectiveness of Total Hip and Knee Replacements for the Australian Population with Osteoarthritis: Discrete-Event Simulation Model

    Science.gov (United States)

    Higashi, Hideki; Barendregt, Jan J.

    2011-01-01

    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. PMID:21966520

  11. Planning acetabular fracture reduction using patient-specific multibody simulation of the hip

    Science.gov (United States)

    Oliveri, Hadrien; Boudissa, Mehdi; Tonetti, Jerome; Chabanas, Matthieu

    2017-03-01

    Acetabular fractures are a challenge in orthopedic surgery. Computer-aided solutions were proposed to segment bone fragments, simulate the fracture reduction or design the osteosynthesis fixation plates. This paper addresses the simulation part, which is usually carried out by freely moving bone fragments with six degrees of freedom to reproduce the pre-fracture state. Instead we propose a different paradigm, closer to actual surgeon's requirements: to simulate the surgical procedure itself rather than the desired result. A simple, patient-specific, biomechanical multibody model is proposed, integrating the main ligaments and muscles of the hip joint while accounting for contacts between bone fragments. Main surgical tools and actions can be simulated, such as clamps, Schanz screws or traction of the femur. Simulations are computed interactively, which enables clinicians to evaluate different strategies for an optimal surgical planning. Six retrospective cases were studied, with simple and complex fracture patterns. After interactively building the models from preoperative CT, gestures from the surgical reports were reproduced. Results of the simulations could then be compared with postoperative CT data. A qualitative study shows the model behavior is excellent and the simulated reductions fit the observed data. A more quantitative analysis is currently being completed. Two cases are particularly significant, for which the surgical reduction actually failed. Simulations show it was indeed not possible to reduce these fractures with the chosen approach. Had our simulator being used, a better planning may have avoided a second surgery to these patients.

  12. Recovery in horizontal gait after hip resurfacing vs. total hip arthroplasty at 6-month follow-up - a RCT study

    DEFF Research Database (Denmark)

    Jensen, Carsten; Aagaard, Per; Overgaard, Søren

    2012-01-01

    and hip kinematics compared to standard total hip arthroplasty in younger hip arthritis patients. Maximal isolated leg muscle strength was a predictor of horizontal gait performance, and thus provides an important and valid functional outcome measure for individuals undergoing total hip arthroplasty....... in walking ability and kinematics have been suggested after R-THA, but no study sofar has objectively assessed this aspect in a randomized trial including S-THA. Purpose: To test the hypothesis that (i) a superior recovery in gait would be observed following resurfacing total hip arthroplasty compared...... to standard total hip arthroplasty and (ii) to investigate the hypothesized relationship between mechanical hip and knee muscle performance and horizontal gait function in patients with total hip replacement. Methods: Forty-three patients were randomized into either standard or resurfacing THA. Three...

  13. Short time-frame from first to second hip fracture in the Funen County Hip Fracture Study

    DEFF Research Database (Denmark)

    Nymark, T; Lauritsen, Jens; Ovesen, O

    2006-01-01

    Hip fracture patients represent a frail group of elderly with increased morbidity and mortality. The aim of this study was to evaluate the occurrence and distribution of a second hip fracture in the time interval between the first and the second hip fracture....

  14. Virtual-reality simulation to assess performance in hip fracture surgery

    DEFF Research Database (Denmark)

    Pedersen, Poul; Palm, Henrik; Ringsted, Charlotte

    2014-01-01

    of an undisplaced femoral neck fracture: 2 hook-pins, 2 screws, and a sliding hip screw. All procedures were preformed on a trauma simulator. Performance scores for each procedure were obtained from the predefined metrics of the simulator. The inter-case reliability of the simulator metrics was explored......BACKGROUND AND PURPOSE: Internal fixation of hip fractures is a common and important procedure that orthopedic surgeons must master early in their career. Virtual-reality training could improve initial skills, and a simulation-based test would make it possible to ensure basic competency of junior...

  15. The association between eccentric hip abduction strength and hip and knee angular movements in recreational male runners: An explorative study.

    Science.gov (United States)

    Brund, R B K; Rasmussen, S; Nielsen, R O; Kersting, U G; Laessoe, U; Voigt, M

    2018-02-01

    Weak hip abductors may be related with increased hip adduction and knee abduction angular movement, which may be risk factors of lower extremity injuries. As the role of eccentric hip abduction strength (EHAS) on hip adduction angular movement and knee abduction angular movement (KABD) remains unclear, the purpose of this study was to explore the association between EHAS and hip and knee angular movement. In 100 healthy male recreational runners, EHAS was quantified using an isokinetic dynamometer, while hip and knee angular movements were collected using pressure-sensitive treadmill and Codamotion active marker system. Using multiple linear regression models (n=186 legs), no relationships between EHAS and hip and knee kinematics were found. A possible reason for the lack of relationship between EHAS and hip and knee kinematics may be owing to differences in the running kinematics. Some runners with weak EHAS may compensate the weakness by leaning toward the stance limb and thereby reduces the demand on the hip abductors with the consequence of increased knee abduction moment, which may lead to an increased knee abduction angular excursion. Possible, others mechanism as the quadriceps strength and activity in the hip and thigh muscles may also be able to explain the lack of relationship that may or may not exist. Despite the inconclusive results of this study, the findings may suggest that weak hip abductor muscles may be a relevant factor to focus on in future studies. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Importance of preclinical evaluation of wear in hip implant designs using simulator machines

    Directory of Open Access Journals (Sweden)

    Rafael Mello Trommer

    Full Text Available ABSTRACT Total hip arthroplasty (THA is a surgical procedure that involves the replacement of the damaged joint of the hip by an artificial device. Despite the recognized clinical success of hip implants, wear of the articulating surfaces remains as one of the critical issues influencing performance. Common material combinations used in hip designs comprise metal-on-polymer (MoP, ceramic-on-polymer (CoP, metal-on-metal (MoM, and ceramic-on-ceramic (CoC. However, when the design of the hip implant is concerned besides the materials used, several parameters can influence its wear performance. In this scenario, where the safety and efficacy for the patient are the main issues, it is fundamental to evaluate and predict the wear rate of the hip implant design before its use in THA. This is one of the issues that should be taken into account in the preclinical evaluation step of the product, in which simulated laboratory tests are necessary. However, it is fundamental that the applied motions and loads can reproduce the wear mechanisms physiologically observed in the patient. To replicate the in vivo angular displacements and loadings, special machines known as joint simulators are employed. This article focuses on the main characteristics related to the wear simulation of hip implants using mechanical simulators, giving information to surgeons, researchers, regulatory bodies, etc., about the importance of preclinical wear evaluation. A critical analysis is performed on the differences in the principles of operation of simulators and their effects on the final results, and about future trends in wear simulation.

  17. Computer tomography prototyping and virtual procedure simulation in difficult cases of hip replacement surgery.

    Science.gov (United States)

    Parchi, Paolo Domenico; Ferrari, Vincenzo; Piolanti, Nicola; Andreani, Lorenzo; Condino, Sara; Evangelisti, Gisberto; Lisanti, Michele

    2013-09-01

    Each year approximately 1 million total hip replacements (THR) are performed worldwide. A percentage of failure due to surgical approach and imprecise implant placement still exists. These result in several serious complications. We propose an approach to plan, to simulate, and to assist prosthesis implantation for difficult cases of THR based on 3-D virtual models, generated by segmenting patients' CT images, 3-D solid models, obtained by rapid prototyping (RP), and virtual procedure simulation. We carried out 8 THR with the aid of 3-D reconstruction and RP. After each procedure a questionnaire was submitted to the surgeon to assess the perceived added value of the technology. In all cases, the surgeon evaluated the 3-D model as useful in order to perform the planning. The clinical results showed a mean increase in the Harris Hip Score of about 42.5 points. The mean time of prototyping was 7.3 hours, (min 3.5 hours, max 9.3 hours). The mean surgery time was 65 minutes (min 50 minutes, max 88 minutes). Our study suggests that meticulous preoperative planning is necessary in front of a great aberration of the joint and in absence of normal anatomical landmarks, CT scan is mandatory, and 3-D reconstruction with solid model is useful.

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

    Science.gov (United States)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2015-09-18

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

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

    Directory of Open Access Journals (Sweden)

    Régis Pailhé

    2013-07-01

    Full Text Available There is a need of independent prospective studies about modern generation of hip resurfacing implants. The aim of this propective observational study was to compare the functional outcomes and revision rates with hip resurfacing arthroplasty and total hip arthroplasty and to present the preliminary results at 2 years. Patients included were recruited prospectively in the Partial Pelvic Replacement Hip Project by a single surgeon between January 2007 and January 2010. Patients were assessed with the Harris Hip Score (HHS and Postel-Merle d’Aubigné (MDA score and Devane Score. The end point of the study was reoperation for any cause related to the prosthesis. At a mean follow up of 38.6 months there were a total of 142 patients with hip resurfacing (group 1 [100 Durom® (Zimmer Inc., Warsaw, IN, USA and 42 Birmingham Hip Resurfacing® (Smith & Nephew, Memphis, TN, USA] and 278 patients with total hip arthroplasty (group 2. The results showed significantly greater gain of HHS, MDA and Devane score with hip resurfacing procedures. However, considering all the complications, the rate was significantly higher in group 16.4% vs 1.79% in group 2 (P<0.0001. In group 1 we observed 6 complications only concerned males with Durom® implants. The follow up of this cohort is still on going and may deliver more information on the evolution of these results in time.

  1. Do jumbo cups cause hip center elevation in revision THA? A computer simulation.

    Science.gov (United States)

    Nwankwo, Chima; Dong, Nick N; Heffernan, Christopher D; Ries, Michael D

    2014-02-01

    Acetabular revision THA with use of a large (jumbo) cup is an effective treatment for many cavitary and segmental peripheral bone defects. However, the jumbo cup may result in elevation of the hip center and protrusion through the anterior acetabular wall as a result of the oversized geometry of the jumbo cup compared with the physiologic acetabulum. The purpose of this computer simulation was to determine how much elevation of the hip center and anterior wall protrusion occurs in revision THA with use of a jumbo cup technique in which the inferior edge of the jumbo cup is placed at the inferior acetabular rim and the superior edge of the jumbo cup is placed against host bone at the superior margin of a posterosuperior bone defect. Two hundred sixty-five pelvic CT scans were analyzed by custom CT analytical software. The computer simulated oversized reaming. The vertical and anterior reamer center shifts were measured, and anterior column bone removal was determined. The computer simulation demonstrated that the hip center shifted 0.27 mm superiorly and 0.02 mm anteriorly, and anterior column bone removal increased 0.86 mm for every 1-mm increase in reamer diameter. Our results indicate that the jumbo cup technique results in hip center elevation despite placement of the cup adjacent to the inferior acetabulum. For a hypothetical increase from a 54-mm socket to a 72-mm socket, as one might see in the context of the revision of a failed THA, our model would predict an elevation of the hip center of approximately 5 mm and loss of approximately 15 mm of anterior column bone. This suggests that an increase in femoral head length may be needed to compensate for the hip center elevation caused by the use of a large jumbo cup in revision THA. A jumbo cup may also result in protrusion through the anterior wall.

  2. Study of sex differences in the association between hip fracture risk and body parameters by DXA-based biomechanical modeling.

    Science.gov (United States)

    Nasiri, Masoud; Luo, Yunhua

    2016-09-01

    There is controversy about whether or not body parameters affect hip fracture in men and women in the same way. In addition, although bone mineral density (BMD) is currently the most important single discriminator of hip fracture, it is unclear if BMD alone is equally effective for men and women. The objective of this study was to quantify and compare the associations of hip fracture risk with BMD and body parameters in men and women using our recently developed two-level biomechanical model that combines a whole-body dynamics model with a proximal-femur finite element model. Sideways fall induced impact force of 130 Chinese clinical cases, including 50 males and 80 females, were determined by subject-specific dynamics modeling. Then, a DXA-based finite element model was used to simulate the femur bone under the fall-induced loading conditions and calculate the hip fracture risk. Body weight, body height, body mass index, trochanteric soft tissue thickness, and hip bone mineral density were determined for each subject and their associations with impact force and hip fracture risk were quantified. Results showed that the association between impact force and hip fracture risk was not strong enough in both men (r=-0.31,phip fracture risk. The correlation between hip BMD and hip fracture risk in men (r=-0.83,phip fracture in men (r=-0.13,p>0.05), but it can be considered as a protective factor among women (r=-0.28,phip fracture in women (r=-0.50,phip fracture are sex-specific. Therefore, the effect of body parameters should be considered differently for men and women in hip fracture risk assessment tools. These findings support further exploration of sex-specific preventive and protective measurements to reduce the incidence of hip fractures. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Affatato, Saverio; Freccero, Nadia; Taddei, Paola

    2016-01-01

    Although hip arthroplasty is an established procedure that relieves pain and improves functions, problems remain with wear and osteolysis. Highly cross-linked polyethylene and Vitamin-E-stabilized polyethylene were introduced in the last years to solve these problems. In this study we compared the in vitro wear behaviour of cross-linked polyethylene (XLPE) versus Vitamin-E diffused XLPE (XLPE_VE) versus conventional ultra-high molecular weight polyethylene (UHMWPE) acetabular cups. The test was performed using a hip joint simulator run for two millions cycles under bovine calf serum as lubricant. Mass loss was found to decrease along the series UHMWPE>XLPE_VE>XLPE, although statistically significant differences were found only between the mass losses of XLPE and UHMWPE at 1.2 and 2 million cycles. The mass loss data were explained in relation to the crystalline morphology of the control unworn cups, as investigated by non-destructive micro-Raman spectroscopy. This technique allowed to disclose a different wear behaviour of the three sets of cups. Wear testing produced a stress-induced crystallisation in UHMWPE, with increases in both amorphous (αa) and orthorhombic (αo) phases at the expense of the third phase (αb), which decreased upon wear. Moreover, the all-trans content decreased, while the ortho-trans content increased, contrarily to the trend observed for XLPE and XLPE_VE, for which no statistically significant changes in αo, αa and αb contents were detected. The XLPE_VE specimens underwent the least significant changes in the spectroscopic markers of micromorphology upon mechanical stress, probably due to their lower starting amorphous content. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Hip range-of-motion (ROM) is less than normal after rotational acetabular osteotomy for developmental dysplasia of the hip: A simulated ROM analysis.

    Science.gov (United States)

    Hamada, Hidetoshi; Takao, Masaki; Nakahara, Ichiro; Sakai, Takashi; Nishii, Takashi; Sugano, Nobuhiko

    2016-02-01

    The optimal reorientation of the acetabulum for developmental dysplasia of the hip (DDH) is unknown in terms of hip range-of-motion (ROM). The simulated ROMs of 52 DDHs after rotational acetabular osteotomy (RAO) with several patterns of femoral head coverage and those of 73 normal hips were analyzed using computer models reconstructed from CT images. After RAO with a lateral center edge angle (LCEA) of 30° and an anterior center edge angle (ACEA) of 55° producing coverage similar to that of normal hips, the maximal flexion and maximal internal rotation at 110° flexion with 20° adduction were significantly smaller than those of the normal group. To achieve ROMs after RAO similar to those of the normal group, an LCEA of 30° with an ACEA of 45°, an LCEA of 25° with an ACEA of 45° to 50°, and an LCEA of 20° with an ACEA of 50° could be preferred angles to target, even though they provided smaller coverage than that of normal hips. After RAO producing femoral head coverage similar to that of normal hips, the maximal flexion and the maximal internal rotation at 110° flexion with 20° adduction were significantly smaller than those of the normal group. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

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

    OpenAIRE

    Watanabe, Susumu

    1998-01-01

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

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

    Science.gov (United States)

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

    2008-12-01

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

  7. Hip muscle strength and static balance in patients with snapping hip syndrome – a pilot study

    Directory of Open Access Journals (Sweden)

    Witke-Woźniak Agnieszka

    2016-09-01

    Full Text Available Introduction: Snapping hip syndrome (SHS occurs in 5-10% of the global population. A back and forth skip of the tendon of the dysfunctional muscle across the osseous prominence is the most common symptom of this condition. Mainly young generation suffers from SHS. Depending on the structures that cause an audible snap, snapping hip syndrome may be classified into intra-articular and extra-articular types. The main aim of the research was to assess the strength of the major hip muscles and static balance in patients with snapping hip syndrome.

  8. An electromyographic study of the hip muscles of transfemoral amputees in walking

    NARCIS (Netherlands)

    Jaegers, SMHJ; Arendzen, JH; deJongh, HJ

    The aim of this study was to obtain insight into the electromyographic activity of the hip muscles after transfemoral amputation and to determine whether the cleaved hip muscles are still functional in locomotion, The electromyographic activity of the superficial hip muscles of both legs was studied

  9. Acetabular QCT in Total Hip Arthroplasty - a reliability study using porcine hips

    DEFF Research Database (Denmark)

    Mussmann, Bo Redder; Overgaard, Soren; Torfing, Trine

    previously shown better delineation of the interface between bone and prosthesis and may be beneficial in quantitative analysis of bone loss close to the implant as compared to single energy computed tomography (SECT). The purpose of this porcine ex-vivo study was to test the intra-observer agreement...... and reliability of bone mineral density measurements (BMD) in close proximity of the acetabular cup using SECT and DECT images and 3D segmentation software. Materials and methods 22 acetabular cups (12 cemented, 10 un-cemented) were inserted in porcine hip specimens ex vivo. A femoral stem was attached to each...... specimen and imaging was performed with SECT and DECT. The specimens were repositioned and scans repeated to obtain double measurements. For each scan BMD was measured in a hemispherical volume around the acetabular cup using in-house segmentation software. Results In the uncemented concept mean BMD...

  10. Contralateral hip fractures and other osteoporosis-related fractures in hip fracture patients: Incidence and risk factors. An observational cohort study of 1,229 patients

    NARCIS (Netherlands)

    A.J.H. Vochteloo (Anne); B.L. Borger van der Burg (Boudewijn); M.L. Röling (Maarten); D.H.-J. van Leeuwen (Diederik); P. van den Berg (Peter); A.H.P. Niggebrugge (Arthur); M.R. de Vries (Mark); W.E. Tuinebreijer (Wim); R.M. Bloem (Rolf); R.G.H.H. Nelissen (Rob); P. Pilot (Peter)

    2012-01-01

    textabstractPurpose: To report risk factors, 1-year and overall risk for a contralateral hip and other osteoporosis-related fractures in a hip fracture population. Methods: An observational study on 1,229 consecutive patients of 50 years and older, who sustained a hip fracture between January 2005

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

    DEFF Research Database (Denmark)

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

    2004-01-01

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

  12. A clinical observational study on patient-reported outcomes, hip functional performance and return to sports activities in hip arthroscopy patients

    NARCIS (Netherlands)

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

    2016-01-01

    OBJECTIVES: To describe data of short- and midterm results of hip arthroscopy patients based on patient-reported hip function, hip functional performance and return to sports activities. DESIGN: Observational cohort study. SETTING: Sports medical center. PARTICIPANTS: 37 recreational athletes (21

  13. Modular hybrid total hip arthroplasty. Experimental study in dogs

    Directory of Open Access Journals (Sweden)

    Ranzani José JT

    2011-07-01

    Full Text Available Abstract Background This prospective experimental study evaluated the surgical procedure and results of modular hybrid total hip arthroplasty in dogs. Methods Ten skeletally mature healthy mongrel dogs with weights varying between 19 and 27 kg were used. Cemented modular femoral stems and uncemented porous-coated acetabular cups were employed. Clinical and radiographic evaluations were performed before surgery and at 30, 60, 90, 120, 180 and 360 days post-operation. Results Excellent weight bearing was noticed in the operated limb in seven dogs. Dislocation followed by loosening of the prosthesis was noticed in two dogs, which were therefore properly treated with a femoral head osteotomy. Femoral fracture occurred in one dog, which was promptly treated with full implant removal and femoral osteosynthesis. Conclusions The canine modular hybrid total hip arthroplasty provided excellent functionality of the operated limb.

  14. Finite Element Analysis of porously punched prosthetic short stem virtually designed for simulative uncemented Hip Arthroplasty.

    Science.gov (United States)

    Peng, Matthew Jian-Qiao; Chen, Hai-Yan; Hu, Yong; Ju, XiangYang; Bai, Bo

    2017-07-11

    There is no universal hip implant suitably fills all femoral types, whether prostheses of porous short-stem suitable for Hip Arthroplasty is to be measured scientifically. Ten specimens of femurs scanned by CT were input onto Mimics to rebuild 3D models; their *stl format dataset were imported into Geomagic-Studio for simulative osteotomy; the generated *.igs dataset were interacted by UG to fit solid models; the prosthesis were obtained by the same way from patients, and bored by punching bears designed by Pro-E virtually; cements between femora and prosthesis were extracted by deleting prosthesis; in HyperMesh, all compartments were assembled onto four artificial joint style as: (a) cemented long-stem prosthesis; (b) porous long-stem prosthesis; (c) cemented short-stem prosthesis; (d) porous short-stem prosthesis. Then, these numerical models of Finite Element Analysis were exported to AnSys for numerical solution. Observed whatever from femur or prosthesis or combinational femora-prostheses, "Kruskal-Wallis" value p > 0.05 demonstrates that displacement of (d) ≈ (a) ≈ (b) ≈ (c) shows nothing different significantly by comparison with 600 N load. If stresses are tested upon prosthesis, (d) ≈ (a) ≈ (b) ≈ (c) is also displayed; if upon femora, (d) ≈ (a) ≈ (b) < (c) is suggested; if upon integral joint, (d) ≈ (a) < (b) < (c) is presented. Mechanically, these four sorts of artificial joint replacement are stabilized in quantity. Cemented short-stem prostheses present the biggest stress, while porous short-stem & cemented long-stem designs are equivalently better than porous long-stem prostheses and alternatives for femoral-head replacement. The preferred design of those two depends on clinical conditions. The cemented long-stem is favorable for inactive elders with osteoporosis, and porously punched cementless short-stem design is suitable for patients with osteoporosis, while the porously punched cementless short-stem is

  15. 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...

  16. Heterotopic ossification after hip arthroplasty: a randomized double-blind multicenter study tenoxicam in 147 hips

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Sletgård, J; Dalsgård, J

    1996-01-01

    147 patients due to have a cemented total hip arthroplasty were randomized to 4 groups. They received either tenoxicam 20 mg or 40 mg, or placebo, for 5 days or morphine on the day of operation and placebo for 4 days. During the first 5 days 14 patients were excluded. The patients were followed f...... that tenoxicam 20 mg for 5 days postoperatively can reduce heterotopic ossification after cemented total hip arthroplasty....

  17. Dynamical analysis of dislocation-associated factors in total hip replacements by hardware-in-the-loop simulation.

    Science.gov (United States)

    Geier, Andreas; Kluess, Daniel; Grawe, Robert; Herrmann, Sven; D'Lima, Darryl; Woernle, Christoph; Bader, Rainer

    2017-11-01

    Since dislocation of total hip replacements (THR) remains a clinical problem, its mechanisms are still in the focus of research. Previous studies ignored the impact of soft tissue structures and dynamic processes or relied on simplified joint contact mechanics, thus, hindered a thorough understanding. Therefore, the purpose of the present study was to use hardware-in-the-loop (HiL) simulation to analyze systematically the impact of varying implant positions and designs as well as gluteal and posterior muscle function on THR instability under physiological-like loading conditions during dynamic movements. A musculoskeletal multibody model emulated the in situ environment of the lower extremity during deep sit-to-stand with femoral adduction maneuver while a six-axis robot moved and loaded a THR accordingly to feed physical measurements back to the multibody model. Commercial THRs with hard-soft bearings were used in the simulation with three different head diameters (28, 36, 44 mm) and two offsets (M, XL). Cup inclination of 45°, cup anteversion of 20°, and stem anteversion of 10° revealed to be outstandingly robust against any instability-related parameter variation. For the flexion motion, higher combined anteversion angles of cup and stem seemed generally favorable. Total hip instability was either deferred or even avoided even in the presence of higher cup inclination. Larger head diameters (>36 mm) and femoral head offsets (8 mm) deferred occurrence of prosthetic and bone impingement associated with increasing resisting torques. In summary, implant positioning had a much higher impact on total hip stability than gluteal insufficiency and impaired muscle function. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2557-2566, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  18. Study of Hip Fracture Risk using Tree Structured Survival Analysis

    Directory of Open Access Journals (Sweden)

    Lu Y

    2003-01-01

    Full Text Available In dieser Studie wird das Hüftfraktur-Risiko bei postmenopausalen Frauen untersucht, indem die Frauen in verschiedene Subgruppen hinsichtlich dieses Risikos klassifiziert werden. Frauen in einer gemeinsamen Subgruppe haben ein ähnliches Risiko, hingegen in verschiedenen Subgruppen ein unterschiedliches Hüftfraktur-Risiko. Die Subgruppen wurden mittels der Tree Structured Survival Analysis (TSSA aus den Daten von 7.665 Frauen der SOF (Study of Osteoporosis Fracture ermittelt. Bei allen Studienteilnehmerinnen wurde die Knochenmineraldichte (BMD von Unterarm, Oberschenkelhals, Hüfte und Wirbelsäule gemessen. Die Zeit von der BMD-Messung bis zur Hüftfraktur wurde als Endpunkt notiert. Eine Stichprobe von 75% der Teilnehmerinnen wurde verwendet, um die prognostischen Subgruppen zu bilden (Trainings-Datensatz, während die anderen 25% als Bestätigung der Ergebnisse diente (Validierungs-Datensatz. Aufgrund des Trainings-Datensatzes konnten mittels TSSA 4 Subgruppen identifiziert werden, deren Hüftfraktur-Risiko bei einem Follow-up von im Mittel 6,5 Jahren bei 19%, 9%, 4% und 1% lag. Die Einteilung in die Subgruppen erfolgte aufgrund der Bewertung der BMD des Ward'schen Dreiecks sowie des Oberschenkelhalses und nach dem Alter. Diese Ergebnisse konnten mittels des Validierungs-Datensatzes reproduziert werden, was die Sinnhaftigkeit der Klassifizierungregeln in einem klinischen Setting bestätigte. Mittels TSSA war eine sinnvolle, aussagekräftige und reproduzierbare Identifikation von prognostischen Subgruppen, die auf dem Alter und den BMD-Werten beruhen, möglich. In this paper we studied the risk of hip fracture for post-menopausal women by classifying women into different subgroups based on their risk of hip fracture. The subgroups were generated such that all the women in a particular subgroup had relatively similar risk while women belonging to two different subgroups had rather different risks of hip fracture. We used the Tree Structured

  19. Heterotopic ossification after hip arthroplasty: a randomized double-blind multicenter study tenoxicam in 147 hips

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Sletgård, J; Dalsgård, J

    1996-01-01

    for 1 year, during which another 10 patients were excluded. At follow-up, significantly fewer patients had heterotopic ossifications in the tenoxicam groups than in the placebo and morphine groups. There was no significant difference between the 2 tenoxicam-treated groups, and we therefore conclude...... that tenoxicam 20 mg for 5 days postoperatively can reduce heterotopic ossification after cemented total hip arthroplasty....

  20. A clinical observational study on patient-reported outcomes, hip functional performance and return to sports activities in hip arthroscopy patients.

    Science.gov (United States)

    Tijssen, Marsha; van Cingel, Robert; de Visser, Enrico; Nijhuis-van der Sanden, Maria

    2016-07-01

    To describe data of short- and midterm results of hip arthroscopy patients based on patient-reported hip function, hip functional performance and return to sports activities. Observational cohort study. Sports medical center. 37 recreational athletes (21 men) at least six months after finishing rehabilitation for hip arthroscopy. International Hip Outcome Tool 33 (IHOT-33), Pain Visual Analogue Scale (VAS), Global Perceived Effect Scale (GPE), sports questionnaires and hip functional performance tests. At a mean follow-up time of 2.3 years, 81% of participants reported improvement on the GPE and 84% returned to sports activities. The mean IHOT-33 score was 69.3; the mean VAS score was 35.0. Range of motion (ROM) and strength were within the 90% Limb Symmetry Index (LSI) limit, except for hip internal rotation ROM. A full recovery of hip functional performance, as measured with balance and hop tests, was established based on the 90% LSI limit. The overall short- and midterm results of these follow-up data show good recovery of hip arthroscopy patients on patient-reported outcomes, functional performance and return to sports activities. The functional performance tests used in this study seem adequate for measuring recovery in hip arthroscopy patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2015-09-01

    The superior biotribological performance of nanocrystalline diamond (NCD) coatings grown by a chemical vapor deposition (CVD) method was already shown to demonstrate high wear resistance in ball on plate experiments under physiological liquid lubrication. However, tests with a close-to-real approach were missing and this constitutes the aim of the present work. Hip joint wear simulator tests were performed with cups and heads made of silicon nitride coated with NCD of ~10 μm in thickness. Five million testing cycles (Mc) were run, which represent nearly five years of hip joint implant activity in a patient. For the wear analysis, gravimetry, profilometry, scanning electron microscopy and Raman spectroscopy techniques were used. After 0.5 Mc of wear test, truncation of the protruded regions of the NCD film happened as a result of a fine-scale abrasive wear mechanism, evolving to extensive plateau regions and highly polished surface condition (Racracking, grain pullouts or delamination of the coatings. A steady state volumetric wear rate of 0.02 mm(3)/Mc, equivalent to a linear wear of 0.27 μm/Mc favorably compares with the best performance reported in the literature for the fourth generation alumina ceramic (0.05 mm(3)/Mc). Also, squeaking, quite common phenomenon in hard-on-hard systems, was absent in the present all-NCD system. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Studies on hip fracture patients : effects of nutrition and rehabilitation

    OpenAIRE

    Flodin, Lena

    2015-01-01

    Hip fracture in the elderly is a serious condition associated with increased mortality. Survivors experience an increase in morbidity and disability that affect their independence and quality of life; the outcome for patients with dementia is particularly poor. Many hip fracture patients have signs of malnutrition already on admission and this patient group has been shown to have a lower body mass index (BMI) than aged-matched controls. A catabolic state develops following hip fracture, chara...

  3. Uncemented custom femoral components in hip arthroplasty. A prospective clinical study of 191 hips followed for at least 7 years.

    Science.gov (United States)

    Benum, Pål; Aamodt, Arild

    2010-08-01

    We have developed an individually designed, uncemented femoral component for achievement of improved strain distribution and fixation to the bone, to make uncemented stems more applicable in femurs of abnormal size and shape, and to improve the joint mechanics. Here we describe the design of the implant and present the results of a prospective clinical study with at least 7 years of follow-up. The prostheses are produced by CAD-CAM technique. The design of the stem is based on CT information, and the neck design is based on the surgeon's planning of the center of rotation, femoral head offset, and leg length correction. The first-generation stem produced before 2001 had a proximal HA coating and a sand-blasted distal part that was down-scaled to avoid contact with compact bone. The second-generation stem had a porous coating beneath the HA layer and the distal part of the stem was polished. The implant was used in 762 hips (614 patients) from 1995 until 2009. 191 of these hips were followed for 7 years and 83 others were followed for 10 years, and these hips are included in the present study. Mean age at surgery was 48 (20-65) years. Congenital dysplasia of the hip was the reason for osteoarthritis in 46% and 57% of the hips in respective groups. Merle d'Aubigné score was recorded in 152 and 75 hips in the two groups. Prostheses followed for 10 years, and almost all in the 7-year group, were first-generation stems. The 7- and 10-year cumulative revision rates were 1.1% and 2.4%, respectively, with stem revision for any reason as endpoint. The clinical results were similar at 7 and 10 years, with Merle d'Aubigné scores of 17. Intraoperative trochanteric fissures occurred in 2 of the 191 operations (1.0%); both healed after wiring. In hips followed for 7 years, 2 periprosthetic fractures occurred; exchange of the stem was necessary in both. One additional fracture occurred between 7 and 10 years, and it was treated successfully with osteosynthesis. The rate of

  4. Educational Inequalities in Post-Hip Fracture Mortality: A NOREPOS Study.

    Science.gov (United States)

    Omsland, Tone K; Eisman, John A; Naess, Øyvind; Center, Jacqueline R; Gjesdal, Clara G; Tell, Grethe S; Emaus, Nina; Meyer, Haakon E; Søgaard, Anne Johanne; Holvik, Kristin; Schei, Berit; Forsmo, Siri; Magnus, Jeanette H

    2015-12-01

    Hip fractures are associated with high excess mortality. Education is an important determinant of health, but little is known about educational inequalities in post-hip fracture mortality. Our objective was to investigate educational inequalities in post-hip fracture mortality and to examine whether comorbidity or family composition could explain any association. We conducted a register-based population study of Norwegians aged 50 years and older from 2002 to 2010. We measured total mortality according to educational attainment in 56,269 hip fracture patients (NORHip) and in the general Norwegian population. Both absolute and relative educational inequalities in mortality in people with and without hip fracture were compared. There was an educational gradient in post-hip fracture mortality in both sexes. Compared with those with primary education only, the age-adjusted relative risk (RR) of mortality in hip fracture patients with tertiary education was 0.82 (95% confidence interval [CI] 0.77-0.87) in men and 0.79 (95% CI 0.75-0.84) in women. Additional adjustments for Charlson comorbidity index, marital status, and number of children did not materially change the estimates. Regardless of educational attainment, the 1-year age-adjusted mortality was three- to fivefold higher in hip fracture patients compared with peers in the general population without fracture. The absolute differences in 1-year mortality according to educational attainment were considerably larger in hip fracture patients than in the population without hip fracture. Absolute educational inequalities in mortality were higher after hip fracture compared with the general population without hip fracture and were not mediated by comorbidity or family composition. Investigation of other possible mediating factors might help to identify new targets for interventions, based on lower educational attainment, to reduce post-hip fracture mortality. © 2015 American Society for Bone and Mineral Research.

  5. Early-stage hip involvement in patients with ankylosing spondylitis: A Chinese study based on magnetic resonance imaging.

    Science.gov (United States)

    Chen, Dongying; Yuan, Shiwen; Zhan, Zhongping; Xiao, Youjun; Li, Hao; Liang, Liuqin; Yang, Xiuyan

    2016-11-01

    To evaluate the clinical characteristics and identify potential factors of the early-stage hip involvement in patients with ankylosing spondylitis (AS) based on the magnetic resonance imaging (MRI). A cross-sectional retrospective study of 655 consecutive patients was performed. Patients with hip pain or limited hip function but lacking definitive evidence of hip involvement on radiography underwent hip MRI. Based on the results of the imaging tests, the patients were classified into three categories: (1) no hip involvement; (2) early-stage hip involvement according to MRI but not radiography; (3) advanced-stage hip involvement according to a Bath Ankylosing Spondylitis Radiology Index-hip score ≥2. One hundred and sixty-eight patients had early-stage hip involvement and 103 patients had advanced-stage hip involvement. Multivariate logistic regression analysis indicated that younger age at onset, worse BASMI score, and more active inflammation in the sacroiliac joints were associated with the occurrence of early-stage hip involvement. Negative plain radiography results cannot be used to rule out hip involvement. MRI was superior to radiography for the detection of early-stage hip involvement. Susceptible AS patients with symptoms or risk factors for hip involvement should undergo hip MRI to test for lesions in the early stage.

  6. Age Related Incidence and Early Outcomes of Hip Fractures: A Prospective Cohort Study of 1177 patients

    OpenAIRE

    Shenoy Ravikiran; Eranki Vivek; Pillai Anand; Hadidi Mahar

    2011-01-01

    Abstract Introduction Associated with the increase in the aging population, there is an increase in the incidence of hip fractures worldwide. Outcome following such fractures is affected by age of the patient. This study aims to assess the incidence and early outcome of hip fractures, comparing between different age groups. Methods Data of hip fractures collected over a period of five years was analysed. Patients were divided into three groups, group A (patients under the age of 64), group B ...

  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...... studies. To develop a comprehensible and reproducible radiographic discriminator of hip OA with as close an association to self reported hip pain as possible. To identify prevalences of hip OA and HD in a Caucasian, urban background population and investigate the influence of sex, age, physical....../reclination of pelvic radiographs to stay inside a measurement error of +/- 3 degrees. We found that minimum joint space width (JSW) /= 60 years of age, and HD prevalence was 4-10%, depending on the radiographic criteria applied. Age and HD were significant risk factors for hip OA development in women, and HD was found...

  8. Christian Hip Hop as Pedagogy: A South African Case Study

    Science.gov (United States)

    Abraham, Ibrahim

    2015-01-01

    Drawing on interviews with creators of Christian hip hop music in South Africa, this article demonstrates that this genre of popular music and youth culture is utilised as a form of pedagogy to transmit religious beliefs and values to contemporary youth. The pedagogical aspects of hip hop have been recognised in research on the topic, but the…

  9. Hydrotherapy after total hip arthroplasty: a follow-up study.

    Science.gov (United States)

    Giaquinto, S; Ciotola, E; Dall'armi, V; Margutti, F

    2010-01-01

    The aim of the study was to evaluate the subjective functional outcome of total hip arthroplasty (THA) in patients who underwent hydrotherapy (HT) 6 months after discharge. A prospective randomized study was performed on 70 elderly inpatients with recent THA, who completed a rehabilitation program. After randomization, 33 of them were treated in conventional gyms (no-hydrotherapy group=NHTG) and 31 received HT (hydrotherapy group=HTG). Interviews with the Western-Ontario MacMasters Universities Osteoarthritis Index (WOMAC) were performed at admission, at discharge and 6 months later. Kruskal-Wallis, Mann-Whitney and Wilcoxon tests were applied for statistical analysis. Both groups improved. Pain, stiffness and function were all positively affected. Statistical analysis indicated that WOMAC sub-scales were significantly lower for all patients treated with HT. The benefits at discharge still remained after 6 months. We conclude that HT is recommended after THA in a geriatric population.

  10. A mechanical model for predicting the probability of osteoporotic hip fractures based in DXA measurements and finite element simulation

    Directory of Open Access Journals (Sweden)

    López Enrique

    2012-11-01

    Full Text Available Abstract Background Osteoporotic hip fractures represent major cause of disability, loss of quality of life and even mortality among the elderly population. Decisions on drug therapy are based on the assessment of risk factors for fracture, from BMD measurements. The combination of biomechanical models with clinical studies could better estimate bone strength and supporting the specialists in their decision. Methods A model to assess the probability of fracture, based on the Damage and Fracture Mechanics has been developed, evaluating the mechanical magnitudes involved in the fracture process from clinical BMD measurements. The model is intended for simulating the degenerative process in the skeleton, with the consequent lost of bone mass and hence the decrease of its mechanical resistance which enables the fracture due to different traumatisms. Clinical studies were chosen, both in non-treatment conditions and receiving drug therapy, and fitted to specific patients according their actual BMD measures. The predictive model is applied in a FE simulation of the proximal femur. The fracture zone would be determined according loading scenario (sideway fall, impact, accidental loads, etc., using the mechanical properties of bone obtained from the evolutionary model corresponding to the considered time. Results BMD evolution in untreated patients and in those under different treatments was analyzed. Evolutionary curves of fracture probability were obtained from the evolution of mechanical damage. The evolutionary curve of the untreated group of patients presented a marked increase of the fracture probability, while the curves of patients under drug treatment showed variable decreased risks, depending on the therapy type. Conclusion The FE model allowed to obtain detailed maps of damage and fracture probability, identifying high-risk local zones at femoral neck and intertrochanteric and subtrochanteric areas, which are the typical locations of

  11. Celiac disease autoimmunity and hip fracture risk: findings from a prospective cohort study.

    Science.gov (United States)

    Heikkilä, Katriina; Heliövaara, Markku; Impivaara, Olli; Kröger, Heikki; Knekt, Paul; Rissanen, Harri; Mäki, Markku; Kaukinen, Katri

    2015-04-01

    The impact of celiac disease autoimmunity on bone health is unclear. We investigated the associations of seropositivity for tissue transglutaminase antibodies (tTGA) and endomysial antibodies (EMA) with incident hip fractures using data from a prospective cohort study, Mini-Finland Health Survey. Baseline serum samples, taken in 1978-80, were tested for tTGA and EMA. Incident hip fractures up to the year 2011 were ascertained from a national hospitalization register. Associations between seropositivity and hip fractures were modeled using Cox proportional hazards regression adjusted for age, sex, body mass index, vitamin D, gamma-glutamyl transferase, smoking, and self-rated health. Our analyses were based on 6919 men and women who had no record of celiac disease or hip fracture before the study baseline. A total of 382 individuals had a hip fracture during a median follow-up of 30 years. Compared with the tTGA-negative individuals (n = 6350), tTGA-positive participants (n = 569; with hip fracture, n = 51) had a higher risk of hip fractures (hazard ratio [HR] = 1.59, 95% confidence interval [CI] 1.17, 2.14). The findings were similar for another tTGA test (n 200; with hip fracture, n = 26; HR = 2.23, 95% CI 1.49, 3.34). We found no evidence for an association between EMA positivity and hip fracture risk (HR = 0.92, 95% CI 0.34, 2.47; n = 74; with hip fracture, n = 4). In our prospective population-based study of Finnish adults, seropositivity for tTGA was associated with an increased hip fracture risk. © 2014 American Society for Bone and Mineral Research.

  12. Is the association between hip fractures and seasonality modified by influenza vaccination? An ecological study.

    Science.gov (United States)

    Fraenkel, M; Yitshak-Sade, M; Beacher, L; Carmeli, M; Mandelboim, M; Siris, E; Novack, V

    2017-05-23

    Osteoporotic hip fractures in 4344 patients were more common during winter. Lower temperatures were associated with higher rates of fracture only in those not vaccinated for influenza. Influenza outbreaks increased the risk of hip fractures. Further studies are needed to assess whether influenza vaccination can prevent hip fractures. Winter seasonality of osteoporotic hip fracture incidence has been demonstrated, yet the explanation for the association is lacking. We hypothesize that the seasonality of osteoporotic hip fracture can be explained by an association between hip fractures and seasonal influenza outbreaks. This retrospective cohort study included all patients admitted to Soroka University Medical Center with a diagnosis of osteoporotic hip fracture (ICD-9 code 820) between the years 2001 and 2013. Patients with malignancies, trauma, and age under 50 were excluded. In a time series analysis, we examined the association between hip fracture incidence and seasonality adjusted for meteorological factors, and population rates of influenza infection and vaccination using Poisson models. Four thousand three hundred forty-four patients with a hip fracture were included (69% females, mean age 78). Daily fracture rates were significantly higher in winter (1.1 fractures/day) compared to summer, fall, and spring (0.79, 0.90, and 0.91; p risk only in those not vaccinated for influenza (n = 2939, for every decrease of 5 °C, RR 1.08, CI 1.02-1.16; p risk for hip fracture, adjusted for seasons and temperature, was 1.26 2 weeks following a week with high infection burden (CI 1.05;1.51 p = 0.01), while the temperature was not significantly associated with the fracture risk. Under dry and warm desert climate, winter hip fracture incidence increase might be associated with influenza infection, and this effect can be negated by influenza vaccination.

  13. Mortality in British hip fracture patients, 2000-2010 : a population-based retrospective cohort study

    NARCIS (Netherlands)

    Klop, Corinne; Welsing, Paco M J; Cooper, Cyrus; Harvey, Nicholas C; Elders, Petra J M; Bijlsma, Johannes W J; Leufkens, Hubert G M; de Vries, Frank

    BACKGROUND: Data on recent trends in mortality after hip fracture are scarce. Aims were therefore to examine secular trends in all-cause and cause-specific mortality post hip fracture and to compare this to the general population from 2000 to 2010. METHODS: Population-based cohort study within the

  14. Mortality in British hip fracture patients, 2000-2010: A population-based retrospective cohort study

    NARCIS (Netherlands)

    Klop, C.; Welsing, P.M.J.; Cooper, C.; Harvey, N.C.; Elders, P.J.M.; Bijlsma, J.W.J.; Leufkens, H.G.M.; de Vries, F.

    2014-01-01

    Background: Data on recent trends in mortality after hip fracture are scarce. Aims were therefore to examine secular trends in all-cause and cause-specific mortality post hip fracture and to compare this to the general population from 2000 to 2010. Methods: Population-based cohort study within the

  15. Characteristics of acute groin injuries in the hip flexor muscles - a detailed MRI study in athletes

    NARCIS (Netherlands)

    Serner, Andreas; Weir, Adam; Tol, Johannes L.; Thorborg, Kristian; Roemer, Frank; Guermazi, Ali; Yamashiro, Eduardo; Hölmich, Per

    2017-01-01

    Hip flexor injuries account for one third of acute groin injuries; however, little is known about specific injury characteristics. The aims of this study was to describe acute hip flexor injuries using magnetic resonance imaging (MRI) in athletes with acute groin pain, and to compare specific muscle

  16. Exposure to antiepileptic drugs and the risk of hip fracture: a case-control study

    DEFF Research Database (Denmark)

    Tsiropoulos, Ioannis; Andersen, Morten; Nymark, Tine

    2008-01-01

    PURPOSE: To investigate whether the use of antiepileptic drugs (AEDs) increases the risk of hip fracture. METHODS: We performed a case-control study using data from the Funen County (population 2004: 475,000) hip fracture register. Cases (n = 7,557) were all patients admitted to county hospitals ...

  17. Comparison of impact force attenuation by various combinations of hip protector and flooring material using a simplified fall-impact simulation device.

    Science.gov (United States)

    Li, Ning; Tsushima, Eiki; Tsushima, Hitoshi

    2013-04-05

    Use of hip protectors and compliant flooring has been recommended for preventing hip fracture due to falls. We aimed to identify the factors attenuating forces in falls by comparing and analyzing the impact forces occurring with various combinations of hip protectors and flooring materials. We designed a simplified pendulum device to simulate the impact force at the hip during falling. The impact force was measured on pressure-sensitive recording film under combined conditions of two kinds of hip protector (hard or soft shell) and three kinds of floor material (concrete, wooden, or tatami matting). We then calculated the percentage force attenuation under each test condition compared with the use of a concrete floor and no hip protector. All the tests using tatami matting reduced the impact to below the average fracture threshold of elderly people (3472N). A combination of tatami and soft hip protector provided the best attenuation (72.5%). Multiple regression analyses showed that use of tatami matting and a soft hip protector had the biggest force-attenuation effect. The soft hip protector gave better percentage force attenuation than did the hard one. Use of tatami matting as a flooring material could be an effective strategy for helping prevent hip fractures. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2015-12-01

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

  19. Comparison of improved range of motion between cam-type femoroacetabular impingement and borderline developmental dysplasia of the hip -evaluation by virtual osteochondroplasty using computer simulation.

    Science.gov (United States)

    Kubota, So; Inaba, Yutaka; Kobayashi, Naomi; Choe, Hyonmin; Tezuka, Taro; Saito, Tomoyuki

    2017-10-16

    While cam resection is essential to achieve a good clinical result with respect to femoroacetabular impingement (FAI), it is unclear whether it should also be performed in cases of borderline developmental dysplasia of the hip (DDH) with a cam deformity. The aim of this study was to evaluate improvements in range of motion (ROM) in cases of cam-type FAI and borderline DDH after virtual osteochondroplasty using a computer impingement simulation. Thirty-eight symptomatic hips in 31 patients (11male and 20 female) diagnosed with cam-type FAI or borderline DDH were analyzed. There were divided into a cam-type FAI group (cam-FAI group: 15 hips), borderline DDH without cam group (DDH W/O cam group: 12 hips), and borderline DDH with cam group (DDH W/ cam group: 11 hips). The bony impingement point on the femoral head-neck junction at 90° flexion and maximum internal rotation of the hip joint was identified using ZedHip® software. Virtual osteochondroplasty of the impingement point was then performed in all cases. The maximum flexion angle and maximum internal rotation angle at 90° flexion were measured before and after virtual osteochondroplasty at two resection ranges (i.e., slight and sufficient). The mean improvement in the internal rotation angle in the DDH W/ cam group after slight resection was significantly greater than that in the DDH W/O cam group (P = 0.046). Furthermore, the mean improvement in the internal rotation angle in the DDH W/ cam and cam-FAI groups after sufficient resection was significantly greater than that in the DDH W/O cam group (DDH W/ cam vs DDH W/O cam: P = 0.002, cam-FAI vs DDH W/O cam: P = 0.043). Virtual osteochondroplasty resulted in a significant improvement in internal rotation angle in DDH W/ cam group but not in DDH W/O cam group. Thus, borderline DDH cases with cam deformity may be better to consider performing osteochondroplasty.

  20. Is congenital talipes equinovarus a risk factor for pathological dysplasia of the hip? : a 21-year prospective, longitudinal observational study.

    Science.gov (United States)

    Paton, R W; Choudry, Q A; Jugdey, R; Hughes, S

    2014-11-01

    There is controversy whether congenital foot abnormalities are true risk factors for pathological dysplasia of the hip. Previous United Kingdom screening guidelines considered congenital talipes equinovarus (CTEV) to be a risk factor for hip dysplasia, but present guidelines do not. We assessed the potential relationship between pathological dysplasia of the hip and fixed idiopathic CTEV. We present a single-centre 21-year prospective longitudinal observational study. All fixed idiopathic CTEV cases were classified (Harrold and Walker Types 1 to 3) and the hips clinically and sonographically assessed. Sonographic Graf Type III, IV and radiological irreducible hip dislocation were considered to be pathological hip dysplasia. Over 21 years there were 139 children with 199 cases of fixed idiopathic CTEV feet. Sonographically, there were 259 normal hips, 18 Graf Type II hips, 1 Graf Type III hip and 0 Graf Type IV hip. There were no cases of radiological or sonographic irreducible hip dislocation. Fixed idiopathic CTEV should not be considered as a significant risk factor for pathological hip dysplasia. This conclusion is in keeping with the current newborn and infant physical examination guidelines in which the only risk factors routinely screened are family history and breech presentation. Our findings suggest CTEV should not be considered a significant risk factor in pathological dysplasia of the hip. ©2014 The British Editorial Society of Bone & Joint Surgery.

  1. Chronic pain following total hip arthroplasty: a nationwide questionnaire study

    DEFF Research Database (Denmark)

    Nikolajsen, Lone; Brandsborg, Birgitte; Lucht, Ulf

    2006-01-01

    BACKGROUND: Chronic post-operative pain is a well-recognized problem after various types of surgery, but little is known about chronic pain after orthopedic surgery. Severe pre-operative pain is the primary indication for total hip arthroplasty (THA). Therefore, we examined the prevalence...... of chronic pain after THA in relation to pre-operative pain and early post-operative pain. METHODS: A questionnaire was sent to 1231 consecutive patients who had undergone THA 12-18 months previously, and whose operations had been reported to the Danish Hip Arthroplasty Registry. RESULTS: The response rate...... was 93.6%. Two hundred and ninety-four patients (28.1%) had chronic ipsilateral hip pain at the time of completion of the questionnaire, and pain limited daily activities to a moderate, severe or very severe degree in 12.1%. The chronic pain state was related to the recalled intensity of early post...

  2. Variability of ischiofemoral space dimensions with changes in hip flexion: an MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Adam C.; Howe, Benjamin M. [Mayo Clinic College of Medicine, Department of Radiology, Rochester, MN (United States); Hollman, John H.; Finnoff, Jonathan T. [Mayo Clinic College of Medicine, Department of Physical Medicine and Rehabilitation, Rochester, MN (United States)

    2017-01-15

    The primary aim of this study was to determine if ischiofemoral space (IFS) dimensions vary with changes in hip flexion as a result of placing a bolster behind the knees during magnetic resonance imaging (MRI). A secondary aim was to determine if IFS dimensions vary between supine and prone hip neutral positions. The study employed a prospective design. Sports medicine center within a tertiary care institution. Five male and five female adult subjects (age mean = 29.2, range = 23-35; body mass index [BMI] mean = 23.5, range = 19.5-26.6) were recruited to participate in the study. An axial, T1-weighted MRI sequence of the pelvis was obtained of each subject in a supine position with their hips in neutral and flexed positions, and in a prone position with their hips in neutral position. Supine hip flexion was induced by placing a standard, 9-cm-diameter MRI knee bolster under the subject's knees. The order of image acquisition (supine hip neutral, supine hip flexed, prone hip neutral) was randomized. The IFS dimensions were then measured on a separate workstation. The investigator performing the IFS measurements was blinded to the subject position for each image. The main outcome measurements were the IFS dimensions acquired with MRI. The mean IFS dimensions in the prone position were 28.25 mm (SD 5.91 mm, standard error mean 1.32 mm). In the supine hip neutral position, the IFS dimensions were 25.1 (SD 5.6) mm. The mean difference between the two positions of 3.15 (3.6) mm was statistically significant (95 % CI of the difference = 1.4 to 4.8 mm, t{sub 19} = 3.911, p =.001). The mean IFS dimensions in the hip flexed position were 36.9 (SD 5.7) mm. The mean difference between the two supine positions of 11.8 (4.1) mm was statistically significant (95 % CI of the difference = 9.9 to 13.7 mm, t{sub 19} = 12.716, p <.001). Our findings demonstrate that the IFS measurements obtained with MRI are dependent upon patient positioning with respect to hip flexion and

  3. Pelvic floor muscle training decreases hip adductors isometric peak torque in incontinent women: an exploratory study

    Directory of Open Access Journals (Sweden)

    Grasiéla Nascimento Correia

    Full Text Available INTRODUCTION: The pelvic floor muscle (PFM training is the most common treatment for urinary incontinence (UI, however many women performed the contraction of PFM with associated contraction of abdominal, gluteus and hip adductors muscles. OBJECTIVE: To assess the effects of pelvic floor muscle (PFM training on isometric and isokinetic hip adductors peak torque (PT among women suffering from urinary incontinence (UI. MATERIALS AND METHODS: It is a longitudinal and prospective exploratory study. This study included 15 physically active women aged 45 years old and over, who presented complaints of UI. The PFM function (digital evaluation and perineometry, isometric and isokinetic hip adductors PT and one hour pad test were performed before and after treatment. The PFM training was performed in group, one hour once a week for 12 sessions. RESULTS: Significant improvement of PFM function and pressure level (p = 0.003, and significant decrease of hip adductors isometric PT and one-hour pad test, were found post-treatment. Moderate negative correlations between PFM contraction pressure and hip adductors isokinetic PT for dominant side (DS (r = -0.62; p = 0.03 and non-dominant side (NDS (r = -0.64; p = 0.02; and between PFM fast fibers contraction and hip adductors isometric PT for DS (r = -0.60; p = 0.03 and NDS (r = -0.59; p = 0.04 were also found. CONCLUSIONS: The PFM training decreased hip adductors PT and improved PFM functions and UI.

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

    Science.gov (United States)

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

    2015-10-01

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

  5. Heavy Barbell Hip Thrusts Do Not Effect Sprint Performance: An 8-Week Randomized-Controlled Study.

    Science.gov (United States)

    Bishop, Chris; Cassone, Natasha; Jarvis, Paul; Turner, Anthony; Chavda, Shyam; Edwards, Mike

    2017-07-24

    The purpose of this study was to examine the effects of an 8-week barbell hip thrust strength training program on sprint performance. Twenty-one collegiate athletes (15 males and 6 females) were randomly assigned to either an intervention (n = 11, age 27.36 ± 3.17 years, height 169.55 ± 10.38 cm, weight 72.7± 18 kg) or control group (n = 10, age 27.2 ± 3.36 years, height 176.2 ± 7.94 cm, weight 76.39 ± 11.47 kg). 1RM hip thrust, 40m sprint time, and individual 10m split timings: 0-10, 10-20, 20-30, 30-40m, were the measured variables; these recorded at both the baseline and post testing time points. Following the 8-week hip thrust strength training intervention significantly greater 1RM hip thrust scores for the training group were observed (p 0.05, r = 0.05 - 0.37). No significant differences were seen for the control group for 1RM hip thrust (p = 0.106, d = 0.24 [mean difference 9.4 kg]) or sprint time (all sprint performance measures: p > 0.05, r = 0.13 - 0.47). These findings suggest that increasing maximum hip thrust strength through use of the barbell hip thrust does not appear to transfer into improvements in sprint performance in collegiate level athletes.

  6. In Vitro Bioactivity Study of RGD-Coated Titanium Alloy Prothesis for Revision Total Hip Arthroplasty

    OpenAIRE

    Man, Zhentao; Sha, Dan; Sun, Shui; Li, Tao; Li, Bin; Yang, Guang; Zhang, Laibo; Wu, Changshun; Jiang, Peng; Han, Xiaojuan; Li, Wei

    2016-01-01

    Total hip arthroplasty (THA) is a common procedure for the treatment of end-stage hip joint disease, and the demand for revision THA will double by 2026. Ti6Al4V (Titanium, 6% Aluminum, and 4% Vanadium) is a kind of alloy commonly used to make hip prothesis. To promote the osseointegration between the prothesis and host bone is very important for the revision THA. The peptide Arg-Gly-Asp (RGD) could increase cell attachment and has been used in the vascular tissue engineering. In this study, ...

  7. The Need for Total Hip Arthroplasty in Perthes Disease: A Long-term Study

    DEFF Research Database (Denmark)

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

    2010-01-01

    BACKGROUND: Legg-Calvé-Perthes disease (LCPD) was described a century ago. In previous long-term reports of patients with LCPD, nonoperative treatment varied considerably. The likelihood of hip osteoarthritis (OA) developing in patients with LCPD and possible need for THA are not well defined...... with those with Classes I/II femoral heads. Given the limitation in the study, we (3) evaluated whether patients with LCPD were at risk for having radiographic hip OA more commonly than control subjects and (4) whether hips with Classes III/IV/V femoral heads had an increased prevalence of OA compared...... with hips with Classes I/II femoral heads. PATIENTS AND METHODS: The study population consisted of 167 patients with LCPD treated with a Thomas splint. The control population consisted of gender- and age-matched control subjects who were participants in the Copenhagen City Heart Study: the Osteoarthritis...

  8. Automated estimation of hip prosthesis migration: a feasibility study

    Science.gov (United States)

    Vandemeulebroucke, Jef; Deklerck, Rudi; Temmermans, Frederik; Van Gompel, Gert; Buls, Nico; Scheerlinck, Thierry; de Mey, Johan

    2013-09-01

    A common complication associated with hip arthoplasty is prosthesis migration, and for most cemented components a migration greater than 0.85 mm within the first six months after surgery, are an indicator for prosthesis failure. Currently, prosthesis migration is evaluated using X-ray images, which can only reliably estimate migrations larger than 5 mm. We propose an automated method for estimating prosthesis migration more accurately, using CT images and image registration techniques. We report on the results obtained using an experimental set-up, in which a metal prosthesis can be translated and rotated with respect to a cadaver femur, over distances and angles applied using a combination of positioning stages. Images are first preprocessed to reduce artefacts. Bone and prosthesis are extracted using consecutive thresholding and morphological operations. Two registrations are performed, one aligning the bones and the other aligning the prostheses. The migration is estimated as the difference between the found transformations. We use a robust, multi-resolution, stochastic optimization approach, and compare the mean squared intensity differences (MS) to mutual information (MI). 30 high-resolution helical CT scans were acquired for prosthesis translations ranging from 0.05 mm to 4 mm, and rotations ranging from 0.3° to 3° . For the translations, the mean 3D registration error was found to be 0.22 mm for MS, and 0.15 mm for MI. For the rotations, the standard deviation of the estimation error was 0.18° for MS, and 0.08° for MI. The results show that the proposed approach is feasible and that clinically acceptable accuracies can be obtained. Clinical validation studies on patient images will now be undertaken.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-03-01

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

  10. Height and Risk of Hip Fracture: A Meta-Analysis of Prospective Cohort Studies.

    Science.gov (United States)

    Xiao, Zhihong; Ren, Dong; Feng, Wei; Chen, Yan; Kan, Wusheng; Xing, Danmou

    2016-01-01

    The association between height and risk of hip fracture has been investigated in several studies, but the evidence is inconclusive. We therefore conducted this meta-analysis of prospective cohort studies to explore whether an association exists between height and risk of hip fracture. We searched PubMed and EMBASE, Web of Science, and the Cochrane Library for studies of height and risk of hip fracture up to February 16, 2016. The random-effects model was used to combine results from individual studies. Seven prospective cohort studies, with 7,478 incident hip fracture cases and 907,913 participants, were included for analysis. The pooled relative risk (RR) was 1.65 (95% confidence interval (CI): 1.26-2.16) comparing the highest with the lowest category of height. Result from dose-response analysis suggested a linear association between height and hip fracture risk (P-nonlinearity = 0.0378). The present evidence suggests that height is positively associated with increased risk of hip fracture. Further well-designed cohort studies are needed to confirm the present findings in other ethnicities.

  11. A comparative prospective study of dynamic variable angle hip screw and Gamma nail in intertrochanteric hip fractures.

    Science.gov (United States)

    Tarantino, Umberto; Oliva, Francesco; Impagliazzo, Angelo; Mattei, Antonio; Cannata, Giuseppe; Pompili, Gian Francesco Spurio; Maffulli, Nicola

    To compare the results between a variable angle dynamic screw-plate(DMS) and the Gamma nail in the treatment of intertrochanteric hip fractures. A comparative prospective study of 142 patients (AO/OTA Type 31-A1; A2; A3 and B2) treated by variable angle dynamic screw-plate (DMS Group = 71) or by intramedullary nailing (Gamma Nail Group = 71). At the 12-month follow-up, we did not find any statistically significant difference, intraoperatively, radiographically, or clinically, between the two groups of patients, except for shortening. In 12 patients in the DMS group (17%) and in one patient in the Gamma nail group, there was shortening of the operated leg between 1 cm and 3 cm (p = 0.02). In all instances, shortening occurred in patients who sustained A.O. type fractures 31A2. 2 and 3 (19 patients), which are unstable and comminuted. The DMS allows effective management of intertrochanteric fractures of the femur. Surgeons should consider choosing surgical treatment according to the type of intertrochanteric fracture. In less comminuted fractures, a compression hip screw may be a faster and safer surgical solution. In comminuted fractures, surgical difficulties may increase in parallel to fracture complexity.

  12. Case Study of Physiotherapy Treatment of a Patient with the Diagnosis of Total Hip Replacement

    OpenAIRE

    Papageorgiou, Chrystalla

    2014-01-01

    The abstract of my study concerns the treatment of the case of my patient who had an operation of total hip replacement on the right hip joint, caused by post dysplastic arthrosis. My practice was performed at Fakultni Nemocnice Kralovske Vinohrady. Physiotherapy program started on Tuesday 29th of January 2013 and ended on Friday 1st of February 2013. My Bachelor Thesis is divided in two parts: 1) Theoretical part 2) Practical part. In the theoretical part I analyse everything concerning the ...

  13. Benzodiazepines and hip fractures in elderly people: case-control study

    Science.gov (United States)

    Pierfitte, Corinne; Macouillard, Gerard; Thicoïpe, Michel; Chaslerie, Anicet; Pehourcq, Fabienne; Aïssou, Myriam; Martinez, Béatrice; Lagnaoui, Rajaa; Fourrier, Annie; Bégaud, Bernard; Dangoumau, Jacques; Moore, Nicholas

    2001-01-01

    Objective To determine whether benzodiazepines are associated with an increased risk of hip fracture. Design Case-control study. Participants All incident cases of hip fracture not related to traffic accidents or cancer in patients over 65 years of age. 245 cases were matched to 817 controls. Setting Emergency department of a university hospital. Main outcome measures Exposure to benzodiazepines and other potential risk or protective factors or lifestyle items. Results The use of benzodiazepines as determined from questionnaires, medical records, or plasma samples at admission to hospital was not associated with an increased risk of hip fracture (odds ratio 0.9, 95% confidence interval 0.5 to 1.5). Hip fracture was, however, associated with the use of two or more benzodiazepines, as determined from questionnaires or medical records but not from plasma samples. Of the individual drugs, only lorazepam was significantly associated with an increased risk of hip fracture (1.8, 1.1 to 3.1). Conclusion Except for lorazepam, the presence of benzodiazepines in plasma was not associated with an increased risk of hip fracture. The method used to ascertain exposure could influence the results of case-control studies. What is already known on this topicBenzodiazepines increase the risk of elderly people falling in a dose dependent wayTheir role in hip fracture remains disputed, with increased risk sometimes attributed to drugs with a longer half life or those used to induce sleepWhat this study addsBenzodiazepines were not associated with hip fracture either as a group or according to half life or to characterisation as hypnotic or anxiolyticPatients using two or more benzodiazepines may be at higher riskPatients using lorazepam or certain other benzodiazepines may also be at a higher risk of fracture PMID:11264208

  14. Hypertension Improvement Project (HIP: study protocol and implementation challenges

    Directory of Open Access Journals (Sweden)

    Pollak Kathryn I

    2009-02-01

    providers and the challenges faced during study implementation are presented. The HIP interventions may improve blood pressure control and lower cardiovascular disease risk in a primary care practice setting by addressing key components of the chronic care model. The study design allows an assessment of the effectiveness and cost of physician and patient interventions separately, so that health care organizations can make informed decisions about implementation of 1 or both interventions in the context of local resources. Trial registration ClinicalTrials.gov identifier NCT00201136

  15. A novel locking screw hip stem to achieve immediate stability in total hip arthroplasty: A biomechanical study.

    Science.gov (United States)

    Grechenig, Stephan; Gueorguiev, Boyko; Berner, Arne; Heiss, Peter; Müller, Michael; Nerlich, Michael; Schmitz, Paul

    2015-10-01

    As total hip arthroplasty is now applicable for younger, healthier, and more active patients, bone preservation becomes even more essential, and proximal fixation, resulting in less stress shielding, draws special attention with focus on new strategies and implant designs. Recently, a new type of non-cemented fixation of the femoral component, featured with the locking screw hip (LSH) stem, was developed by Scyon Orthopaedics AG (Au-Waedenswil, Switzerland). The idea to rigidly fix the femoral component of a prosthesis for total hip replacement in this fashion evolved from the very good results achieved with the internal point-contact fixator PC-Fix. The purpose of this study was to investigate the unique characteristics of the LSH-stem and to assess its biomechanical performance in comparison to a conventional cemented prosthesis (Mueller straight stem). Six paired human cadaveric femora were preserved with the method of Thiel, split in two study groups, implanted with either cemented Mueller straight stem or LSH-stem prostheses and biomechanically tested under progressively increasing axial loading until catastrophic failure. Bone mineral density (BMD) of all femora was evaluated in the femoral head prior to implantation. Axial construct stiffness, failure load and cycles to failure were calculated from the machine data and statistically evaluated at a level of significance p = 0.05. No statistically significant difference between the LSH-stem and the Mueller straight stem was found in terms of axial construct stiffness (2031.5 N/mm ± 483.1 N/mm and 2403.6 N/mm ± 705.2 N/mm, p = 0.115), failure load (4958.8 N ± 1094.1 N and 5907.2 N ± 1562.8 N, p = 0.138) and cycles to failure (7917.7 ± 2188.1 and 9814.3 ± 3125.6, p = 0.138). BMD showed no significant difference between the two study groups, p = 0.616. The LSH-stem seems to be stable enough to carry loads experienced during the rehabilitation period of a patient after THR. Its stability, which is similar to

  16. Recovery after Hip Fracture: Interventions and Their Timing to Address Deficits and Desired Outcomes--Evidence from the Baltimore Hip Studies.

    Science.gov (United States)

    Magaziner, Jay; Chiles, Nancy; Orwig, Denise

    2015-01-01

    Hip fracture is a significant public health problem affecting an estimated 1.6 million persons annually. The consequences of hip fracture are also significant, with more than half of those who sustain a fracture either dying or not returning to functional abilities present before fracture required to function independently. The Baltimore Hip Studies (BHS) is a program of research that for more than 30 years has been doing investigations to identify, develop, and evaluate strategies to optimize recovery from hip fracture. This paper provides an overview of known outcomes and recovery patterns following a hip fracture, which are derived primarily from the BHS. Target areas and timing for interventions based on this recovery sequence are suggested. The paper concludes with a discussion of some of the areas that the next generation of studies needs to concentrate on in order to advance knowledge about the care of hip fracture patients to maximize their recovery. © 2015 Nestec Ltd., Vevey/S. Karger AG, Basel.

  17. Cementless, modular, distally fixed stem in hip revision arthroplasty: a single-center study of 132 consecutive hips.

    Science.gov (United States)

    Hashem, Ali; Al-Azzawi, Ammar; Riyadh, Hasan; Mukka, Sebastian; Sayed-Noor, Arkan

    2018-01-01

    The use of cementless, modular, distally fixed stem in hip revision arthroplasty has increased during the last decades. We aimed to analyze the early and late postoperative complications, re-operation rate, and survival rate of the MP stem operated at our county hospital with relatively limited caseload. In this retrospective study, we included 132 hips operated with MP stem between January 2007-2014. An independent observer reviewed patients' medical records in July 2015 (18-102 months postoperatively, median 52.5) to collect the following data: age, sex, American Society of Anesthesiologists (ASA) class, body mass index, indication of revision, type of operation, early and late complications, re-operation rate, and mortality during study period. The commonest indication for MP stem operation was aseptic loosening (72%). We found early and late postoperative complications in 29% of cases. The most common complication was prosthetic dislocation (8%), followed by intra-operative peri-prosthetic fracture (5%). The commonest indication for MP re-operation was soft tissue revision for infection (7%) followed by closed reduction for prosthetic dislocation (6%). We found no correlation between the age, sex, ASA class, and type of operation and the re-operation risk. Only one prosthesis was extracted giving a survival rate for 99% for the study period. This study showed good results of the MP prosthesis with reasonable complication and re-operation rates and negligible extraction rate, indicating the good performance of this implant even when used in the setting of a county hospital with limited caseload.

  18. Hip Strength as a Predictor of Ankle Sprains in Male Soccer Players: A Prospective Study.

    Science.gov (United States)

    Powers, Christopher M; Ghoddosi, Navid; Straub, Rachel K; Khayambashi, Khalil

    2017-11-08

      Diminished hip-abductor strength has been suggested to increase the risk of noncontact lateral ankle sprains.   To determine prospectively whether baseline hip-abductor strength predicts future noncontact lateral ankle sprains in competitive male soccer players.   Prospective cohort study.   Athletic training facilities and various athletic fields.   Two hundred ten competitive male soccer players.   Before the start of the sport season, isometric hip-abductor strength was measured bilaterally using a handheld dynamometer. Any previous history of ankle sprains, body mass index, age, height, and weight was documented. During the sport season (30 weeks), ankle injury status was recorded by team medical providers. Injured athletes were further classified based on the mechanism of injury. Only data from injured athletes who sustained noncontact lateral ankle sprains were used for analysis. Postseason, logistic regression was used to determine whether baseline hip strength predicted future noncontact lateral ankle sprains. A receiver operating characteristic curve was constructed for hip strength to determine the cutoff value for distinguishing between high-risk and low-risk outcomes.   A total of 25 noncontact lateral ankle sprains were confirmed, for an overall annual incidence of 11.9%. Baseline hip-abductor strength was lower in injured players than in uninjured players (P = .008). Logistic regression indicated that impaired hip-abductor strength increased the future injury risk (odds ratio = 1.10 [95% confidence interval = 1.02, 1.18], P = .010). The strength cutoff to define high risk was ≤33.8% body weight, as determined by receiver operating characteristic curve analysis. For athletes classified as high risk, the probability of injury increased from 11.9% to 26.7%.   Reduced isometric hip-abductor strength predisposed competitive male soccer players to noncontact lateral ankle sprains.

  19. Evaluation of the effect of a comprehensive multidisciplinary care pathway for hip fractures: design of a controlled study.

    Science.gov (United States)

    Flikweert, Elvira R; Izaks, Gerbrand J; Reininga, Inge H F; Wendt, Klaus W; Stevens, Martin

    2013-10-12

    Hip fractures constitute an economic burden on healthcare resources. Most persons with a hip fracture undergo surgery. As morbidity and mortality rates are high, perioperative care leaves room for improvement. Improvement can be achieved if it is organized in comprehensive care pathways, but the effectiveness of these pathways is not yet clear. Hence the objective of this study is to compare the clinical effectiveness of a comprehensive care pathway with care as usual on self-reported limitations in Activities of Daily Living. A controlled trial will be conducted in which the comprehensive care pathway of University Medical Center Groningen will be compared with care as usual in two other, nonacademic, hospitals. In this trial, propensity scores will be used to adjust for differences at baseline between the intervention and control group. Propensity scores can be used in intervention studies where a classical randomized controlled trial is not feasible. Patients aged 60 years and older will be included. The hypothesis is that 15% more patients at University Medical Center Groningen compared with patients in the care-as-usual condition will have recovered at least as well at 6 months follow-up to pre-fracture levels for Activities of Daily Living. This study will yield new knowledge with respect to the clinical effectiveness of a comprehensive care pathway for the treatment of hip fractures. This is relevant because of the growing incidence of hip fractures and the consequent massive burden on the healthcare system. Additionally, this study will contribute to the growing knowledge of the application of propensity scores, a relatively novel statistical technique to simulate a randomized controlled trial in studies where it is not possible or difficult to execute this kind of design. Nederlands Trial Register NTR3171.

  20. Screening for developmental dysplasia of the hip in primary care : implementation by simulation

    NARCIS (Netherlands)

    Ramwadhdoebe, S.

    2010-01-01

    Developmental Dysplasia of the hip (DDH) is a disorder which occurs at an early age. Early discovery and treatment of DDH can reduce the chance on joint deviation in the future. Screening on DDH is done at a young age in the Netherlands. Current screening in the Netherlands exists from doing

  1. The influence of renal dialysis and hip fracture sites on the 10-year mortality of elderly hip fracture patients: A nationwide population-based observational study.

    Science.gov (United States)

    Hung, Li-Wei; Hwang, Yi-Ting; Huang, Guey-Shiun; Liang, Cheng-Chih; Lin, Jinn

    2017-09-01

    Hip fractures in older people requiring dialysis are associated with high mortality. Our study primarily aimed to evaluate the specific burden of dialysis on the mortality rate following hip fracture. The secondary aim was to clarify the effect of the fracture site on mortality. A retrospective cohort study was conducted using Taiwan's National Health Insurance Research Database to analyze nationwide health data regarding dialysis and non-dialysis patients ≥65 years who sustained a first fragility-related hip fracture during the period from 2001 to 2005. Each dialysis hip fracture patient was age- and sex-matched to 5 non-dialysis hip fracture patients to construct the matched cohort. Survival status of patients was followed-up until death or the end of 2011. Survival analyses using multivariate Cox proportional hazards models and the Kaplan-Meier estimator were performed to compare between-group survival and impact of hip fracture sites on mortality. A total of 61,346 hip fracture patients were included nationwide. Among them, 997 dialysis hip fracture patients were identified and matched to 4985 non-dialysis hip fracture patients. Mortality events were 155, 188, 464, and 103 in the dialysis group, and 314, 382, 1505, and 284 in the non-dialysis group, with adjusted hazard ratios (associated 95% confidence intervals) of 2.58 (2.13-3.13), 2.95 (2.48-3.51), 2.84 (2.55-3.15), and 2.39 (1.94-2.93) at 0 to 3 months, 3 months to 1 year, 1 to 6 years, and 6 to 10 years after the fracture, respectively. In the non-dialysis group, survival was consistently better for patients who sustained femoral neck fractures compared to trochanteric fractures (0-10 years' log-rank test, P dialysis group, survival of patients with femoral neck fractures was better than that of patients with trochanteric fractures only within the first 6 years post-fracture (0-6 years' log-rank, P Dialysis was a significant risk factor of mortality in geriatric hip fracture patients. Survival

  2. Height Loss Predicts Subsequent Hip Fracture in Men and Women of the Framingham Study

    Science.gov (United States)

    Hannan, Marian T.; Broe, Kerry E.; Cupples, L. Adrienne; Dufour, Alyssa B.; Rockwell, Margo; Kiel, Douglas P.

    2013-01-01

    Background Although height is a risk factor for osteoporotic fracture, current risk assessments do not consider height loss. Height loss may be a simple measurement that clinicians could use to predict fracture or need for further testing. Objective To examine height loss and subsequent hip fracture, evaluating both long-term adult height loss and recent height loss. Methods Prospective cohort of 3,081 adults from the Framingham Heart Study. Height was measured biennially since 1948, and cohort followed for hip fracture through 2005. Adult height loss from middle-age years across 24 years and recent height loss in elderly years were considered. Cox proportional hazard regression was used to estimate association between height loss and risk of hip fracture. Results Of 1,297 men and 1,784 women, mean baseline age was 66y (SD7.8). Average height loss for men was 1.06 inches (0.76), and for women was 1.12 inches (0.84). 11% of men and 15% of women lost ≤ 2 inches of height. Mean follow-up was 17y during which 71 men and 278 women had incident hip fractures. For each 1-inch of height loss, HR=1.4 in men (95%CI: 1.00, 1.99), and 1.04 in women (95%CI: 0.88, 1.23). Men and women who lost ≤ 2 inches of height had increased fracture risk (compared to 0 to height loss in elders significantly increased the risk of hip fracture, 54% in men and 21% in women (95%CI: 1.14, 2.09; 1.03, 1.42, respectively). Conclusions Adult height loss predicted hip fracture risk in men in our study. Recent height loss in elderly men and women predicted risk of hip fracture. PMID:22072590

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

    Science.gov (United States)

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

    1993-02-01

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

  4. Case-control study of risk factors for hip fractures in the elderly.

    Science.gov (United States)

    Cumming, R G; Klineberg, R J

    1994-03-01

    The objective of this population-based case-control study was to identify risk factors for hip fracture among elderly women and men, particularly factors during young and middle adult life. The study base comprised people aged 65 years and over living in a defined region in Sydney, Australia, during 1990-1991. Cases were recruited from 12 hospitals, and controls were selected using an area probability sampling method, with additional sampling from nursing homes. There were 416 subjects (209 cases and 207 controls); proxy respondents were needed for 27 percent of the subjects. Smoking, underweight in old age, overweight at age 20 years, and weight loss were associated with an increased risk of hip fracture. Consumption of dairy products, particularly at age 20 years, was associated with an increased risk of hip fracture in old age. Multivariate-adjusted odds ratios for quintiles of dairy product consumption at age 20 years were 1.0 (lowest quintile), 0.8, 1.8, 3.4, 2.9 (highest quintile). Caffeine and alcohol intake were not associated with hip fracture risk. Some of the results of this study were unanticipated and may be due to chance or bias. If confirmed by other studies, these results would challenge some current approaches to hip fracture prevention.

  5. Prediction of incident hip fracture with the estimated femoral strength by finite element analysis of DXA Scans in the study of osteoporotic fractures.

    Science.gov (United States)

    Yang, Lang; Palermo, Lisa; Black, Dennis M; Eastell, Richard

    2014-12-01

    A bone fractures only when loaded beyond its strength. The purpose of this study was to determine the association of femoral strength, as estimated by finite element (FE) analysis of dual-energy X-ray absorptiometry (DXA) scans, with incident hip fracture in comparison to hip bone mineral density (BMD), Fracture Risk Assessment Tool (FRAX), and hip structure analysis (HSA) variables. This prospective case-cohort study included a random sample of 1941 women and 668 incident hip fracture cases (295 in the random sample) during a mean ± SD follow-up of 12.8 ± 5.7 years from the Study of Osteoporotic Fractures (n = 7860 community-dwelling women ≥67 years of age). We analyzed the baseline DXA scans (Hologic 1000) of the hip using a validated plane-stress, linear-elastic finite element (FE) model of the proximal femur and estimated the femoral strength during a simulated sideways fall. Cox regression accounting for the case-cohort design assessed the association of estimated femoral strength with hip fracture. The age-body mass index (BMI)-adjusted hazard ratio (HR) per SD decrease for estimated strength (2.21; 95% CI, 1.95-2.50) was greater than that for total hip (TH) BMD (1.86; 95% CI, 1.67-2.08; p  0.05), FRAX scores (range, 1.32-1.68; p hip BMD or FRAX scores. The association of estimated strength with incident hip fracture was strong (Harrell's C index 0.770), significantly better than TH BMD (0.759; p  0.05). Similar findings were obtained for intracapsular and extracapsular fractures. In conclusion, the estimated femoral strength from FE analysis of DXA scans is an independent predictor and performs at least as well as FN BMD in predicting incident hip fracture in postmenopausal women. © 2014 American Society for Bone and Mineral Research.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-08-15

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

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

    Directory of Open Access Journals (Sweden)

    Anil Kumar Rai

    2011-01-01

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

  8. The serious mental illness health improvement profile [HIP]: study protocol for a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Swift Louise

    2011-07-01

    Full Text Available Abstract Background The serious mental illness Health Improvement Profile [HIP] is a brief pragmatic tool, which enables mental health nurses to work together with patients to screen physical health and take evidence-based action when variables are identified to be at risk. Piloting has demonstrated clinical utility and acceptability. Methods/Design A single blind parallel group cluster randomised controlled trial with secondary economic analysis and process observation. Unit of randomisation: mental health nurses [MHNs] working in adult community mental health teams across two NHS Trusts. Subjects: Patients over 18 years with a diagnosis of schizophrenia, schizoaffective or bipolar disorder on the caseload of participating MHNs. Primary objective: To determine the effects of the HIP programme on patients' physical wellbeing assessed by the physical component score of the Medical Outcome Study (MOS 36 Item Short Form Health Survey version 2 [SF-36v2]. Secondary objectives: To determine the effects of the HIP programme on: cost effectiveness, mental wellbeing, cardiovascular risk, physical health care attitudes and knowledge of MHNs and to determine the acceptability of the HIP Programme in the NHS. Consented nurses (and patients will be randomised to receive the HIP Programme or treatment as usual. Outcomes will be measured at baseline and 12 months with a process observation after 12 months to include evaluation of patients' and professionals' experience and observation of any effect on care plans and primary-secondary care interface communication. Outcomes will be analysed on an intention-to-treat (ITT basis. Discussion The results of the trial and process observation will provide information about the effectiveness of the HIP Programme in supporting MHNs to address physical comorbidity in serious mental illness. Given the current unacceptable prevalence of physical comorbidity and mortality in the serious mental illness population, it is

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

    Directory of Open Access Journals (Sweden)

    Omar Q. Samarah

    2016-02-01

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

  10. A Biomechanical Study for Developing Wearable-Sensor System to Prevent Hip Fractures among Seniors

    Directory of Open Access Journals (Sweden)

    Gongbing Shan

    2017-07-01

    Full Text Available As the population ages, falls are becoming a major health problem, not only for those with some degree of balance or mobility impairment, but also among healthy active seniors. Previous studies suggest that the degradation of human sensorimotor function related to age contributes to falls. Hip bones are among the most frequently fractured body parts resulting from falls. Hip fractures are a frequent cause of early death, functional dependence, and high medical care costs. The current prevention method is to use hip protectors. Unfortunately, it often fails to do so because the pocket containing the pad can move away from the area during falls. Additionally, some seniors refuse to use hip protectors because they find them constraining. Hence, a new protector that is only activated during a fall is much desired. The current study explored the possibility via biomechanical analyses for building a wearable sensor system that triggers a mini-airbag system during a fall, i.e., the air-pad is only present for protection when a fall occurs. The results have revealed that two sensors placed on the left and right shoulder would be best for a detection of any-direction fall and could be applied for building a wearable sensor system for prevention of hip fractures resulting from falls.

  11. LENGTH CHANGE OF THE SHORT EXTERNAL ROTATORS OF THE HIP IN COMMON STRETCH POSITIONS: A CADAVERIC STUDY.

    Science.gov (United States)

    McGovern, Ryan P; Kivlan, Benjamin R; Martin, RobRoy L

    2017-12-01

    Stretching of the deep rotators of the hip is commonly employed in patients with lumbosacral, sacroiliac, posterior hip, and buttock pain. There is limited research demonstrating the effectiveness of common stretching techniques on the short external rotators of the hip. The objective of this study was to evaluate length change during stretching of the superior and inferior fibers of the piriformis, superior gemellus, obturator internus, and inferior gemellus. Repeated-measures laboratory controlled cadaveric study. Seventeen hip joints from nine embalmed cadavers (5 male; 4 female) with an age between 49-96 years were skeletonized. Polypropylene strings were attached from the origin to insertion sites of the short external rotators. The change of length (mm) noted by excursion of the strings was used as a proxy for change in muscle length, when the hip was moved from the anatomical position to four specific stretch positions: 1) 45 ° internal rotation from hip neutral flexion/extension, 2) 45 ° external rotation from 90 ° hip and knee flexion, 3) 30 ° adduction from 90 ° of hip and knee flexion, and 4) 30 ° of adduction with the hip and knee flexed so the lateral malleolus contacted the lateral femoral epicondyle of the contralateral limb , were recorded. There was a significant effect on string displacement by stretch position, F (15,166) = 14.67, p obturator internus and inferior gemellus had the largest string displacement with 45 ° internal rotation from neutral flexion/extension. While all stretch positions caused a significant string displacement indicating length changes of the deep rotators of the hip, the three stretch positions that caused the greatest change were: 1) 30 ° adduction from 90 ° of hip and knee flexion, 2) 45 ° internal rotation from neutral flexion/extension, and 3) 45 ° external rotation with 90 ° hip and knee flexion. This study has clinical implications for the effectiveness of specific stretching

  12. Topographic anatomical study of the sciatic nerve relationship to the posterior portal in hip arthroscopy

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    Berliet Assad Gomes

    Full Text Available Objective: To evaluate the anatomic topographic relation between the sciatic nerve in relation to the piriform muscle and the posterior portal for the establishment of hip arthroscopy.Methods: We dissected 40 hips of 20 corpses of adult Brazilians, 17 male and three female, six black, six brown and eight white. We studied the anatomical relationship between the sciatic nerve and the piriform muscle with their variations and the distance between the lateral edge of the sciatic nerve and the posterior portal used in hip arthroscopy. We then classified the anatomical alterations found in the path of the sciatic nerve on the piriform muscle.Results: Seventeen corpses had bilateral relationship between the sciatic nerve and the piriform muscle, i.e., type A. We found the following anatomical variations: 12.5% of variant type B; and an average distance between the sciatic nerve and the portal for arthroscopy of 2.98cm. One body had type B anatomical variation on the left hip and type A on the right.Conclusion: the making of the posterior arthroscopic portal to the hip joint must be done with careful marking of the trochanter massive; should there be difficult to find it, a small surgical access is recommended. The access point to the portal should not exceed two centimeters towards the posterior superior aspect of the greater trochanter, and must be made with the limb in internal rotation of 15 degrees.

  13. Double acetabular wall--a misleading point for hip arthroplasty: an anatomical, radiological, clinical study.

    Science.gov (United States)

    Madadi, Firooz; Yazdanshenas, Hamed; Madadi, Firoozeh; Bazargan-Hejazi, Shahrzad

    2013-06-01

    Despite the great attention focused on cup positioning in primary total hip arthroplasty (PTHA), it is surprising to find so few studies that have dealt with cup placement. A common thwarting problem for correct cup placement during PTHA is the existence of osteophytes, which obscure the anatomical landmarks. In this study we aimed to evaluate the morphology of acetabular osteophyte formation in patients with osteoarthritis. We evaluated 276 patients with hip complaints, using plain X-rays and CT scans. Of these patients, 57 underwent surgery. We developed a staging system for central osteophytes in hip osteoarthritis based on the radiographic and anatomical findings of our patients. We recommend routine use of CT scans for patients scheduled for PTHA in order to assess the stage of osteophyte before surgery and, thus, reduce the risk of failure resulting from the interrupted acetabular landmarks.

  14. Age related incidence and early outcomes of hip fractures: a prospective cohort study of 1177 patients.

    Science.gov (United States)

    Pillai, Anand; Eranki, Vivek; Shenoy, Ravikiran; Hadidi, Mahar

    2011-01-24

    Associated with the increase in the aging population, there is an increase in the incidence of hip fractures worldwide. Outcome following such fractures is affected by age of the patient. This study aims to assess the incidence and early outcome of hip fractures, comparing between different age groups. Data of hip fractures collected over a period of five years was analysed. Patients were divided into three groups, group A (patients under the age of 64), group B (patients between 65 and 84 years of age), and group C (patients over the age of 85). Of the 1177 patients included in the study, there were 90 patients in group A, 702 patients in group B and 385 patients in group C. There was a female preponderance across all age groups, and this increased as age advanced (p propioception and shorter operation time.

  15. In vivo study of acute effects of hip and knee positions on blood flow in canine sciatic nerve.

    Science.gov (United States)

    Koga, Kei; Naito, Masatoshi; Akiyoshi, Yuichiro; Asayama, Isao; Shiramizu, Kei; Abe, Tatunobu; Kanbe, Taichi

    2002-01-01

    We studied blood flow in the canine sciatic nerve using a laser Doppler flowmeter. Blood flow was measured in 20 hind limbs of ten adult dogs at varying angles of hip flexion, hip rotation and knee flexion. Blood flow decreased as flexion and internal rotation of the hip increased and also with only slight flexion of the knee. With 90 degrees knee flexion, the mean blood flow did not change significantly when the hip was internally rotated from 0 degrees to 30 degrees. When the knee was straight, the blood flow changed significantly during the same procedure. To prevent sciatic nerve palsy, attention should be paid to the positioning of the hip and knee during total hip arthroplasty.

  16. Beer and wine consumption and risk of knee or hip osteoarthritis: a case control study.

    Science.gov (United States)

    Muthuri, Stella G; Zhang, Weiya; Maciewicz, Rose A; Muir, Kenneth; Doherty, Michael

    2015-02-05

    The aim of this study was to investigate the association between alcoholic and non-alcoholic beverages and knee or hip osteoarthritis (OA). We conducted a case-control study of Caucasian men and women aged 45 to 86 years of age from Nottingham, UK. Cases had clinically severe symptoms and radiographic knee or hip OA; controls had no symptoms and no radiographic knee or hip OA. Exposure information was sought using interview-based questionnaires and a semi-quantitative food frequency questionnaire to assess beverage consumption at ages 21 to 50 years. Odds ratios (ORs), adjusted ORs (aORs), 95% confidence intervals (CI) and P values were estimated using logistic regression models. A total of 1,001 knee OA, 993 hip OA and 933 control participants were included in the study. Increasing beer consumption was associated with an increasing risk of OA (P for trend≤0.001). Compared to those who did not consume beer, aORs for people who consumed 20 or more servings of beer were 1.93 (95% CI 1.26 to 2.94) and 2.15 (95% CI 1.45 to 3.19) for knee OA and hip OA, respectively. In contrast, increasing levels of wine consumption were associated with decreased likelihood of knee OA (P for trendBeer consumption appears to be a risk factor for knee and hip OA whereas consumption of wine has a negative association with knee OA. The mechanism behind these findings is speculative but warrants further study.

  17. Using a finite element pediatric hip model in clinical 2 evaluation - a feasibility study

    DEFF Research Database (Denmark)

    Skytte, T. L.; Mikkelsen, Lars Pilgaard; Sonne-Holm, Stig

    2017-01-01

    to calculate the resulting stress in the normal direction. At a load of 233% BW the model predicted peak pressures in the hip joint of 9.7-13.8 MPa and an area in contact of 351-405 mm2. Experimental validation using the hip joint of a child was not ethical viable. Instead, our results were compared......The paper describe a method to construct a finite element model of the hip joint of a child based on clinical recorded CT data. A model which can be used for diagnostic aid and pre-operative surgical evaluation. First part of this development is a feasibility study of this method. A scan...

  18. In vivo study of acute effects of hip and knee positions on blood flow in canine sciatic nerve

    OpenAIRE

    Koga, Kei; Naito, Masatoshi; Akiyoshi, Yuichiro; Asayama, Isao; Shiramizu, Kei; Abe, Tatunobu; Kanbe, Taichi

    2002-01-01

    We studied blood flow in the canine sciatic nerve using a laser Doppler flowmeter. Blood flow was measured in 20 hind limbs of ten adult dogs at varying angles of hip flexion, hip rotation and knee flexion. Blood flow decreased as flexion and internal rotation of the hip increased and also with only slight flexion of the knee. With 90° knee flexion, the mean blood flow did not change significantly when the hip was internally rotated from 0° to 30°. When the knee was straight, the blood flow c...

  19. Case-only designs for studying the association of antidepressants and hip or femur fracture.

    NARCIS (Netherlands)

    Groot, M.C.H. de; Candore, G.; Uddin, M.J.; Souverein, P.C.; Ali, M.S.; Belitser, S.V.; Huerta, C.; Groenwold, R.H.H.; Alvarez, Y.; Slattery, J.; Korevaar, J.; Hoes, A.W.; Roes, K.C.B.; Boer, A. de; Douglas, I.J.; Schlienger, R.G.; Reynolds, R.; Klungel, O.H.; Gardarsdottir, H.

    2016-01-01

    Purpose: The purpose of this study is to evaluate the performance and validity of the case-crossover (CCO) and self-controlled case-series (SCCS) designs when studying the association between hip/femur fracture (HF) and antidepressant (AD) use in general practitioner databases. In addition,

  20. Case-only designs for studying the association of antidepressants and hip or femur fracture

    NARCIS (Netherlands)

    De Groot, Mark C H; Candore, Gianmario; Uddin, Md Jamal; Souverein, Patrick C.; Ali, M. Sanni; Belitser, Svetlana V.; Huerta, Consuelo; Groenwold, Rolf H H; Alvarez, Yolanda; Slattery, Jim; Korevaar, Joke; Hoes, Arno W.; Roes, Kit C B; de Boer, Anthonius; Douglas, Ian J.; Schlienger, Raymond G.; Reynolds, Robert; Klungel, Olaf H.; Gardarsdottir, Helga

    2016-01-01

    PURPOSE: The purpose of this study is to evaluate the performance and validity of the case-crossover (CCO) and self-controlled case-series (SCCS) designs when studying the association between hip/femur fracture (HF) and antidepressant (AD) use in general practitioner databases. In addition,

  1. Case-only designs for studying the association of antidepressants and hip or femur fracture

    NARCIS (Netherlands)

    De Groot, Mark C. H.; Candore, Gianmario; Uddin, Jamal; Souverein, Patrick; Ali, M. Sanni; Belitser, S.; Huerta, Consuelo; Groenwold, Rolf H. H.; Alvarez, Yolanda; Slattery, Jim; Korevaar, Joke; Hoes, Arno W.; Roes, Kit C. B.; de Boer, Anthonius; Douglas, Ian J.; Schlienger, Raymond G.; Reynolds, Robert; Klungel, Olaf H.; Gardarsdottir, Helga

    2016-01-01

    Purpose: The purpose of this study is to evaluate the performance and validity of the case-crossover (CCO) and self-controlled case-series (SCCS) designs when studying the association between hip/femur fracture (HF) and antidepressant (AD) use in general practitioner databases. In addition,

  2. Quality of life and functionality after total hip arthroplasty: a long-term follow-up study

    Directory of Open Access Journals (Sweden)

    Recano Pasquale

    2011-10-01

    Full Text Available Abstract Background There is a lack of data on the long-term outcome of total hip arthroplasty procedures, as assessed by validated tools. Methods We conducted a follow-up study to evaluate the quality of life and functionality of 250 patients an average of 16 years (range: 11-23 years after total hip arthroplasty using a validated assessment set including the SF-36 questionnaire, Harris Hip Score, WOMAC score, Functional Comorbidity Index, and a study specific questionnaire. Models of multiple stepwise linear and logistic regression analysis were constructed to evaluate the relationships between several explanatory variables and these functional outcomes. Results The SF-36 physical indexes of these patients compared negatively with the normative values but positively with the results obtained in untreated subjects with severe hip osteoarthritis. Similar results were detected for the Harris Hip Score and WOMAC score. There was a 96% rate of post-surgical satisfaction. Hip functionality and comorbidities were the most important determinants of physical measures on the SF-36. Conclusions Patients who had undergone total hip arthroplasty have impaired long-term self-reported physical quality of life and hip functionality but they still perform physically better than untreated patients with advanced hip osteoarthritis. However, the level of post-surgical satisfaction is high.

  3. Hip and fragility fracture prediction by 4-item clinical risk score and mobile heel BMD: a women cohort study

    Directory of Open Access Journals (Sweden)

    Thulesius Hans

    2010-03-01

    Full Text Available Abstract Background One in four Swedish women suffers a hip fracture yielding high morbidity and mortality. We wanted to revalidate a 4-item clinical risk score and evaluate a portable heel bone mineral density (BMD technique regarding hip and fragility fracture risk among elderly women. Methods In a population-based prospective cohort study we used clinical risk factors from a baseline questionnaire and heel BMD to predict a two-year hip and fragility fracture outcome for women, in a fracture preventive program. Calcaneal heel BMD was measured by portable dual X-ray laser absorptiometry (DXL and compared to hip BMD, measured with stationary dual X-ray absorptiometry (DXA technique. Results Seven women suffered hip fracture and 14 women fragility fracture/s (at hip, radius, humerus and pelvis among 285 women; 60% having heel BMD ≤ -2.5 SD. The 4-item FRAMO (Fracture and Mortality Index combined the clinical risk factors age ≥80 years, weight Conclusions In a follow-up study we identified high risk groups for hip and fragility fracture with our plain 4-item risk model. Increased fracture risk was also related to decreasing heel BMD in calcaneal bone, measured with a mobile DXL technique. A combination of high FRAMO Index, prior fragility fracture, and very low BMD restricted the high risk group to 11%, among whom most hip fractures occurred (71%. These practical screening methods could eventually reduce hip fracture incidence by concentrating preventive resources to high fracture risk women.

  4. Organizational Factors and Long-Term Mortality after Hip Fracture Surgery. A Cohort Study of 6143 Consecutive Patients Undergoing Hip Fracture Surgery

    DEFF Research Database (Denmark)

    Lund, Caterina A; Møller, Ann M; Wetterslev, Jørn

    2014-01-01

    OBJECTIVE: In hospital and health care organizational factors may be changed to reduce postoperative mortality. The aim of this study is to evaluate a possible association between mortality and 'length of hospital stay', 'priority of surgery', 'time of surgery', or 'surgical delay' in hip fracture......, anaesthetic and surgical procedures were retrieved. PARTICIPANTS: 6143 patients aged more than 65 years undergoing hip fracture surgery. MAIN OUTCOME MEASURES: All-cause mortality. RESULTS: The one year mortality was 30% (28-31%, 95% Confidence interval (CI)). In a multivariate model 'length of hospital stay...

  5. A retrospective study on findings of canine hip dysplasia screening in Kenya.

    Science.gov (United States)

    Kimeli, Peter; Mbugua, Susan W; Cap, Roger M; Kirui, Gilbert; Abuom, Tequiero O; Mwangi, Willy E; Kipyegon, Ambrose N; Mande, John D

    2015-11-01

    The current study was undertaken to evaluate the findings of canine hip dysplasia screening in Kenya. Records for 591 dogs were included in this study. The data was obtained from the national screening office, Kenya Veterinary Board, for the period between the years 1998 and 2014. Monthly screening records were assessed and information relating to year of evaluation, breed, sex, age, and hip score captured. Descriptive statistics of hip scores was computed based on year, sex, age, and breed. A total of 591 records from the year 1998 to 2014 were retrieved at the National Screening Centre, the Kenya Veterinary Board. Each record was examined and data pertaining to year of screening, the breed, sex, age of the dogs, and the total hip score were recorded. The highest number of dogs screened for hip dysplasia (HD) was in the year 2009 and the lowest in the year 1998. More females than males were screened for HD and the mean age of all the dogs was 22.9±12.7 months. The most common breeds of dogs screened during the study period were German Shepherd (67.0%), Rottweiler (15.6%), and Labrador Retriever (12.2%). The mean hip score for the 591 dogs was 15.1±10.9 and the median 12.0. The mean hip scores per breed were; German Shepherd (16.3±12.1); Golden Retriever (16.0); Hungarian Vizla (15.0); Labrador Retriever (3.0±6.7); Great Dane (13.3±3.2); Rottweiler (12.2±8.2); Doberman (10.3±4.2); Rhodesian Ridgeback (9.6±3.8); and Boxer (9.3±0.6). Based on the hip score, moderate to severe HD was diagnosed in 16.6% of the dogs, mild HD in 32.7%, Borderline HD in 37.7%, fair HD in 6.9%, and good HD in 6.1%. Canine HD is a common occurrence in Kenya with most dogs suffering mild to border line HD. In addition, German Shepherd and Golden Retriever appear to be the most affected breeds. It is therefore recommended that stringent measures be imposed to dog breeding programs to avoid transmission of this undesirable trait and consequently improve the welfare and the quality of

  6. A retrospective study on findings of canine hip dysplasia screening in Kenya

    Directory of Open Access Journals (Sweden)

    Peter Kimeli

    2015-11-01

    Full Text Available Aim: The current study was undertaken to evaluate the findings of canine hip dysplasia screening in Kenya. Materials and Methods: Records for 591 dogs were included in this study. The data was obtained from the national screening office, Kenya Veterinary Board, for the period between the years 1998 and 2014. Monthly screening records were assessed and information relating to year of evaluation, breed, sex, age, and hip score captured. Descriptive statistics of hip scores was computed based on year, sex, age, and breed. Results: A total of 591 records from the year 1998 to 2014 were retrieved at the National Screening Centre, the Kenya Veterinary Board. Each record was examined and data pertaining to year of screening, the breed, sex, age of the dogs, and the total hip score were recorded. The highest number of dogs screened for hip dysplasia (HD was in the year 2009 and the lowest in the year 1998. More females than males were screened for HD and the mean age of all the dogs was 22.9±12.7 months. The most common breeds of dogs screened during the study period were German Shepherd (67.0%, Rottweiler (15.6%, and Labrador Retriever (12.2%. The mean hip score for the 591 dogs was 15.1±10.9 and the median 12.0. The mean hip scores per breed were; German Shepherd (16.3±12.1; Golden Retriever (16.0; Hungarian Vizla (15.0; Labrador Retriever (3.0±6.7; Great Dane (13.3±3.2; Rottweiler (12.2±8.2; Doberman (10.3±4.2; Rhodesian Ridgeback (9.6±3.8; and Boxer (9.3±0.6. Based on the hip score, moderate to severe HD was diagnosed in 16.6% of the dogs, mild HD in 32.7%, Borderline HD in 37.7%, fair HD in 6.9%, and good HD in 6.1%. Conclusion: Canine HD is a common occurrence in Kenya with most dogs suffering mild to border line HD. In addition, German Shepherd and Golden Retriever appear to be the most affected breeds. It is therefore recommended that stringent measures be imposed to dog breeding programs to avoid transmission of this undesirable trait

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

    Science.gov (United States)

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

    2017-03-01

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

  8. Factors influencing inpatient rehabilitation length of stay following revision hip replacements: a retrospective study

    Directory of Open Access Journals (Sweden)

    Davis Aileen M

    2010-10-01

    Full Text Available Abstract Background The annual incidence of revision hip replacements has increased in both Canada and United States, particularly in younger adults. Patients following revision hip replacements often require longer hospital length of stay (LOS but little is known about predictors of inpatient rehabilitation LOS in this group of patients. The purpose of this study was to evaluate the socio-demographic, pre-surgery, surgery and post-surgery related factors that might influence rehabilitation LOS of inpatients following revision hip replacements. Methods This study included inpatients discharged from a musculoskeletal ward between 2002 and 2006 following rehabilitation revision hip replacement. Data sources included the National Reporting System, a standardized, provincial administrative database and augmented by chart abstraction. The collected elements included the outcome LOS and the following independent variables: age, sex, support at home, environmental barriers, language barrier, number of revision surgeries on the affected hip, comorbidity, previous orthopaedic surgeries in the lower extremities (L/ES, the hip component(s revised, weight-bearing status, hemoglobin level, complications, days lapsed from surgery to rehabilitation admission and admission scores on the Functional Independence Measure (FIM. Simple linear regression was used to take forward any predictors significant at p Results The 275 patients in this sample had a mean age of 69 years; 62% were female and the mean LOS was 29.6 days. Statistically significant predictors of longer LOS were low admission FIM score, female sex, revision of only the femoral component, 2 or more prior surgeries in the L/Es and 2 or more hip revisions (redo revision. The final model explained 28% of variance in inpatient LOS. Conclusions A score of 9-14 points lower in admission FIM, female sex, revision of only the femoral component, prior surgeries in the L/Es and redo hip revision are all

  9. Finite element analysis of 2-Station hip himulator

    Science.gov (United States)

    Fazli, M. I. M.; Yahya, A.; Shahrom, A.; Nawawi, S. W.; Zainudin, M. R.; Nazarudin, M. S.

    2017-10-01

    This paper presented the analysis of materials and design architecture of 2-station hip simulator. Hip simulator is a machine used to conduct the joint and wear test of hip prosthetic. In earlier work, the hip simulator was modified and some improvement were made by using SolidWorks software. The simulator consists of 3DOF which controlled by separate stepper motor and a static load that set up by manual method in each station. In this work, finite element analysis (FEA) of hip simulator was implemented to analyse the structure of the design and selected materials used for simulator component. The analysis is completed based on two categories which are safety factor and stress tests. Both design drawing and FEA was done using SolidWorks software. The study of the two categories is performed by applying the peak load up to 4000N on the main frame that is embedded with metal-on-metal hip prosthesis. From FEA, the value of safety factor and degree of stress formation are successfully obtained. All the components exceed the value of 2 for safety factor analysis while the degree of stress formation shows higher value compare to the yield strength of the material. With this results, it provides information regarding part of simulator which are susceptible to destruct. Besides, the results could be used for design improvement and certify the stability of the hip simulator in real application.

  10. Study of wind forces on low-rise hip-roof building | Jameel ...

    African Journals Online (AJOL)

    A comprehensive numerical study of wind effects using Computational Fluid Dynamics (CFD) techniques on the low-rise hipped roof building is presented in this paper. Two Reynolds Averaged Navier–Stokes Equations (RANS) techniques such as the Standard k -e turbulence model and the Renormalization group (RNG) k ...

  11. Hip-Hop High School: A Study of the Attitudes, Beliefs and Perceptions of Suburban High School Faculty towards Representation of the Hip-Hop Culture

    Science.gov (United States)

    Rowland, Ronald K.

    2011-01-01

    Research historically has demonstrated that a generational disconnect between the popular cultures from which students and teachers define normative behavior can impact classroom management and student learning. The purpose of this study was to examine attitudes, beliefs and perceptions of high school faculty toward the hip-hop culture and its…

  12. Hip resurfacing arthroplasty.

    Science.gov (United States)

    van Gerwen, Marijke; Shaerf, Daniel A; Veen, Remmelt M

    2010-12-01

    Hip resurfacing arthroplasty is claimed to allow higher activity levels and to give better quality of life than total hip arthroplasty. In this literature review, we assessed the therapeutic value of hip resurfacing arthroplasty as measured by functional outcome. An extensive literature search was performed using the PubMed, Embase, and Cochrane databases. 9 patient series, 1 case-control study, and 1 randomized controlled trial (RCT) were included. Clinically and statistically significant improvement in sporting activity and hip scores were found in 10 studies. Studies with low levels of evidence have shown improvement in various different hip scores and one RCT showed better outcomes with hip resurfacing arthroplasty. There is no high-level evidence to prove that there is improved clinical outcome using hip resurfacing arthroplasty. More randomized research needs to be done.

  13. Age Related Incidence and Early Outcomes of Hip Fractures: A Prospective Cohort Study of 1177 patients

    Directory of Open Access Journals (Sweden)

    Shenoy Ravikiran

    2011-01-01

    Full Text Available Abstract Introduction Associated with the increase in the aging population, there is an increase in the incidence of hip fractures worldwide. Outcome following such fractures is affected by age of the patient. This study aims to assess the incidence and early outcome of hip fractures, comparing between different age groups. Methods Data of hip fractures collected over a period of five years was analysed. Patients were divided into three groups, group A (patients under the age of 64, group B (patients between 65 and 84 years of age, and group C (patients over the age of 85. Results Of the 1177 patients included in the study, there were 90 patients in group A, 702 patients in group B and 385 patients in group C. There was a female preponderance across all age groups, and this increased as age advanced (p Conclusions Hip fractures are more common among females irrespective of age group. Older patients have a higher mortality and a greater deterioration of walking ability after such injuries. Internal fixation of intracapsular fractures have demonstrated satisfactory early outcome in the immediate period. This could be attributed to retention of native bone, better propioception and shorter operation time.

  14. Estimated drinking water fluoride exposure and risk of hip fracture: a cohort study.

    Science.gov (United States)

    Näsman, P; Ekstrand, J; Granath, F; Ekbom, A; Fored, C M

    2013-11-01

    The cariostatic benefit from water fluoridation is indisputable, but the knowledge of possible adverse effects on bone and fracture risk due to fluoride exposure is ambiguous. The association between long-term (chronic) drinking water fluoride exposure and hip fracture (ICD-7-9: '820' and ICD-10: 'S72.0-S72.2') was assessed in Sweden using nationwide registers. All individuals born in Sweden between January 1, 1900 and December 31, 1919, alive and living in their municipality of birth at the time of start of follow-up, were eligible for this study. Information on the study population (n = 473,277) was linked among the Swedish National In-Patient Register (IPR), the Swedish Cause of Death Register, and the Register of Population and Population Changes. Estimated individual drinking water fluoride exposure was stratified into 4 categories: very low, fluoride exposure and the occurrence of hip fracture. The risk estimates did not change in analyses restricted to only low-trauma osteoporotic hip fractures. Chronic fluoride exposure from drinking water does not seem to have any important effects on the risk of hip fracture, in the investigated exposure range.

  15. Physical activity in middle-aged women and hip fracture risk: the UFO study.

    Science.gov (United States)

    Englund, U; Nordström, P; Nilsson, J; Bucht, G; Björnstig, U; Hallmans, G; Svensson, O; Pettersson, U

    2011-02-01

    In a population-based case-control study, we demonstrate that middle-aged women who were active with walking or in different physical spare time activities were at lower risk of later sustaining a hip fracture compared to more sedentary women. In middle-aged women participating in the Umeå Fracture and Osteoporosis (UFO) study, we investigated whether physical activity is associated with a subsequent decreased risk of sustaining a hip fracture. The UFO study is a nested case-control study investigating associations between bone markers, lifestyle, and osteoporotic fractures. We identified 81 female hip fracture cases that had reported lifestyle data before they sustained their fracture. Each case was compared with two female controls who were identified from the same cohort and matched for age and week of reporting data, yielding a total cohort of 237 subjects. Mean age at baseline was 57.2 ± 5.0 years, and mean age at fracture was 65.4 ± 6.4 years. Conditional logistic regression analysis with adjustments for height, weight, smoking, and menopausal status showed that subjects who were regularly active with walking or had a moderate or high frequency of physical spare time activities (i.e. berry/mushroom picking and snow shovelling) were at reduced risk of sustaining a hip fracture (OR 0.14; 95% CI; 0.05-0.53 for walking and OR 0.19; 95% CI; 0.08-0.46, OR 0.17, 95% CI; 0.05-0.64 for moderate and high frequency of spare time activities, respectively) compared to more sedentary women. An active lifestyle in middle age seems to reduce the risk of future hip fracture. Possible mechanisms may include improved muscle strength, coordination, and balance resulting in a decreased risk of falling and perhaps also direct skeletal benefits.

  16. Hip fracture history and risk of nonmelanoma skin cancer: a Danish population-based study

    Directory of Open Access Journals (Sweden)

    Lamberg AL

    2011-11-01

    Full Text Available Anna Lei Lamberg1,2, Anne Braae Olesen1,2, Annette Østergaard Jensen11Department of Clinical Epidemiology, 2Department of Dermatology, Aarhus University Hospital, DenmarkBackground: Vitamin D deficiency is associated with osteoporotic fractures, such as hip fracture. Sun exposure, the natural source of vitamin D, is the main risk factor for basal cell carcinoma (BCC and squamous cell carcinoma (SCC. In this study, we examined the association between a history of hip fracture and risk of BCC and SCC.Methods: We conducted a population-based case-controlled study using data on BCC and SCC cases registered in the Danish Cancer Registry from 1990–2005. For each case, we selected five population controls matched by age and gender. We used conditional logistic regression to compute odds ratios (OR and 95% confidence intervals (CI, while adjusting for chronic diseases and socioeconomic status.Results: A history of hip fracture was associated with a decreased risk of BCC (OR 0.90, 95% CI 0.85–0.94, which was most pronounced in cases of tumors on the trunk, extremities, or at multiple sites. We found no association for SCC (OR 1.07, 95% CI 0.98–1.17.Conclusion: Our study showed an inverse association between history of hip fracture and risk of BCC, but not of SCC. Sun exposure, resulting in vitamin D synthesis, may explain the link between the two diseases.Keywords: hip fracture, vitamin D, sunlight, basal cell carcinoma, squamous cell carcinoma

  17. Inflammatory markers and risk of hip fracture in older white women: the study of osteoporotic fractures.

    Science.gov (United States)

    Barbour, Kamil E; Lui, Li-Yung; Ensrud, Kristine E; Hillier, Teresa A; LeBlanc, Erin S; Ing, Steven W; Hochberg, Marc C; Cauley, Jane A

    2014-09-01

    Hip fractures are the most devastating consequence of osteoporosis and impact 1 in 6 white women leading to a two- to threefold increased mortality risk in the first year. Despite evidence of inflammatory markers in the pathogenesis of osteoporosis, few studies have examined their effect on hip fracture. To determine if high levels of inflammation increase hip fracture risk and to explore mediation pathways, a case-cohort design nested in a cohort of 4709 white women from the Study of Osteoporotic Fractures was used. A random sample of 1171 women was selected as the subcohort (mean age 80.1 ± 4.2 years) plus the first 300 women with incident hip fracture. Inflammatory markers interleukin-6 (IL-6) and soluble receptors (SR) for IL-6 (IL-6 SR) and tumor necrosis factor (TNF SR1 and TNF SR2) were measured, and participants were followed for a median (interquartile range) of 6.3 (3.7, 6.9) years. In multivariable models, the hazard ratio (HR) of hip fracture for women in the highest inflammatory marker level (quartile 4) was 1.64 (95% confidence interval [CI], 1.09-2.48, p trend = 0.03) for IL-6 and 2.05 (95% CI, 1.35-3.12, p trend hip fracture was 1.51 (95% CI, 1.07-2.14) and 1.42 (95% CI, 0.87-2.31) compared with women with zero to one marker(s) in the highest quartile (p trend = 0.03). After individually adjusting for seven potential mediators, cystatin-C (a biomarker of renal function) and bone mineral density (BMD) attenuated HRs among women with the highest inflammatory burden by 64% and 50%, respectively, suggesting a potential mediating role. Older white women with high inflammatory burden are at increased risk of hip fracture in part due to poor renal function and low BMD. © 2014 American Society for Bone and Mineral Research.

  18. Pregnancy-associated transient osteoporosis of the hip: results of a case-control study.

    Science.gov (United States)

    Hadji, Peyman; Boekhoff, Jelena; Hahn, Melitta; Hellmeyer, Lars; Hars, Olaf; Kyvernitakis, Ioannis

    2017-12-01

    The etiology and underlying mechanisms of transient of osteoporosis of the hip (TOH) during pregnancy are still unclear, since no systematic analyses exist. Our results support the hypothesis that TOH is a multifactorial disease, which is associated with immobility, dental problems, and lack of exercise in childhood. Pregnancy-associated transient osteoporosis of the hip (TOH) is a rare but severe form of osteoporosis, which may affect a subgroup of women in the last trimester of pregnancy or immediately postpartum. Common symptoms include acute pain of the hip(s) due to bone marrow edema or even hip fractures. The exact underlining mechanisms of this disorder are still unknown since no published systematic analyses exist. Out of a total of 52 TOH patients, 33 TOH patients could be matched with 33 healthy controls according to age, region, and gravity. The aim of this retrospective case-control study was to evaluate the risk factors for TOH in a homogenous population of women. The baseline characteristics of the two study groups were similar. Overall, 12.1% of the TOH patients sustained a hip fracture. Expectedly, 90.9% of the TOH patients complained about pain of the hip (p ≤ 0.001). TOH patients suffered more frequently from severe dental problems during childhood (p = 0.023) and performed less often sports before and after puberty (p ≤ 0.001), whereas the frequency of immobilization during pregnancy was threefold higher compared to the control group (p = 0.007). We found a significant increase of the TOH risk in patients with dental problems in childhood (OR 3.7; CI 1.3-10.7) as well as in patients with lack of exercise during childhood (OR 4.2; CI 1.3-12.9). Our results support the hypothesis that pregnancy-associated TOH is a multifactorial disease, to which several individual factors may contribute. Hereby, we found significant associations with immobility, dental problems, and lack of exercise in childhood.

  19. 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

    2017-10-01

    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. Evidence suggests that a biomechanical gait therapy program improves subjective and objective outcomes measures and is a valid treatment option for hip osteoarthritis. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2222-2232, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  20. Hormone replacement therapy and risk of hip fracture: population based case-control study

    Science.gov (United States)

    Michaëlsson, Karl; Baron, John A; Farahmand, Bahman Y; Johnell, Olof; Magnusson, Cecilia; Persson, Per-Gunnar; Persson, Ingemar; Ljunghall, Sverker

    1998-01-01

    Objective: To determine the relative risk of hip fracture associated with postmenopausal hormone replacement therapy including the effect of duration and recency of treatment, the addition of progestins, route of administration, and dose. Design: Population based case-control study. Setting: Six counties in Sweden. Subjects: 1327 women aged 50-81 years with hip fracture and 3262 randomly selected controls. Main outcome measure: Use of hormone replacement therapy. Results: Compared with women who had never used hormone replacement therapy, current users had an odds ratio of 0.35 (95 % confidence interval 0.24 to 0.53) for hip fracture and former users had an odds ratio of 0.76 (0.57 to 1.01). For every year of therapy, the overall risk decreased by 6% (3% to 9%): 4% (1% to 8%) for regimens without progestin and 11% (6% to 16%) for those with progestin. Last use between one and five years previously, with a duration of use more than five years, was associated with an odds ratio of 0.27 (0.08 to 0.94). After five years without hormone replacement therapy the protective effect was substantially diminished (−7% to 48%). With current use, an initiation of therapy nine or more years after the menopause gave equally strong reduction in risk for hip fracture as an earlier start. Oestrogen treatment with skin patches gave similar risk estimates as oral regimens. Conclusions: Recent use of hormone replacement therapy is required for optimum fracture protection, but therapy can be started several years after the menopause. The protective effect increases with duration of use, and an oestrogen-sparing effect is achieved when progestins are included in the regimen. Key messages Hormone replacement therapy should be continued for long periods for optimal protection of hip fracture No overall substantial hip fracture protection remains after five years without hormone replacement therapy Therapy can be initiated several years after menopause without loss of fracture protection

  1. Effects of trunk-hip strengthening on standing in children with spastic diplegia: a comparative pilot study.

    Science.gov (United States)

    Kim, Joong-Hwi; Seo, Hye-Jung

    2015-05-01

    [Purpose] This study evaluated the effects of trunk-hip strengthening exercise on trunk-hip activation and pelvic tilt motion during standing in children with spastic diplegia and compared the improvement of pelvic tilt between the modified trunk-hip strengthening exercise and conventional exercise. [Subjects and Methods] Ten ambulant children with spastic diplegia were randomized to the modified trunk-hip strengthening exercise (n = 5) or conventional exercise (n = 5) group. The intervention consisted of a 6-week modified trunk-hip strengthening exercise 3 times per week. The children were tested for trunk-hip muscles activation and pelvic tilt motion during standing by surface electromyography and an inclinometer before and after the intervention. [Results] The anterior pelvic tilt angle and activation of the extensor spinae, rectus femoris, and semitendinosus during standing decreased significantly in the modified exercise group. The activation of extensor spinae differed significantly between groups. [Conclusion] Compared to the conventional exercise, the modified exercise was more effective for trunk-hip activation improvement and anterior pelvic tilt motion decrease during standing in children with spastic diplegia. We suggest clinicians use an individually tailored modified trunk-hip strengthening exercise for strengthening the weakest muscle groups in children with standing ability problems.

  2. Efficacy of the Flinders chronic condition management program in obese patients with hip or knee osteoarthritis: A study rationale and protocol

    Directory of Open Access Journals (Sweden)

    Ladan Sahafi

    2016-09-01

    Full Text Available This study investigates the relative efficacy of the Flinders chronic condition self-management program versus treatment as usual in obese patients with hip or knee osteoarthritis on a knee/hip joint replacement waiting list

  3. Risk of hip fractures associated with benzodiazepines: Applying common protocol to a multi-database nested case-control study. The protect project

    NARCIS (Netherlands)

    Requena, Gema; Logie, John; González-González, Rocío; Gardarsdottir, Helga|info:eu-repo/dai/nl/321858131; Afonso, Ana; Souverein, Patrick C.|info:eu-repo/dai/nl/243074948; Merino, Elisa Martin; Boudiaf, Nada; Huerta, Consuelo; Bate, Andrew; Alvarez, Yolanda; García-Rodríguez, Luis A.; Reynolds, Robert; Schlienger, Raymond G.; De Groot, Mark C.H.|info:eu-repo/dai/nl/313936455; Klungel, Olaf H.|info:eu-repo/dai/nl/181447649; De Abajo, Francisco J.

    2014-01-01

    Background: The association between benzodiazepines (BZD) and hip fractures has been estimated in several observational studies although diverse methodologies and definitions have hampered comparability. Objectives: To evaluate the discrepancies in the risk estimates of hip/femur fractures

  4. Modular necks in primary hip arthroplasty without anatomical deformity: no clear benefit on restoration of hip geometry and dislocation rate. An exploratory study

    NARCIS (Netherlands)

    Gerhardt, D.M.; Bisseling, P.; Visser, E. de; Susante, J.L.C. van

    2014-01-01

    Modular necks were introduced in total hip arthroplasty (THA) to improve restoration of hip-geometry and reduce dislocation-rates. This presumed advantage was evaluated retrospectively for patients with arthritis in otherwise anatomically normal hips. Restoration of hip-geometry was assessed on

  5. Sagittal Plane Hip, Knee, and Ankle Biomechanics and the Risk of Anterior Cruciate Ligament Injury: A Prospective Study

    National Research Council Canada - National Science Library

    Leppänen, Mari; Pasanen, Kati; Krosshaug, Tron; Kannus, Pekka; Vasankari, Tommi; Kujala, Urho M; Bahr, Roald; Perttunen, Jarmo; Parkkari, Jari

    2017-01-01

    ...: To investigate the relationship between selected sagittal plane hip, knee, and ankle biomechanics and the risk of ACL injury in young female team-sport athletes. Study Design: Case-control study...

  6. Influence of Premature Mortality on the Link Between Type 2 Diabetes and Hip Fracture: The Fremantle Diabetes Study.

    Science.gov (United States)

    Hamilton, Emma; Davis, Wendy A; Bruce, David G; Davis, Timothy M E

    2017-02-01

    Studies of hip fracture complicating diabetes have not considered the effect of premature mortality. The aim of our study was to determine influence of the competing risk of death on the association between type 2 diabetes and hip fracture. The study was designed as a longitudinal observational study. The study setting was an urban community. Participants included 1291 patients with type 2 diabetes (mean age 64.0 years) and 5159 matched residents without diabetes. Primary outcome measures were incident hip fracture hospitalizations and deaths. Hip fracture risk was assessed using proportional hazards and competing risk regression modeling. During a mean of 14.1 years of follow-up, the incidence rate ratio for first hip fracture hospitalization in participants with vs without diabetes was 1.33 [95% confidence interval (CI), 1.05 to 1.68; P = 0.013]. Type 2 diabetes was associated with a cause-specific hazard ratio (csHR) for hip fracture of 1.50 (95% CI, 1.19 to 1.89; P < 0.001) and a subdistribution hazard ratio (sdHR) of 1.21 (95% CI, 0.96 to 1.52; P = 0.11) after adjustment for age, sex, and comorbidities. In patients with diabetes, significant csHRs for incident hip fracture were male sex (protective), body mass index (protective), insulin use, and renal impairment. These variables, with increasing age, also had significant sdHRs. The diabetes-associated risk of hip fracture is attenuated after allowing for the competing risk of death. Risk factors for hip fracture in diabetes were those in reported in general population studies plus insulin use.

  7. Hip Strength as an Intrinsic Risk Factor for Lateral Ankle Sprains in Youth Soccer Players: A 3-Season Prospective Study.

    Science.gov (United States)

    De Ridder, Roel; Witvrouw, Erik; Dolphens, Mieke; Roosen, Philip; Van Ginckel, Ans

    2017-02-01

    Numerous epidemiological studies have emphasized the burden of lateral ankle sprains in youth soccer players. However, no prospective study has identified intrinsic physical and modifiable risk factors for these injuries in this particular population. Although injury prevention programs in soccer incorporate proximal hip and core stability exercises, it is striking that the relationship between impaired proximal hip function and ankle sprains has not yet been prospectively investigated in youth soccer players. This prospective study aimed to examine whether hip muscle strength is a risk factor for sustaining a lateral ankle sprain in youth soccer players. We hypothesized that decreased hip muscle strength would predispose youth soccer players to an increased risk of lateral ankle sprains. Case-control study; Level of evidence, 3. This study included a total of 133 male youth soccer players (age divisions U11-U17) for analysis. At the beginning of the season, anthropometric characteristics were collected and hip muscle strength was assessed using a handheld dynamometer. Injury registration was performed by the team medical staff during 3 consecutive seasons. A principal-component, multivariate Cox regression analysis was performed to identify potential risk factors for sustaining a lateral ankle sprain. Twelve participants (18% of all reported injuries) sustained a lateral ankle sprain (0.36 per 1000 athletic-exposure hours). After adjustment for body size dependencies and other hip muscle forces, an increase in hip muscle extension force was associated with a significant decrease in the hazard of the injury (hazard ratio, 0.3; 95% confidence interval, 0.1-0.9; P = .028). No other study variable could be identified as a risk factor for lateral ankle sprains. Reduced hip extension muscle strength is an independent risk factor for lateral ankle sprains in male youth soccer players. Other hip muscle strength outcomes were not identified as risk factors. Replication in

  8. Sex effects on short-term complications after hip fracture: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Ekström W

    2015-08-01

    Full Text Available Wilhelmina Ekström,1 Bodil Samuelsson,2 Sari Ponzer,3 Tommy Cederholm,4,5 Karl-Göran Thorngren,6 Margareta Hedström7 1Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, 2Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, 3Department of Clinical Science and Education, Section of Orthopaedics, Karolinska Institutet, Södersjukhuset, Stockholm, 4Department of Public Health and Caring Sciences, 5Department of Geriatrics, Uppsala University, Uppsala University Hospital, Uppsala, 6Department of Clinical Sciences, Lund, Orthopaedics, Lund University, Lund, 7Department of Orthopaedics, Institute of Clinical Science, Intervention and Technology (CLINTEC, Karolinska University Hospital, Huddinge, Stockholm, Sweden Objectives: To evaluate potential sex differences and other factors associated with complications within 4 months after a hip fracture.Methods: A total of 1,915 patients ≥65 years (480 men with hip fracture were consecutively included in a prospective multicenter cohort study. A review of medical records and patient interviews according to a study protocol based on the Standardized Audit of Hip Fractures in Europe (SAHFE, RIKSHÖFT was performed. Sex differences in comorbidity according to the American Society of Anesthesiologists score and complications 4 months after a hip fracture were registered. Multivariate logistic regression analysis was performed to identify factors related to complications.Results: Male sex was associated with worse general health according to the American Society of Anesthesiologists classification (P=0.005 and with more comorbidities (P<0.001. Male sex emerged as a risk factor for developing pneumonia (P<0.001, and additionally, 18% of the men suffered from cardiac complications compared with 13% of the females (P=0.018. Female sex was predisposed for urinary tract infections, 30% vs 23

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

    Science.gov (United States)

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

    2011-01-16

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

  10. Validation of the Spanish version of the Hip Outcome Score: a multicenter study.

    Science.gov (United States)

    Seijas, Roberto; Sallent, Andrea; Ruiz-Ibán, Miguel Angel; Ares, Oscar; Marín-Peña, Oliver; Cuéllar, Ricardo; Muriel, Alfonso

    2014-05-13

    The Hip Outcome Score (HOS) is a self-reported questionnaire evaluating the outcomes of treatment interventions for hip pathologies, divided in 19 items of activities of daily life (ADL) and 9 sports' items. The aim of the present study is to translate and validate HOS into Spanish. A prospective and multicenter study with 100 patients undergoing hip arthroscopy was performed between June 2012 and January 2013. Crosscultural adaptation was used to translate HOS into Spanish. Patients completed the questionnaire before and after surgery. Feasibility, reliability, internal consistency, construct validity (correlation with Western Ontario and McMaster Universities Osteoarthritis Index), ceiling and floor effects and sensitivity to change were assessed for the present study. Mean age was 45.05 years old. 36 women and 64 men were included. Feasibility: 13% had at least one missing item within the ADL subscale and 17% within the sport subscale. Reliability: the translated version of HOS was highly reproducible with intraclass correlation coefficient of 0.95 for ADL and 0.94 for the sports subscale. Internal consistency was confirmed with Cronbach's alpha >0.90 in both subscales. Construct validity showed statistically significant correlation with WOMAC. Ceiling effect was observed in 6% and 12% for ADL and sports subscale, respectively. Floor effect was found in 3% and 37% ADL and sports subscale, respectively. Large sensitivity to change was shown in both subscales. The translated version of HOS into Spanish has shown to be feasible, reliable and sensible to changes for patients undergoing hip arthroscopy. This validated translation of HOS allows for comparisons between studies involving either Spanish- or English-speaking patients. Prognostic study, Level I.

  11. Risk factors for failure to return to the pre-fracture place of residence after hip fracture: a prospective longitudinal study of 444 patients

    NARCIS (Netherlands)

    A.J.H. Vochteloo (Anne); S.T. Vliet-Koppert; A.B. Maier (Andrea); W.E. Tuinebreijer (Wim); M.R. de Vries (Mark); R.M. Bloem (Rolf); R.G.H.H. Nelissen (Rob); P. Pilot (Peter)

    2012-01-01

    textabstractIntroduction: Long-term place of residence after hip fracture is not often described in literature. The goal of this study was to identify risk factors, known at admission, for failure to return to the pre-fracture place of residence of hip fracture patients in the Wrst year after a hip

  12. 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

  13. 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

  14. The association between leptin, interleukin-6, and hip radiographic osteoarthritis in older people: a cross-sectional study.

    Science.gov (United States)

    Stannus, Oliver P; Jones, Graeme; Quinn, Stephen J; Cicuttini, Flavia M; Dore, Dawn; Ding, Changhai

    2010-01-01

    The associations between leptin, interleukin (IL)-6, and hip radiographic osteoarthritis (OA) have not been reported, and their roles in obesity-related hip OA are unclear. The aim of this study was to describe the associations between leptin, IL-6, and hip radiographic osteoarthritis (ROA) in older adults. A cross-sectional sample of 193 randomly selected subjects (mean age, 63 years; range, 52 to 78 years; 48% female subjects) were studied. Hip ROA, including joint-space narrowing (JSN) and osteophytes, was determined by anteroposterior radiograph. Serum levels of leptin and interleukin (IL)-6 were measured with radioimmunoassay. Fat mass was measured with dual-energy x-ray absorptiometry (DXA). Body mass index (BMI) and waist-to-hip ratio (WHR) were calculated. In multivariable analysis, hip JSN was associated with serum levels of leptin in the whole sample (beta=0.046 per microg/L, P=0.024 for superior; beta=0.068 per microg/L, P=0.004 for axial compartment) and IL-6 only in females (beta=0.241 per pg/ml, P=0.002 for superior; beta=0.239 per pg/ml, P=0.001 for axial compartment). The positive associations between body-composition measures (BMI, WHR, percentage total fat mass, and percentage trunk fat mass) and hip JSN in women became nonsignificant after adjustment for leptin but not for IL-6. No significant associations were found between leptin, IL-6, and the presence or severity of osteophytes. This study suggests that metabolic and inflammatory mechanisms may play a role in the etiology of hip OA and that the associations between body composition and hip JSN are mediated by leptin, particularly in women.

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

    Science.gov (United States)

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

    2011-03-01

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

  16. Comparative study of fat-suppression techniques for hip arthroplasty MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Moliere, Sebastien [University Hospital of Strasbourg, Imaging Department, Strasbourg (France); Dillenseger, Jean-Philippe; Kremer, Stephane; Bierry, Guillaume [University Hospital of Strasbourg, Imaging Department, Strasbourg (France); ICube UMR 7357, University of Strasbourg, Strasbourg (France); Ehlinger, Matthieu [ICube UMR 7357, University of Strasbourg, Strasbourg (France); University Hospital of Strasbourg, Orthopaedic Department, Strasbourg (France)

    2017-09-15

    The goal of this study was to evaluate different fat-suppressed fluid-sensitive sequences in association with different metal artifacts reduction techniques (MARS) to determine which combination allows better fat suppression around metallic hip implants. An experimental study using an MRI fat-water phantom quantitatively evaluated contrast shift induced by metallic hip implant for different fat-suppression techniques and MARS. Then a clinical study with patients addressed to MRI unit for painful hip prosthesis compared these techniques in terms of fat suppression quality and diagnosis confidence. Among sequences without MARS, both T2 Dixon and short tau inversion recuperation (STIR) had significantly lower contrast shift (p < 0.05), Dixon offering the best fat suppression. Adding MARS (view-angle tilting or slice-encoding for metal artifact correction (SEMAC)) to STIR gave better results than Dixon alone, and also better than SPAIR and fat saturation with MARS (p < 0.05). There were no statistically significant differences between STIR with view-angle tilting and STIR with SEMAC in terms of fat suppression quality. STIR sequence is the preferred fluid-sensitive MR sequence in patients with metal implant. In combination with MARS (view-angle tilting or SEMAC), STIR appears to be the best option for high-quality fat suppression. (orig.)

  17. Comparative study of fat-suppression techniques for hip arthroplasty MR imaging.

    Science.gov (United States)

    Molière, Sébastien; Dillenseger, Jean-Philippe; Ehlinger, Matthieu; Kremer, Stéphane; Bierry, Guillaume

    2017-09-01

    The goal of this study was to evaluate different fat-suppressed fluid-sensitive sequences in association with different metal artifacts reduction techniques (MARS) to determine which combination allows better fat suppression around metallic hip implants. An experimental study using an MRI fat-water phantom quantitatively evaluated contrast shift induced by metallic hip implant for different fat-suppression techniques and MARS. Then a clinical study with patients addressed to MRI unit for painful hip prosthesis compared these techniques in terms of fat suppression quality and diagnosis confidence. Among sequences without MARS, both T2 Dixon and short tau inversion recuperation (STIR) had significantly lower contrast shift (p fat suppression. Adding MARS (view-angle tilting or slice-encoding for metal artifact correction (SEMAC)) to STIR gave better results than Dixon alone, and also better than SPAIR and fat saturation with MARS (p fat suppression quality. STIR sequence is the preferred fluid-sensitive MR sequence in patients with metal implant. In combination with MARS (view-angle tilting or SEMAC), STIR appears to be the best option for high-quality fat suppression.

  18. Heavy barbell hip thrusts do not effect sprint performance: an 8-week randomized–controlled study

    OpenAIRE

    Jarvis, Paul; Cassone, Natasha; Turner, Anthony N.; Chavda, Shyam; Edwards, Michael; Bishop, Chris

    2017-01-01

    The purpose of this study was to examine the effects of an 8-week barbell hip thrust strength training program on sprint performance. Twenty-one collegiate athletes (15 males and 6 females) were randomly assigned to either an intervention (n = 11, age 27.36 ± 3.17 years, height 169.55 ± 10.38 cm, weight 72.7± 18 kg) or control group (n = 10, age 27.2 ± 3.36 years, height 176.2 ± 7.94 cm, weight 76.39 ± 11.47 kg). 1RM hip thrust, 40m sprint time, and individual 10m split timings: 0-10, 10-20, ...

  19. Naproxen prevention of heterotopic ossification after hip arthroplasty. A prospective control study of 55 patients

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Orsnes, T

    1991-01-01

    The effect of naproxen on heterotopic ossification after total hip replacement was studied in a randomized, double-blind trial. Twenty-eight patients received 250 mg naproxen thrice daily for 4 weeks postoperatively starting on the morning of the operation while 27 control patients received...... a placebo. Three months after the operation, 13 patients in the control group had heterotopic ossification compared with 4 patients in the group that received naproxen; and after 1 year, the figures were 15 and 4, respectively (P less than 0.01). Three control patients had severe ossifications. We conclude...... that naproxen given for 4 weeks is sufficient to decrease the incidence of heterotopic ossification after cemented total hip replacement....

  20. Distribution of cortical bone in the femoral neck and hip fracture: a prospective case-control analysis of 143 incident hip fractures; the AGES-REYKJAVIK Study.

    Science.gov (United States)

    Johannesdottir, Fjola; Poole, Kenneth E S; Reeve, Jonathan; Siggeirsdottir, Kristin; Aspelund, Thor; Mogensen, Brynjolfur; Jonsson, Brynjolfur Y; Sigurdsson, Sigurdur; Harris, Tamara B; Gudnason, Vilmundur G; Sigurdsson, Gunnar

    2011-06-01

    In this prospective nested case-control study we analyzed the circumferential differences in estimated cortical thickness (Est CTh) of the mid femoral neck as a risk factor for osteoporotic hip fractures in elderly women and men. Segmental QCT analysis of the mid femoral neck was applied to assess cortical thickness in anatomical quadrants. The superior region of the femoral neck was a stronger predictor for hip fracture than the inferior region, particularly in men. There were significant gender differences in Est CTh measurements in the control group but not in the case group. In multivariable analysis for risk of femoral neck (FN) fracture, Est CTh in the supero-anterior (SA) quadrant was significant in both women and men, and remained a significant predictor after adjustment for FN areal BMD (aBMD, dimensions g/cm², DXA-like), (p=0.05 and pfracture. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Electromyographic Comparison of Barbell Deadlift, Hex Bar Deadlift, and Hip Thrust Exercises: A Cross-Over Study.

    Science.gov (United States)

    Andersen, Vidar; Fimland, Marius S; Mo, Dag-Andrè; Iversen, Vegard M; Vederhus, Torbjørn; Rockland Hellebø, Lars R; Nordaune, Kristina I; Saeterbakken, Atle H

    2018-03-01

    Andersen, V, Fimland, MS, Mo, D-A, Iversen, VM, Vederhus, T, Rockland Hellebø, LR, Nordaune, KI, and Saeterbakken, AH. Electromyographic comparison of barbell deadlift, hex bar deadlift, and hip thrust exercises: a cross-over study. J Strength Cond Res 32(3): 587-593, 2018-The aim of the study was to compare the muscle activation level of the gluteus maximus, biceps femoris, and erector spinae in the hip thrust, barbell deadlift, and hex bar deadlift; each of which are compound resisted hip extension exercises. After 2 familiarization sessions, 13 resistance-trained men performed a 1 repetition maximum in all 3 exercises in 1 session, in randomized and counterbalanced order. The whole ascending movement (concentric phase), as well as its lower and upper parts (whole movement divided in 2), were analyzed. The hip thrust induced greater activation of the gluteus maximus compared with the hex bar deadlift in the whole (16%, p = 0.025) and the upper part (26%, p = 0.015) of the movement. For the whole movement, the biceps femoris was more activated during barbell deadlift compared with both the hex bar deadlift (28%, p hip thrust (20%, p = 0.005). In the lower part of the movement, the biceps femoris activation was, respectively, 48% and 26% higher for the barbell deadlift (p hip thrust. Biceps femoris activation in the upper part of the movement was 39% higher for the barbell deadlift compared with the hex bar deadlift (p = 0.001) and 34% higher for the hip thrust compared with the hex bar deadlift (p = 0.002). No differences were displayed for the erector spinae activation (p = 0.312-0.859). In conclusion, the barbell deadlift was clearly superior in activating the biceps femoris compared with the hex bar deadlift and hip thrust, whereas the hip thrust provided the highest gluteus maximus activation.

  2. Prognostic factors after a traumatic hip dislocation. A long-term retrospective study.

    Science.gov (United States)

    Moreta, J; Foruria, X; Sánchez, A; Aguirre, U

    Traumatic hip dislocations can have devastating complications such as osteoarthritis or osteonecrosis. The aim of this study was to identify the variables and prognostic factors associated with clinical and radiological outcome after a traumatic hip dislocation at long-term follow-up. A review was performed of all dislocations and fracture-dislocations of the hip from January 1999 to December 2012. A computed tomography scan was performed after reduction in all cases. The Harris Hip Score and modified Merle-d'Aubigné-Postel method were used for clinical evaluation and radiological assessment was performed according to the Thompson and Epstein classification. There were 30 cases in 29 patients with a mean follow-up of 11 years (range, 4-17). The great majority were simple dislocations (21; 70%) vs. complex dislocations (9; 30%). Closed reduction was performed in less than 6h in all except one case (29; 96.7%). All of the patients with simple dislocations had an excellent outcome without radiological signs of osteoarthritis at the end of the follow-up (P<.01). Overall, arthritic signs had developed in 4 patients (13.3%) and avascular necrosis was noted in 3 patients (10%). Five patients with intraarticular fragments were treated non-operatively, and 3 of them developed arthritic changes (P<.05). Our study suggests that complex dislocations are associated with poorer functional and radiological outcomes than simple dislocations. We also found a strong association between intraarticular fragments and osteoarthritis, so surgical fragment removal could be considered in these cases. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. The Fascia Iliaca Block as the Primary Intraoperative Anesthesia for Hip Fracture Surgery: A Preliminary Study.

    Science.gov (United States)

    Ruzbarsky, Joseph J; Gausden, Elizabeth B; Goldwyn, Elan M; Lowenwirt, Isaac P; Kotlyar, Vitaly

    2018-02-01

    Early surgical intervention for hip fractures in the elderly has proven efficacious. However, surgical delays commonly occur in this patient population due to comorbid conditions that put these patients at a high risk for hypotension-related complications of general or neuraxial anesthesia or anticoagulants that delay the safe use of neuraxial anesthesia. The questions/purposes of this study are (1) to investigate if a fascia iliaca block in conjunction with light to moderate sedation could provide adequate analgesia throughout open surgery for intertrochanteric hip fractures (AO/OTA 31-1) without requiring conversion to general anesthesia with airway support and (2) to assess its perioperative complication profile. A retrospective chart review was conducted to identify patients with intertrochanteric hip fractures who underwent anesthesia with a fascia iliaca block over a 1.5-year period. In the six patients identified, there were no intraoperative conversions to general anesthesia requiring airway support. Additionally, there were no intraoperative complications, no mortalities within 30 days, 2 patients on anticoagulation who required a blood transfusion, and a single patient who developed a postoperative hospital-acquired pneumonia that resolved with an antibiotic course. In this series of patients, we demonstrate that a fascia iliaca block can reliably be utilized as the primary anesthetic for patients undergoing surgical fixation of intertrochanteric hip fractures, with an acceptable perioperative complication profile. Although concomitant sedation was provided with the block, this anesthesia strategy has the potential to reduce preoperative delays and minimize the overall burden of sedative and anesthetic medications in a geriatric population. These initial findings may serve as a basis for future, higher-quality prospective and comparative studies.

  4. Secondary prevention of fractures after hip fracture: a qualitative study of effective service delivery.

    Science.gov (United States)

    Drew, S; Judge, A; Cooper, C; Javaid, M K; Farmer, A; Gooberman-Hill, R

    2016-05-01

    There is variation in how services to prevent secondary fractures after hip fracture are delivered and no consensus on best models of care. This study identifies healthcare professionals' views on effective care for the prevention of these fractures. It is hoped this will provide information on how to develop services. Hip fracture patients are at high risk of subsequent osteoporotic fractures. Whilst fracture prevention services are recommended, there is variation in delivery and no consensus on best models of care. This study aims to identify healthcare professionals' views on effective care for prevention of secondary fracture after hip fracture. Forty-three semi-structured interviews were undertaken with healthcare professionals involved in delivering fracture prevention across 11 hospitals in one English region. Interviews explored views on four components of care: (1) case finding, (2) osteoporosis assessment, (3) treatment initiation, and (4) monitoring and coordination. Interviews were audio-recorded, transcribed, anonymised and coded using NVivo software. Case finding: a number of approaches were discussed. Multiple methods ensured there was a 'backstop' if patients were overlooked. Osteoporosis assessment: there was no consensus on who should conduct this. The location of the dual energy X-ray absorptiometry (DXA) scanner influenced the likelihood of patients receiving a scan. Treatment initiation: it was felt this was best done in inpatients rather request initiation in the post-discharge/outpatients period. Monitoring (adherence): adherence was a major concern, and participants felt more monitoring could be conducted by secondary care. Coordination of care: participants advocated using dedicated coordinators and formal and informal methods of communication. A gap between primary and secondary care was identified and strategies suggested for addressing this. A number of ways of organising effective fracture prevention services after hip fracture were

  5. Prospective monitoring improves outcomes of primary total hip replacement: a cohort study

    Directory of Open Access Journals (Sweden)

    Zayed Gamal

    2009-04-01

    Full Text Available Abstract Background Over the past decade several studies have questioned current standards of patient safety in health care delivery. In response, our institution started a clinical pathway for total hip replacement in 1996. Prospective monitoring with regular feedback sessions to the individuals involved in patient care did however not start until 2003. The present study evaluates the effect of prospective monitoring on outcomes of total hip replacement. Methods Clinical records of patients undergoing primary elective total hip replacement between 1997 and 2004 were reviewed. Data on adverse events as well as adherence to protocols for venous thromboembolism prophylaxis were extracted retrospectively for the period 1997 to 2001 and prospectively from 2003 to 2004. Results were compared and analyzed in order to establish possible improvement in outcomes. Data was analyzed with Chi-square or Fisher's Exact test for categorical variables and Student's t-test for continuous variables. Alpha was set as less than 5% and analysis was performed with Stata 9.0 for Macintosh. Results Two-hundred and eighty-three patients were included from 1997 to 2001, and 62 from 2003 to 2004. Mean age, male to female ratio and initial diagnosis were similar in both groups. At least one adverse event occurred in 45% of patients in 1997–2001 and in 21% in 2003–2004 (p Conclusion Overall rate of adverse events as well as in-hospital hip dislocations, oliguria and non-adherence to VTE prophylaxis protocols were significantly reduced during the second period. We conclude that clinical pathways alone are insufficient to improve patient safety and require prospective monitoring and continuous feedback to health care providers in order to achieve the desired effect.

  6. Preoperative position splint versus skin traction in patients with hip fracture: An experimental study.

    Science.gov (United States)

    Tosun, Betul; Aslan, Ozlem; Tunay, Servet

    2018-02-01

    The aim of the study was to compare the effects of a preoperative position splint and skin traction on pain, comfort, complications, and satisfaction with the treatment and care for patients with hip fracture. This randomized trial was conducted with a total of 68 patients with hip fracture in a tertiary care hospital in Turkey. Preoperatively, a position splint was applied to the patients in the intervention group (n = 34) and skin traction was applied to patients (n = 34) in the control group. Outcomes studied were pain, comfort, satisfaction and complications. Mann-Whitney U Test showed a significant difference between the position splint group and skin traction group regarding pain severity after the application (p < .05). A significant difference was demonstrated between the two groups concerning comfort levels after the application (p < .05). The position splint group was significantly more satisfied with the treatment and care than the control group in the later period after the application (p < .05). The number of preoperative complications in the position splint group was significantly fewer than that of the skin traction group in the preoperative period (p < .05). Preoperative position splint application in patients with hip fracture relieved pain and complications and increased comfort and satisfaction with treatment and care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Preoperative CSF Melatonin Concentrations and the Occurrence of Delirium in Older Hip Fracture Patients : A Preliminary Study

    NARCIS (Netherlands)

    Scholtens, Rikie M; de Rooij, Sophia E J A; Vellekoop, Annelies E; Vrouenraets, Bart C; van Munster, Barbara C

    2016-01-01

    BACKGROUND: Delirium is characterized by disturbances in circadian rhythm. Melatonin regulates our circadian rhythm. Our aim was to compare preoperative cerebrospinal fluid (CSF) melatonin levels in patients with and without postoperative delirium. METHODS: Prospective cohort study with hip fracture

  8. A prospective randomised study comparing the jubilee dressing method to a standard adhesive dressing for total hip and knee replacements.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2012-08-01

    It is important to reduce potential wound complications in total hip and total knee arthroplasty procedures. The purpose of this study was to compare the jubilee dressing method to a standard adhesive dressing.

  9. Clinical Outcomes of Hip Arthroscopic Surgery in Patients With Femoral Retroversion: A Matched Study to Patients With Normal Femoral Anteversion.

    Science.gov (United States)

    Hartigan, David E; Perets, Itay; Walsh, John P; Chaharbakhshi, Edwin O; Yuen, Leslie C; Domb, Benjamin G

    2017-10-01

    Femoral retroversion has been noted as a possible risk factor for poor clinical results after hip arthroscopic surgery. To compare the outcomes of the arthroscopic treatment of hip abnormalities in patients with femoral retroversion to patients with femoral anteversion between 10° and 20°. Cohort study; Level of evidence, 3. Between November 2011 and September 2013, 790 hip arthroscopic procedures were performed at a single institution. Of these, 59 hips (7.5%) were located in patients with femoral version ≤0°, calculated using preoperative magnetic resonance imaging. These patients were pair matched, based on body mass index ±5 kg/m2, age ±5 years, and Tönnis grade, with 59 patients with femoral anteversion between 10° and 20°. Exclusion criteria included Perthes disease, inflammatory arthritis, slipped capital femoral epiphysis, previous hip surgery, abductor repair, lateral center-edge angle 1, and acetabular profunda or protrusio. Patient-reported outcomes (PROs) were recorded preoperatively, at 3 months postoperatively, and annually thereafter. The PROs utilized were the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score-Sports-Specific Subscale (HOS-SSS). The visual analog scale (VAS) was collected to assess the patients' pain; patient satisfaction scores (0-10) were also collected. Radiographs were collected at the above time intervals as well. Two patients from the control group and 1 patient from the retroverted group required total hip arthroplasty at a mean 19.5 and 26.3 months, respectively. Both groups demonstrated significant improvement from their preoperative state in all PRO and VAS scores (P arthroscopic surgery. Both groups had similar improvements from the preoperative state.

  10. 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....

  11. Efficacy evaluation of a cosmetic slimming treatment for the waist and hips: a double-blind study.

    Science.gov (United States)

    2015-01-01

    The aim of this study was to evaluate by clinical and noninvasive instrumental evaluations the efficacy and tolerance of a cosmetic topical slimming treatment specific for light/moderate adipose pannicula at the level of the waist and hips. The protocol was performed as a double-blind active vs placebo trial in 110 volunteers for a period of 4 weeks, with an additional visit 4 weeks after the last product application. The following clinical/instrumental evaluation was performed during the visit: clinical assessment of hip-abdomen adipose pannicula, circumference measurements, ultrasonographic evaluation of adipose pannicula thickness, and plicometry. At the end of treatment, the slimming activity of the study product resulted in clinically different results than placebo, determined by a significant decrease in abdomen/hips circumferences and considerable reduction of abdomen/hips adipose pannicula thickness. The tolerability of the product was good and the enrolled volunteers expressed their full satisfaction with the studied product.

  12. In Vitro Bioactivity Study of RGD-Coated Titanium Alloy Prothesis for Revision Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Zhentao Man

    2016-01-01

    Full Text Available Total hip arthroplasty (THA is a common procedure for the treatment of end-stage hip joint disease, and the demand for revision THA will double by 2026. Ti6Al4V (Titanium, 6% Aluminum, and 4% Vanadium is a kind of alloy commonly used to make hip prothesis. To promote the osseointegration between the prothesis and host bone is very important for the revision THA. The peptide Arg-Gly-Asp (RGD could increase cell attachment and has been used in the vascular tissue engineering. In this study, we combined the RGD with Ti6Al4V alloy using the covalent cross-linking method to fabricate the functional Ti6Al4V alloy (FTA. The distribution of RGD oligopeptide on the FTA was even and homogeneous. The FTA scaffolds could promote mouse osteoblasts adhesion and spreading. Furthermore, the result of RT-qPCR indicated that the FTA scaffolds were more beneficial to osteogenesis, which may be due to the improvement of osteoblast adhesion by the RGD oligopeptide coated on FTA. Overall, the FTA scaffolds developed herein pave the road for designing and building more efficient prothesis for osseointegration between the host bone and prothesis in revision THA.

  13. In Vitro Bioactivity Study of RGD-Coated Titanium Alloy Prothesis for Revision Total Hip Arthroplasty.

    Science.gov (United States)

    Man, Zhentao; Sha, Dan; Sun, Shui; Li, Tao; Li, Bin; Yang, Guang; Zhang, Laibo; Wu, Changshun; Jiang, Peng; Han, Xiaojuan; Li, Wei

    2016-01-01

    Total hip arthroplasty (THA) is a common procedure for the treatment of end-stage hip joint disease, and the demand for revision THA will double by 2026. Ti6Al4V (Titanium, 6% Aluminum, and 4% Vanadium) is a kind of alloy commonly used to make hip prothesis. To promote the osseointegration between the prothesis and host bone is very important for the revision THA. The peptide Arg-Gly-Asp (RGD) could increase cell attachment and has been used in the vascular tissue engineering. In this study, we combined the RGD with Ti6Al4V alloy using the covalent cross-linking method to fabricate the functional Ti6Al4V alloy (FTA). The distribution of RGD oligopeptide on the FTA was even and homogeneous. The FTA scaffolds could promote mouse osteoblasts adhesion and spreading. Furthermore, the result of RT-qPCR indicated that the FTA scaffolds were more beneficial to osteogenesis, which may be due to the improvement of osteoblast adhesion by the RGD oligopeptide coated on FTA. Overall, the FTA scaffolds developed herein pave the road for designing and building more efficient prothesis for osseointegration between the host bone and prothesis in revision THA.

  14. In Vitro Bioactivity Study of RGD-Coated Titanium Alloy Prothesis for Revision Total Hip Arthroplasty

    Science.gov (United States)

    Man, Zhentao; Sha, Dan; Sun, Shui; Li, Tao; Li, Bin; Yang, Guang; Wu, Changshun; Jiang, Peng

    2016-01-01

    Total hip arthroplasty (THA) is a common procedure for the treatment of end-stage hip joint disease, and the demand for revision THA will double by 2026. Ti6Al4V (Titanium, 6% Aluminum, and 4% Vanadium) is a kind of alloy commonly used to make hip prothesis. To promote the osseointegration between the prothesis and host bone is very important for the revision THA. The peptide Arg-Gly-Asp (RGD) could increase cell attachment and has been used in the vascular tissue engineering. In this study, we combined the RGD with Ti6Al4V alloy using the covalent cross-linking method to fabricate the functional Ti6Al4V alloy (FTA). The distribution of RGD oligopeptide on the FTA was even and homogeneous. The FTA scaffolds could promote mouse osteoblasts adhesion and spreading. Furthermore, the result of RT-qPCR indicated that the FTA scaffolds were more beneficial to osteogenesis, which may be due to the improvement of osteoblast adhesion by the RGD oligopeptide coated on FTA. Overall, the FTA scaffolds developed herein pave the road for designing and building more efficient prothesis for osseointegration between the host bone and prothesis in revision THA. PMID:27493968

  15. The vertical hip fracture – a treatment challenge. A cohort study with an up to 9 year follow-up of 137 consecutive hips treated with sliding hip screw and antirotation screw

    Directory of Open Access Journals (Sweden)

    Enocson Anders

    2012-09-01

    Full Text Available Abstract Background Femoral neck fractures with a vertical orientation have been associated with an increased risk for failure as they are both axial and rotational unstable and experience increased shear forces compared to the conventional and more horizontally oriented femoral neck fractures. The purpose of this study was to analyse outcome and risk factors for reoperation of these uncommon fractures. Methods A cohort study with a consecutive series of 137 hips suffering from a vertical hip fracture, treated with one method: a sliding hips screw with plate and an antirotation screw. Median follow-up time was 4.8 years. Reoperation data was validated against the National Board of Health and Welfare’s national registry using the unique Swedish personal identification number. Results The total reoperation rate was 18%. After multivariable Logistic regression analysis adjusting for possible confounding factors there was an increased risk for reoperation for displaced fractures (22% compared to undisplaced fractures (3%, and for fractures with poor implant position (38% compared to fractures with adequate implant position (15%. Conclusions The reoperation rate was high, and special attention should be given to achieve an appropriate position of the implant.

  16. A Comparison of Clinical Outcomes After Unilateral or Bilateral Hip Arthroscopic Surgery: Age- and Sex-Matched Cohort Study.

    Science.gov (United States)

    Kuhns, Benjamin D; Hannon, Charles P; Makhni, Eric C; Alter, Jennifer; Mather, Richard C; Salata, Michael J; Nho, Shane J

    2017-11-01

    A significant number of patients undergoing hip arthroscopic surgery for femoroacetabular impingement (FAI) have bilateral deformities and may require surgery for both hips. To compare outcomes between patients who underwent bilateral hip arthroscopic surgery to a matched cohort of patients who underwent unilateral hip arthroscopic surgery. Cohort study; Level of evidence, 3. A consecutive series of patients who underwent primary hip arthroscopic surgery for FAI by a single fellowship-trained surgeon from January 2012 to January 2014 and had a minimum follow-up of 2 years were evaluated. Patients who underwent staged bilateral hip arthroscopic surgery were identified and matched 1:2 to patients who underwent unilateral hip arthroscopic surgery based on age, sex, and body mass index (BMI). Demographic, preoperative, and postoperative variables were compared between the groups. Forty-three patients in the bilateral group were matched with 86 patients in the unilateral group based on sex (24 female [56%] vs 48 female [56%], respectively; P > .99), age (28.6 ± 10.8 years vs 28.9 ± 10.8 years, respectively; P = .88), and BMI (24.8 ± 5.8 kg/m2 vs 24.8 ± 4.0 kg/m2, respectively; P = .98). There were no significant preoperative demographic or radiographic differences between the groups. Both groups demonstrated significant preoperative to postoperative improvements in the Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports Subscale (HOS-SS), and modified Harris Hip Score (mHHS) ( P arthroscopic surgery had less improvement in mHHS and pain scores. Sixty-five (76%) patients in the unilateral group achieved the minimum clinically important difference (MCID) for the mHHS compared with 21 (49%) in the bilateral group ( P = .03), while 64 (74%) patients achieved the patient acceptable symptomatic state (PASS) for the mHHS compared with 22 (51%) in the bilateral group ( P = .02). Patients in the bilateral group with greater than 10 months between

  17. A Genetic Predictive Model for Canine Hip Dysplasia : Integration of Genome Wide Association Study (GWAS) and Candidate Gene Approaches

    OpenAIRE

    Nerea Bartolomé; Sergi Segarra; Marta Artieda; Olga Francino; Elisenda Sánchez; Magdalena Szczypiorska; Joaquim Casellas; Diego Tejedor; Joaquín Cerdeira; Antonio Martínez; Alfonso Velasco; Armand Sánchez

    2015-01-01

    Canine hip dysplasia is one of the most prevalent developmental orthopedic diseases in dogs worldwide. Unfortunately, the success of eradication programs against this disease based on radiographic diagnosis is low. Adding the use of diagnostic genetic tools to the current phenotype-based approach might be beneficial. The aim of this study was to develop a genetic prognostic test for early diagnosis of hip dysplasia in Labrador Retrievers. To develop our DNA test, 775 Labrador Retrievers were ...

  18. Associations between weather conditions and clinical symptoms in patients with hip osteoarthritis: a 2-year cohort study.

    Science.gov (United States)

    Dorleijn, Desirée M J; Luijsterburg, Pim A J; Burdorf, Alex; Rozendaal, Rianne M; Verhaar, Jan A N; Bos, Pieter K; Bierma-Zeinstra, Sita M A

    2014-04-01

    The goal of this study was to assess whether there is an association between ambient weather conditions and patients' clinical symptoms in patients with hip osteoarthritis (OA). The design was a cohort study with a 2-year follow-up and 3-monthly measurements and prospectively collected data on weather variables. The study population consisted of 222 primary care patients with hip OA. Weather variables included temperature, wind speed, total amount of sun hours, precipitation, barometric pressure, and relative humidity. The primary outcomes were severity of hip pain and hip disability as measured with the Western Ontario and McMasters University Osteoarthritis Index (WOMAC) pain and function subscales. Associations between hip pain and hip disability and the weather variables were assessed using crude and multivariate adjusted linear mixed-model analysis for repeated measurements. On the day of questionnaire completion, mean relative humidity was associated with WOMAC pain (estimate 0.1; 95% confidence interval=0.0-0.2; P=.02). Relative humidity contributed weather variables were not associated with the WOMAC pain or function score. Our results support the general opinion of OA patients that barometric pressure and relative humidity influence perceived OA symptoms. However, the contribution of these weather variables (< or = 1%) to the severity of OA symptoms is not considered to be clinically relevant. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  19. Danish, national cross-sectional observational study on the prevalence of prior major osteoporotic fractures in adults presenting with hip fracture—limitations and scope for fracture liaison services in prevention of hip fracture

    DEFF Research Database (Denmark)

    Frederiksen, A.; Abrahamsen, B.; Johansen, P. B.

    2018-01-01

    . Identification of vertebral fractures in particular is lacking. Introduction: The purpose of this study was to examine the prevalence of prior major osteoporotic fractures (MOF) in the prior 10 years preceding hip fracture in order to provide information about the potential for prevention of hip fractures...... if occurring more than 6 months before the present fracture. Results: A total of 28% of hip fracture patients (32% of women and 19% of men) had at least one recognized MOF in the preceding 10 years. Forearm and humerus fractures constituted > 70% of prior MOF. In both genders, vertebral fractures only...... represented a small percentage (2.6%) of previously recognized MOF. Men were less likely than women to have experienced a prior MOF, chiefly due to fewer forearm and humerus fractures. Conclusion: The majority of hip fractures—and in particular hip fractures in men—occur without a previously treated MOF...

  20. Magnitude and consequences of misclassification of incident hip fractures in large cohort studies: the Study of Osteoporotic Fractures and Medicare claims data.

    Science.gov (United States)

    Schousboe, J T; Paudel, M L; Taylor, B C; Virnig, B A; Cauley, J A; Curtis, J R; Ensrud, K E

    2013-03-01

    In the Study of Osteoporotic Fractures (SOF), 18.5 % of incident hip fractures identified in Medicare Fee-for-Service claims data were not reported to or confirmed by the cohort. Cognitive impairment was a modest risk factor for false-negative hip fracture ascertainment via self-report. Prospective cohort studies of fractures that rely on participant self-report to be the initial signal of an incident fracture could be prone to bias if a significant proportion of fractures are not self-reported. We used data from the SOF merged with Medicare Fee-for-Service claims data to estimate the proportion of participants who had an incident hip fracture identified in Medicare claims that was either not self-reported or confirmed (by review of radiographic reports) in SOF. Between 1/1/1991 and 12/31/2007, 647 SOF participants had a hip fracture identified in Medicare claims, but 120 (18.5 %) were either not reported to or confirmed by the cohort. False-negative hip fracture ascertainment was associated with a reduced modified Mini-Mental State Exam (MMSE) score (odds ratio 1.31 per SD decrease, 95 % C.I. 1.06-1.63). Point estimates of associations of predictors of incident hip fracture were changed minimally when the misclassification of incident hip fracture status was corrected with use of claims data. A substantial minority of incident hip fractures were not reported to or confirmed in the SOF. Cognitive impairment was modestly associated with false-negative hip fracture ascertainment. While there was no evidence to suggest that misclassification of incident hip fracture status resulted in biased associations of potential predictors with hip fracture in this study, false-negative incident fracture ascertainment in smaller cohort studies with limited power may increase the risk of type 2 error (not finding significant associations of predictors with incident fractures).

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  2. [Reproduction of the anatomy (offset, CCD, leg length) with a modern short stem hip design--a radiological study].

    Science.gov (United States)

    Jerosch, J; Grasselli, C; Kothny, P C; Litzkow, D; Hennecke, T

    2012-02-01

    The purpose of the study was to analyse different parameters before and after implantation of a modern short-stem hip design. In this prospective radiological study 250 consecutive hips with degenerative hip osteoarthritis were included (246 patients). The patients were operated by five different surgeons at 4 different hospitals and a metadiaphysial fixed short-stem prothesis (Mini Hip, Corin) was used. Standardised X-rays were performed with the same technique pre- and postoperatively in all patients. Different anatomic parameters of the hip were documented by using the pre- and postoperative Xrays (ofset, CCD angle, length of leg). All measurements were performed by an independent examiner. The 246 patients included 129 females and 117 males. The average age of the patients was 59.7 years (range: 27-82 years). The offset only changed by + 0.28 cm (SD: 0.45 cm) after surgery. We could document only a small decrease of -0.51° (SD: 4.10°) of the CCD angle. The length of the leg increased on average by + 0.09 cm (SD: 0.34 cm). We found no difference between the measurements of female and male patients. Conspicuous was also the increasing use of small protheses (size 2) for hips with a small CCD angle and the increasing implantation of large protheses (size 9) in hips with a high CCD angle. Our results showed that we could reconstruct the individual geometry of the hip quite well by using the metadiaphysial short-stem prothesis. The tendency of an increasing CCD angle and a decrease of the offset seems not to be existent with the design of this kind of short-stem prothesis. © Georg Thieme Verlag KG Stuttgart · New York.

  3. A genetic predictive model for canine hip dysplasia: integration of Genome Wide Association Study (GWAS) and candidate gene approaches.

    Science.gov (United States)

    Bartolomé, Nerea; Segarra, Sergi; Artieda, Marta; Francino, Olga; Sánchez, Elisenda; Szczypiorska, Magdalena; Casellas, Joaquim; Tejedor, Diego; Cerdeira, Joaquín; Martínez, Antonio; Velasco, Alfonso; Sánchez, Armand

    2015-01-01

    Canine hip dysplasia is one of the most prevalent developmental orthopedic diseases in dogs worldwide. Unfortunately, the success of eradication programs against this disease based on radiographic diagnosis is low. Adding the use of diagnostic genetic tools to the current phenotype-based approach might be beneficial. The aim of this study was to develop a genetic prognostic test for early diagnosis of hip dysplasia in Labrador Retrievers. To develop our DNA test, 775 Labrador Retrievers were recruited. For each dog, a blood sample and a ventrodorsal hip radiograph were taken. Dogs were divided into two groups according to their FCI hip score: control (A/B) and case (D/E). C dogs were not included in the sample. Genetic characterization combining a GWAS and a candidate gene strategy using SNPs allowed a case-control population association study. A mathematical model which included 7 SNPs was developed using logistic regression. The model showed a good accuracy (Area under the ROC curve = 0.85) and was validated in an independent population of 114 dogs. This prognostic genetic test represents a useful tool for choosing the most appropriate therapeutic approach once genetic predisposition to hip dysplasia is known. Therefore, it allows a more individualized management of the disease. It is also applicable during genetic selection processes, since breeders can benefit from the information given by this test as soon as a blood sample can be collected, and act accordingly. In the authors' opinion, a shift towards genomic screening might importantly contribute to reducing canine hip dysplasia in the future. In conclusion, based on genetic and radiographic information from Labrador Retrievers with hip dysplasia, we developed an accurate predictive genetic test for early diagnosis of hip dysplasia in Labrador Retrievers. However, further research is warranted in order to evaluate the validity of this genetic test in other dog breeds.

  4. A genetic predictive model for canine hip dysplasia: integration of Genome Wide Association Study (GWAS and candidate gene approaches.

    Directory of Open Access Journals (Sweden)

    Nerea Bartolomé

    Full Text Available Canine hip dysplasia is one of the most prevalent developmental orthopedic diseases in dogs worldwide. Unfortunately, the success of eradication programs against this disease based on radiographic diagnosis is low. Adding the use of diagnostic genetic tools to the current phenotype-based approach might be beneficial. The aim of this study was to develop a genetic prognostic test for early diagnosis of hip dysplasia in Labrador Retrievers. To develop our DNA test, 775 Labrador Retrievers were recruited. For each dog, a blood sample and a ventrodorsal hip radiograph were taken. Dogs were divided into two groups according to their FCI hip score: control (A/B and case (D/E. C dogs were not included in the sample. Genetic characterization combining a GWAS and a candidate gene strategy using SNPs allowed a case-control population association study. A mathematical model which included 7 SNPs was developed using logistic regression. The model showed a good accuracy (Area under the ROC curve = 0.85 and was validated in an independent population of 114 dogs. This prognostic genetic test represents a useful tool for choosing the most appropriate therapeutic approach once genetic predisposition to hip dysplasia is known. Therefore, it allows a more individualized management of the disease. It is also applicable during genetic selection processes, since breeders can benefit from the information given by this test as soon as a blood sample can be collected, and act accordingly. In the authors' opinion, a shift towards genomic screening might importantly contribute to reducing canine hip dysplasia in the future. In conclusion, based on genetic and radiographic information from Labrador Retrievers with hip dysplasia, we developed an accurate predictive genetic test for early diagnosis of hip dysplasia in Labrador Retrievers. However, further research is warranted in order to evaluate the validity of this genetic test in other dog breeds.

  5. [Hip fracture as risk factor for mortality in patients over 65 years of age. Case-control study].

    Science.gov (United States)

    Negrete-Corona, J; Alvarado-Soriano, J C; Reyes-Santiago, L A

    2014-01-01

    Hip fracture among older patients is a devastating injury in most cases. It profoundly affects the physical, mental, functional and social balance that patients used to have and, beyond the orthopedic injury, it reflects the aging process and its dire consequences. Some reports show that up to 50% of patients with hip fracture die within six months and many of those who survive do not recover their baseline independence and function. In recent decades the increase in life expectancy after 60 years of age has led to an exponential growth in hip fractures. This is why it is essential to determine the patient-related and environmental factors leading to the increased mortality rates seen in patients with hip fracture, to improve the survival and quality of life of older adults. The objective was to determine the association between hip fracture and mortality in patients over 65 years of age. An observational, longitudinal, retrospective, descriptive, comparative case-control study was conducted. The clinical records of all patients over 65 years of age admitted to the Orthopedics Service, Hospital Regional , ISSSTE, with a diagnosis of hip fracture during the previous 12 months were analyzed, regardless of the type of fracture and treatment they received. A group of patients without hip fracture was used as control group. Total sample size was 50 patients with hip fracture and 50 patients without hip fracture. The following data were collected in data collection forms: age, sex, time elapsed since the fracture, survival at one year and, in the case of deceased patients, the cause of death (pneumonia, sepsis, arrhythmia, hydroelectrolytic imbalance, heart failure and others). The results obtained are shown as tables and charts to facilitate their visual understanding. Patient demographics show that there were 40 (80%) female patients and 10 (20%) male patients with a diagnosis of hip fracture. The control group included 35 (70%) females and 15 (30) males. An

  6. Predicting Future Hip Fractures on Routine Abdominal CT Using Opportunistic Osteoporosis Screening Measures: A Matched Case-Control Study.

    Science.gov (United States)

    Lee, Scott J; Anderson, Paul A; Pickhardt, Perry J

    2017-08-01

    Hip fracture is a major consequence of low bone mineral density, which is treatable but underdiagnosed. The purpose of this case-control study is to determine whether lumbar vertebral trabecular attenuation, vertebral compression fractures, and femoral neck T scores readily derived from abdominopelvic CT scans obtained for various indications are associated with future hip fragility fracture. A cohort of 204 patients with hip fracture (130 women and 74 men; mean age, 74.3 years) who had undergone abdominopelvic CT before fracture occurred (mean interval, 24.8 months) was compared with an age- and sex-matched control cohort without hip fracture. L1 trabecular attenuation, vertebral compression fractures of grades 2 and 3, and femoral neck T scores derived from asynchronous quantitative CT were recorded. The presence of one or more clinical risk factor for fracture was also recorded. Multivariate logistic regression models were used to determine the association of each measurement with the occurrence of hip fracture. The mean L1 trabecular attenuation value, the presence of one or more vertebral compression fracture, and CT-derived femoral neck T scores were all significantly different in patients with hip fracture versus control subjects (p hip fracture outcome after adjustments were made for age, sex, and the presence of one or more clinical risk factor. L1 trabecular attenuation and CT-derived femoral neck T scores showed moderate accuracy in differentiating case and control patients (AUC, 0.70 and 0.78, respectively). L1 trabecular attenuation, CT-derived femoral neck T scores, and the presence of at least one vertebral compression fracture on CT are all associated with future hip fragility fracture in adults undergoing routine abdominopelvic CT for a variety of conditions.

  7. Risk Factors for Hip Fracture in Older Men: The Osteoporotic Fractures in Men Study (MrOS).

    Science.gov (United States)

    Cauley, Jane A; Cawthon, Peggy M; Peters, Katherine E; Cummings, Steven R; Ensrud, Kristine E; Bauer, Douglas C; Taylor, Brent C; Shikany, James M; Hoffman, Andrew R; Lane, Nancy E; Kado, Deborah M; Stefanick, Marcia L; Orwoll, Eric S

    2016-10-01

    Almost 30% of hip fractures occur in men; the mortality, morbidity, and loss of independence after hip fractures are greater in men than in women. To comprehensively evaluate risk factors for hip fracture in older men, we performed a prospective study of 5994 men, primarily white, age 65+ years recruited at six US clinical centers. During a mean of 8.6 years of 97% complete follow-up, 178 men experienced incident hip fractures. Information on risk factors including femoral neck bone mineral density (FNBMD) was obtained at the baseline visit. Cox proportional hazards models were used to calculate the hazard ratio (HR) with 95% confidence intervals; Fine and Gray models adjusted for competing mortality risk. Older age (≥75 years), low FNBMD, currently smoking, greater height and height loss since age 25 years, history of fracture, use of tricyclic antidepressants, history of myocardial infarction or angina, hyperthyroidism or Parkinson's disease, lower protein intake, and lower executive function were all associated with an increased hip fracture risk. Further adjustment for competing mortality attenuated HR for smoking, hyperthyroidism, and Parkinson's disease. The incidence rate of hip fracture per 1000 person-years (PY) was greatest in men with FNBMD T-scores hip fracture at rates of 14.52 versus 0.88 per 1000 PY in men age hip fracture. Many of these assessments can easily be incorporated into routine clinical practice and may lead to improved risk stratification. © 2016 American Society for Bone and Mineral Research. © 2016 American Society for Bone and Mineral Research.

  8. Computed tomography compared to magnetic resonance imaging in occult or suspect hip fractures. A retrospective study in 44 patients

    Energy Technology Data Exchange (ETDEWEB)

    Collin, David; Goethlin, Jan H. [Sahlgrenska University Hospital, Department of Radiology, Moelndal (Sweden); Geijer, Mats [Lund University, Department of Medical Imaging and Physiology, Skaane University Hospital, Lund (Sweden)

    2016-11-15

    Computed tomography (CT) for evaluation of occult and suspect hip fractures has been proposed as a good second-line investigation. The diagnostic precision compared to magnetic resonance imaging (MRI) is unclear. To compare the diagnostic performance of CT and MRI in a retrospective study on patients with suspect and occult hip fractures. Forty-four elderly consecutive patients with low-energy trauma to the hip were identified where negative or suspect CT was followed by MRI. Primary reporting and review by two observers as well as the diagnostic performance of the two modalities were compared. Surgical treatment and clinical course were used as outcomes. Compared to the primary reports, the CT reviewers found fewer normal and no suspect cases. MRI changed the primary diagnoses in 27 cases, and in 14 and 15 cases, respectively, at review. There was no disagreement on MRI diagnoses. In our patient population, MRI was deemed a more reliable modality for hip fracture diagnosis in comparison to CT. For clinical decision making, MRI seems to have a higher accuracy than CT. A negative CT finding cannot completely rule out a hip fracture in patients where clinical findings of hip fracture persevere. (orig.)

  9. Conducting Simulation Studies in Psychometrics

    Science.gov (United States)

    Feinberg, Richard A.; Rubright, Jonathan D.

    2016-01-01

    Simulation studies are fundamental to psychometric discourse and play a crucial role in operational and academic research. Yet, resources for psychometricians interested in conducting simulations are scarce. This Instructional Topics in Educational Measurement Series (ITEMS) module is meant to address this deficiency by providing a comprehensive…

  10. Danish Hip Arthroscopy Registry

    DEFF Research Database (Denmark)

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

    2016-01-01

    Danish Hip Arthroscopy Registry (DHAR) was initiated in 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the epidemiologic and perioperative data of the first 2000 procedures in a Danish hip arthroscopy population and to describe the development of DH...

  11. Feasibility of day-case total hip arthroplasty: a single-centre observational study.

    Science.gov (United States)

    Larsen, Jens Rolighed; Skovgaard, Birgitte; Prynø, Thomas; Bendikas, Laimonas; Mikkelsen, Lone R; Laursen, Malene; Høybye, Mette T; Mikkelsen, Søren; Jørgensen, Lene Bastrup

    2017-02-21

    Recent reports indicate that total hip arthroplasty (THA) can be further accelerated and might be managed as day-case. This could provide benefits to health care expenditure, lower patient risks and change patient satisfaction. We evaluated the feasibility, efficacy, safety and patient satisfaction of same-day (study. THA was managed as day-case (case THA. Safety, complications and overall patient acceptance were satisfactory. Light spinal anaesthesia facilitated quick transit through postanaesthesia care unit to early mobilisation. Support persons and patient education may play a part in high patient acceptance of day-case surgery.

  12. Is excessive running predictive of degenerative hip disease? Controlled study of former elite athletes.

    OpenAIRE

    Marti, B.; Knobloch, M; Tschopp, A; Jucker, A.; Howald, H.

    1989-01-01

    OBJECTIVE--To determine the effects of regular long distance running on the state of the hips in later life. DESIGN--Retrospective study of a cohort of elite athletes and a group of normal, healthy, untrained controls examined 15 years after initial testing. SETTING--Research project at school for physical education and sports. SUBJECTS--27 Former long distance runners (mean age 42), nine former bobsleigh riders (mean age 42), and 23 normal, healthy, untrained men (mean age 35) who had been e...

  13. Sarcopenia in patients with hip fracture: A multicenter cross-sectional study.

    Science.gov (United States)

    Steihaug, Ole Martin; Gjesdal, Clara Gram; Bogen, Bård; Kristoffersen, Målfrid Holen; Lien, Gunhild; Ranhoff, Anette Hylen

    2017-01-01

    Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a) the feasibility of determining sarcopenia in patients with acute hip fracture, b) the prevalence of sarcopenia and c) associations of sarcopenia with nutritional status and comorbidities. A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory and living in the community. Sarcopenia was assessed postoperatively with muscle mass estimated by anthropometry using triceps skinfold, arm circumference, height, weight and sex. Grip strength was measured by Jamar dynamometer and pre-fracture mobility was by self-report using the New Mobility Score. Out of 282 patients, 202 were assessed for sarcopenia of whom 74 (37%) were diagnosed as sarcopenic. Sarcopenia was associated with age, odds ratio (OR) 1.4 per 5 years, 95% confidence interval (CI) [1.1, 1.8], ASA Physical Status Classification System score, OR 2.3 per point, 95% CI [1.3, 4.3] and number of medications at discharge, OR 1.2 per medication, 95% CI [1.0, 1.3] and inversely associated with BMI, OR 0.8, 95% CI [0.7, 0.9] and serum albumin, OR 0.9, 95% CI [0.8,1.0]. Thirty-seven percent of assessed subjects were diagnosed with sarcopenia. Our data demonstrates that the prevalence of sarcopenia is associated with older age, malnutrition and comorbidities. Determining sarcopenia at the bedside was feasible in postoperative hip fracture patients by using grip strength, estimation of muscle mass by anthropometry and self-reported mobility.

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

    NARCIS (Netherlands)

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

    2000-01-01

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

  15. [Functional capabilities of users of mobility devices after femoral hip fracture. A comparison study].

    Science.gov (United States)

    Mischker, A; Steinhagen-Thiessen, E

    2010-10-01

    The present study investigates the functional skills and capabilities of a sample of 105 patients treated at the Lutheran Geriatric Center Berlin after a hip fracture during a period of two years between 2004 and 2006. Geriatric assessment instruments (Barthel index, Instrumental Activities of Daily Living Scale (IADL), Timed Up & Go (TUG), Tinetti, grip strength, Geriatric Depression Scale (GDS)) were implemented to measure the functional capabilities in this prospective study. The subjects were divided into three groups, characterized by the type of mobility device they used: crutches, a four-wheeled walker, or a wheel chair. Furthermore, the data were measured at three test intervals (t(0:): baseline before discharge, t(1): 4 weeks after discharge, t(2): 4 months after discharge). The results of the study differ significantly for each of the three groups at the different test intervals (Barthel index, IADL, TUG, Tinetti, grip strength, all pTinetti, grip strength, IADL, TUG, p≤0.05, general linear model). The results of the study differ significantly for each of the three groups at the different test intervals (Barthel index, IADL, TUG, Tinetti, grip strength, all p Tinetti, grip strength, IADL, TUG, p≤0.001, general linear model) A group-specific approach, based on the mobility devices used, allowed for better differentiation of functional capabilities after femoral hip fracture.

  16. TREATMENT OF HIP DYSPLASIA

    Directory of Open Access Journals (Sweden)

    Iulian ICLEANU

    2015-11-01

    Full Text Available In this thesis, our purpose is to show that using physiotherapy on patients with hip dysplasia from the very beginning, in the first months of life, helps treating them faster. Common literature proposes to use physiotherapy on patients with hip dysplasia either after their recovery or in the terminal phase of recovery, claiming that any earlier intervention will prolong the hip recovery. The effects of hip dysplasia reflect over the whole musculoskeletal system, while it hinders the knees (genu valgum, the ankles (ankle valgus, calcaneal valgus and the spine (scoliosis especially at the lumbar level. The most spectacular are at the hip level, that is why we made an analytical evaluation only for this joint. To show the importance of physiotherapy for children with hip dysplasia we started from the hypothesis: untimely treatment for children with hip dysplasia has improved results in functional recovery and in obtaining a better stability, without the necessity of orthopedics or surgical interventions. The research methods used in this study are: the observation method, the bibliographic study method, the experimental method, the graphics method and the statistical mathematical method to process the data and to represent the results graphically. In the end, the results obtained are significantly different from the initial evaluations and we came to the conclusion that starting an untimely analytical kinetic treatment and globally personalizing it to every patient improves stability and biomechanical parameters for the hip.

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

    Science.gov (United States)

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

    2009-02-23

    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. 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. 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. NTR1053.

  18. Sagittal Plane Hip, Knee, and Ankle Biomechanics and the Risk of Anterior Cruciate Ligament Injury: A Prospective Study.

    Science.gov (United States)

    Leppänen, Mari; Pasanen, Kati; Krosshaug, Tron; Kannus, Pekka; Vasankari, Tommi; Kujala, Urho M; Bahr, Roald; Perttunen, Jarmo; Parkkari, Jari

    2017-12-01

    Stiff landings with less knee flexion and high vertical ground-reaction forces have been shown to be associated with an increased risk of anterior cruciate ligament (ACL) injury. The literature on the association between other sagittal plane measures and the risk of ACL injuries with a prospective study design is lacking. To investigate the relationship between selected sagittal plane hip, knee, and ankle biomechanics and the risk of ACL injury in young female team-sport athletes. Case-control study; Level of evidence, 3. A total of 171 female basketball and floorball athletes (age range, 12-21 years) participated in a vertical drop jump test using 3-dimensional motion analysis. All new ACL injuries, as well as match and training exposure data, were recorded for 1 to 3 years. Biomechanical variables, including hip and ankle flexion at initial contact (IC), hip and ankle ranges of motion (ROMs), and peak external knee and hip flexion moments, were selected for analysis. Cox regression models were used to calculate hazard ratios (HRs) with 95% CIs. The combined sensitivity and specificity of significant test variables were assessed using a receiver operating characteristic (ROC) curve analysis. A total of 15 noncontact ACL injuries were recorded during follow-up (0.2 injuries/1000 player-hours). Of the variables investigated, landing with less hip flexion ROM (HR for each 10° increase in hip ROM, 0.61 [95% CI, 0.38-0.99]; P sport players. Studies with larger populations are needed to confirm these findings and to determine the role of ankle flexion ROM as a risk factor for ACL injury. Increasing knee and hip flexion ROMs to produce soft landings might reduce knee loading and risk of ACL injury in young female athletes.

  19. 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

  20. Association of 25-hydroxyvitamin D with prevalent osteoarthritis of the hip in elderly men: the osteoporotic fractures in men study.

    Science.gov (United States)

    Chaganti, R K; Parimi, N; Cawthon, P; Dam, T L; Nevitt, M C; Lane, N E

    2010-02-01

    To examine the cross-sectional association of serum levels of 25-hydroxyvitamin D, or 25(OH)D, with prevalent radiographic hip osteoarthritis (OA) in elderly men. In a cohort of 1,104 elderly men from the Osteoporotic Fractures in Men Study, 25(OH)D serum levels were determined by mass spectrometry, followed by pelvic radiographs approximately 4.6 years later. Categories of vitamin D levels were defined as follows: deficiency as 30 ng/ml. Radiographs were assessed for severity of hip OA using a summary grade of 0-4 for individual features of hip OA. Logistic regression was used to assess associations of serum 25(OH)D levels with prevalent radiographic hip OA; covariates included age, clinic site, season at the time of blood withdrawal, self-reported hip pain for >30 days, timed 6-meter walk, presence of at least 1 coexisting condition, and self-rated health status. Men with radiographic hip OA had a slower 6-meter walking time (P vitamin D level (P = 0.0002), and had a higher prevalence of vitamin D insufficiency (P = 0.002) and vitamin D deficiency (P = 0.012) compared with controls. Higher 25(OH)D levels were associated with a lower prevalence of radiographic hip OA (odds ratio [OR] 1.39 per 1 SD decrease in 25[OH]D, 95% confidence interval [95% CI] 1.11-1.74) after adjusting for age, season, and clinic site. Men with vitamin D insufficiency had an increased likelihood of prevalent radiographic hip OA (OR 2.19, 95% CI 1.21-3.97) compared with men with sufficient levels of 25(OH)D, and in men with vitamin D deficiency, there was a tendency toward an increased likelihood of radiographic hip OA (OR 1.99, 95% CI 0.83-4.74). Men with vitamin D deficiencies are twice as likely to have prevalent radiographic hip OA, and therefore vitamin D therapy to augment skeletal health in the elderly is warranted.

  1. Mechanical testing of different hip protectors according to a European Standard.

    Science.gov (United States)

    Holzer, Lukas A; von Skrbensky, Gobert; Holzer, Gerold

    2009-11-01

    The effect of hip protectors depends on two factors: (1) mechanical features and (2) wearing time, which depends on the user's compliance. Various biomechanical studies have been performed to test hip protectors' ability in reducing impacts. However, none of these has shown the ability to simulate a fall in a natural way. Therefore, we tested conventional and newly designed hip protectors that might raise user's compliance using a standardised mechanical test. Mechanical testing was performed according to a European Standard testing method for protective impact clothing (EN 1621-1) where an impact is released vertically onto the hip protectors with an energy of 50J. Seven different hip protectors were tested three times each. Using this test, four of the hip protectors were able to reduce the impact below a suggested fracture threshold. The two newly designed hip protectors using special absorption materials were superior (9.10kN, 12.65kN) to the other commercially available hip protectors (21.97-50.62kN), which differ in their mechanical testing performance. This is the first study using a standardised mechanical test on hip protectors and allows an objective comparison because only mechanical properties are tested. New hip protectors with improved mechanical properties are superior to conventional hip protectors. Furthermore, they allow a more appealing design that increases the comfort of the wearer. Mechanical testing should be performed as a first step and has to be followed up by clinical trials to determine and clarify their overall effect.

  2. The cost of infection in hip arthroplasty: a matched case-control study.

    Science.gov (United States)

    González-Vélez, A E; Romero-Martín, M; Villanueva-Orbaiz, R; Díaz-Agero-Pérez, C; Robustillo-Rodela, A; Monge-Jodra, V

    2016-01-01

    Surgical site infection (SSI) represents 30% of all causes of health care-associated infection (HAI) and is one of the most dreaded complications in surgical patients. We estimated the excess direct costs of SSI using a matched nested case-control study in acute-term care at Ramon y Cajal University Hospital in Spain. Cases were patients who developed a first episode of SSI according to the criteria established by the CDC's National Healthcare Safety Network. Controls were matched to cases in 1:1 ratio taking into account the American Society of Anesthesiologists score, age, sex, surgery date, and principal diagnosis. This study found that infection in hip replacement increased direct costs by 134%. Likewise, the excess cost due to the infections caused by methicillin resistant Staphylococcus aureus was 69% higher than the excess cost attributable to infections caused by other microorganisms. SSI after hip replacement continues to be a costly complication from the hospital perspective. Costs due to SSI can be used to prioritise preventive interventions to monitor and control HAI. Copyright © 2016 SECOT. Published by Elsevier Espana. All rights reserved.

  3. The effects of necrotic lesion size and orientation of the femoral component on stress alterations in the proximal femur in hip resurfacing - a finite element simulation.

    Science.gov (United States)

    Tai, Ching-Lung; Chen, Yung-Chou; Hsieh, Pang-Hsin

    2014-08-05

    Due to the advantages of its bone-conserving nature, hip resurface arthroplasty (HRA) has recently gained the interest of orthopedic surgeons for the treatment of young and active patients who have osteonerosis of the femoral head. However, in long-term follow-up studies after HRA, narrowing of the femoral neck has often been found, which may lead to fracture. This phenomenon has been attributed to the stress alteration (stress shielding). Studies addressing the effects of necrotic size and the orientation of the implant on stress alterations are lacking. Computed tomography images of a standard composite femur were used to create a three-dimensional finite-element (FE) intact femur model. Based on the intact model, FE models simulating four different levels of necrotic regions (0°, 60°, 100°, 115°) and three different implant insertion angles (varus 10°, neutral, valgus 10°) were created. The von Mises stress distributions and the displacement of the stem tip of each model were analyzed and compared for loading conditions that simulated a single-legged stance. Stress shielding occurred at the femoral neck after HRA. More severe stress shielding and an increased displacement of the stem tip were found for femoral heads that had a wider necrotic lesion. From a biomechanics perspective, the results were consistent with clinical evidence of femoral neck narrowing after HRA. In addition, a varus orientation of the implant resulted in a larger displacement of the stem tip, which could lead to an increased risk of implant loosening. A femoral head with a wide necrotic lesion combined with a varus orientation of the prosthesis increases the risk of femoral neck narrowing and implant loosening following HRA.

  4. Hip Fractures.

    Science.gov (United States)

    Ramponi, Denise R; Kaufmann, Judith; Drahnak, Gwendolen

    Hip fractures are associated with significant morbidity and mortality and a major health problem in the United States (). Eighty percent of hip fractures are experienced by 80-year-old women. Plain radiographs usually confirm the diagnosis, but if there is a high level of suspicion of an occult hip fracture, magnetic resonance imaging or bone scan is the next step to confirm the diagnosis. Areas of the hip bone have varied bone strength and blood supply, making the femoral neck one of the most vulnerable areas for fracture. A consultation to an orthopedic surgeon will determine surgical interventions.

  5. Influence of personality psychology on outcome of total hip arthroplasty: a cross-sectional study on 69 patients.

    Science.gov (United States)

    Trevisan, C L; Klumpp, R; Recalcati, W; Compagnoni, R

    2015-12-01

    Patient's satisfaction after total hip arthroplasty is influenced by many surgical and rehabilitation aspects, but is not available in the literature, a study that analyses the correlation between patient's psychology and clinical results of this procedure. The aim of this study was to investigate the relationship between memory of pain, clinical outcome and subjective satisfaction with the Multidimensional Health Locus of Control. We conducted a cross-sectional study on a cohort of 69 patients operated of total hip arthroplasty in our department from November 2008 to August 2011. Pre- and post-operative hip function was assessed by the Harris Hip Score. At the follow-up visit, patient satisfaction was assessed by means of the Patient Satisfaction Questionnaire. The memory of pain was evaluated by a modified questionnaire of pain experience. Multidimensional Health Locus of Control was evaluated in all patients, and results were connected with patient's subjective satisfaction and pain indexes. Patients were divided into two groups about patient satisfaction, those with GPS > 15 and those with GPS ≤ 15. Patients very satisfied showed a significantly higher mean value of IHLC. Regarding pain experience, patients were divided into two categories: those recalling less pain with OvP score ≤11 (Q1 11. IHLC score resulted significantly higher in patients recalling less pain. Multidimensional Health Locus of Control can be considered a predictor of patient's satisfaction after an invasive surgical procedure as total hip arthroplasty.

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

    Science.gov (United States)

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

    2014-12-01

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

  7. Early morbidity after aseptic revision hip arthroplasty in Denmark: a two-year nationwide study.

    Science.gov (United States)

    Lindberg-Larsen, M; Jørgensen, C C; Hansen, T B; Solgaard, S; Kehlet, H

    2014-11-01

    Data on early morbidity and complications after revision total hip replacement (THR) are limited. The aim of this nationwide study was to describe and quantify early morbidity after aseptic revision THR and relate the morbidity to the extent of the revision surgical procedure. We analysed all aseptic revision THRs from 1st October 2009 to 30th September 2011 using the Danish National Patient Registry, with additional information from the Danish Hip Arthroplasty Registry. There were 1553 procedures (1490 patients) performed in 40 centres and we divided them into total revisions, acetabular component revisions, femoral stem revisions and partial revisions. The mean age of the patients was 70.4 years (25 to 98) and the median hospital stay was five days (interquartile range 3 to 7). Within 90 days of surgery, the readmission rate was 18.3%, mortality rate 1.4%, re-operation rate 6.1%, dislocation rate 7.0% and infection rate 3.0%. There were no differences in these outcomes between high- and low-volume centres. Of all readmissions, 255 (63.9%) were due to 'surgical' complications versus 144 (36.1%) 'medical' complications. Importantly, we found no differences in early morbidity across the surgical subgroups, despite major differences in the extent and complexity of operations. However, dislocations and the resulting morbidity represent the major challenge for improvement in aseptic revision THR. ©2014 The British Editorial Society of Bone & Joint Surgery.

  8. A Multi-centre Study to Assess the Long-term Performance of the Summit™ Hip in Primary Total Hip Replacement

    Science.gov (United States)

    2016-08-03

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

    Science.gov (United States)

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

    2017-09-01

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

  11. A longitudinal study of quality of life and functional status in total hip and total knee replacement patients.

    Science.gov (United States)

    Mandzuk, Lynda L; McMillan, Diana E; Bohm, Eric R

    2015-05-01

    Primary total hip and primary total knee surgeries are commonly performed to improve patients' quality of life and functional status. This longitudinal retrospective study (N = 851) examined self-reported quality of life and functional status over the preoperative and postoperative periods: 12 months prior to surgery, one month prior to surgery and 12 months following surgery. A linear mixed effects model was used to analyze the changes in quality of life and functional status over the sampling period. Patients in the convenience sample reported improvements in quality of life and functional status utilizing the SF-12 and Oxford Hip and Oxford Knee, although differences were noted by procedure and gender. Total hip patients tended to demonstrate greater improvement than total knee patients and males reported higher levels of physical and mental quality of life as well as functional status when compared to females. Of particular note was that mental health scores were consistently lower in both total hip and total knee replacement patients across the perioperative period and up to one year postoperative. This study identifies an opportunity for health care providers to proactively address the mental health of total hip and total knee replacement patients throughout their joint replacement trajectory. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Adherence of hip and knee arthroplasty studies to RSA standardization guidelines. A systematic review.

    Science.gov (United States)

    Madanat, Rami; Mäkinen, Tatu J; Aro, Hannu T; Bragdon, Charles; Malchau, Henrik

    2014-09-01

    Guidelines for standardization of radiostereometry (RSA) of implants were published in 2005 to facilitate comparison of outcomes between various research groups. In this systematic review, we determined how well studies have adhered to these guidelines. We carried out a literature search to identify all articles published between January 2000 and December 2011 that used RSA in the evaluation of hip or knee prosthesis migration. 2 investigators independently evaluated each of the studies for adherence to the 13 individual guideline items. Since some of the 13 points included more than 1 criterion, studies were assessed on whether each point was fully met, partially met, or not met. 153 studies that met our inclusion criteria were identified. 61 of these were published before the guidelines were introduced (2000-2005) and 92 after the guidelines were introduced (2006-2011). The methodological quality of RSA studies clearly improved from 2000 to 2011. None of the studies fully met all 13 guidelines. Nearly half (43) of the studies published after the guidelines demonstrated a high methodological quality and adhered at least partially to 10 of the 13 guidelines, whereas less than one-fifth (11) of the studies published before the guidelines had the same methodological quality. Commonly unaddressed guideline items were related to imaging methodology, determination of precision from double examinations, and also mean error of rigid-body fitting and condition number cutoff levels. The guidelines have improved methodological reporting in RSA studies, but adherence to these guidelines is still relatively low. There is a need to update and clarify the guidelines for clinical hip and knee arthroplasty RSA studies.

  13. Adherence of hip and knee arthroplasty studies to RSA standardization guidelines

    Science.gov (United States)

    Mäkinen, Tatu J; Aro, Hannu T; Bragdon, Charles; Malchau, Henrik

    2014-01-01

    Background and purpose Guidelines for standardization of radiostereometry (RSA) of implants were published in 2005 to facilitate comparison of outcomes between various research groups. In this systematic review, we determined how well studies have adhered to these guidelines. Methods We carried out a literature search to identify all articles published between January 2000 and December 2011 that used RSA in the evaluation of hip or knee prosthesis migration. 2 investigators independently evaluated each of the studies for adherence to the 13 individual guideline items. Since some of the 13 points included more than 1 criterion, studies were assessed on whether each point was fully met, partially met, or not met. Results 153 studies that met our inclusion criteria were identified. 61 of these were published before the guidelines were introduced (2000–2005) and 92 after the guidelines were introduced (2006–2011). The methodological quality of RSA studies clearly improved from 2000 to 2011. None of the studies fully met all 13 guidelines. Nearly half (43) of the studies published after the guidelines demonstrated a high methodological quality and adhered at least partially to 10 of the 13 guidelines, whereas less than one-fifth (11) of the studies published before the guidelines had the same methodological quality. Commonly unaddressed guideline items were related to imaging methodology, determination of precision from double examinations, and also mean error of rigid-body fitting and condition number cutoff levels. Interpretation The guidelines have improved methodological reporting in RSA studies, but adherence to these guidelines is still relatively low. There is a need to update and clarify the guidelines for clinical hip and knee arthroplasty RSA studies. PMID:24954489

  14. Use of Oral Corticosteroids and Risk of Hip Fracture in the Elderly in a Case-Control Study

    Directory of Open Access Journals (Sweden)

    Shih-Wei Lai

    2017-09-01

    Full Text Available Aim: Little is known regarding the relationship between use of oral corticosteroids and hip fracture in the elderly in Taiwan. The aim of the study was to examine this issue.Methods: A retrospective population-based case-control study using the database of the Taiwan National Health Insurance Program (2000–2013 was conducted. We identified 4538 individuals aged ≥ 65 years with newly diagnosed hip fracture as the cases. We randomly selected 4538 individuals without hip fracture as the control subjects. The cases and the control subjects were matched with sex, age, comorbidities, and the year of index date. Individuals who never had a prescription for oral corticosteroids were defined as never use. Individuals who ever had at least one prescription for oral corticosteroids were defined as ever use. The odds ratio (OR and 95% confidence interval (CI of hip fracture associated with oral corticosteroids use was estimated by a multivariable unconditional logistic regression analysis.Results: After adjustments for potential confounding factors, the multivariable logistic regression model showed that the adjusted OR of hip fracture was 1.17 for individuals with ever use of oral corticosteroids (95%CI 1.08, 1.28, compared to those with never use of oral corticosteroids. An sub-analysis showed that for every 1-mg increase in cumulative dose of oral corticosteroids, the adjusted OR of hip fracture was 1.01 (95% CI 1.01, 1.02. The adjusted ORs were 1.31 (95% CI 1.17, 1.47 for cumulative exposure to oral corticosteroids ≥ 3 months and 1.09 (95% CI 0.98, 1.20 for cumulative exposure < 3 months.Conclusion: We conclude that oral corticosteroids use is associated with a trivial but statistically significant increase in risk of hip fracture in Taiwan. Additionally, the results suggest that there are dose-response and duration-response effects of oral corticosteroids on the risk of hip fracture. The results confirm our understanding of oral corticosteroid

  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. Parathyroid hormone response to severe vitamin D deficiency is sex associated: an observational study of 571 hip fracture inpatients.

    Science.gov (United States)

    Di Monaco, M; Castiglioni, C; Vallero, F; Di Monaco, R; Tappero, R

    2013-02-01

    To investigate the association between sex and parathyroid hormone response to severe vitamin D deficiency after hip fracture. Cross-sectional study. Rehabilitation hospital in Italy. 571 consecutive inpatients with hip fracture and severe vitamin D deficiency (serum 25-hydroxyvitamin D secondary hyperparathyroidism (serum PTH >75pg/ml) or functional hypoparathyroidism, i.e., inappropriate normal levels of PTH (≤75pg/ml). Among the 571 patients, 336 (59%) had functional hypoparathyroidism, whereas 235 (41%) had secondary hyperparathyroidism. PTH status was significantly different between sexes (p=0.003): we found functional hypoparathyroidism in 61% of women and 43% of men (secondary hyperparathyroidism in 39% of women and 57% of men). The significance of the between-sex difference was maintained after adjustment for age, estimated GFR, phosphate, albumin-adjusted total calcium, albumin, Barthel index scores, 25-hydroxyvitamin D, and hip fracture type (either cervical or trochanteric). The adjusted odds ratio was 1.85 (95%CI from 1.09 to 3.13; p=0.023). Data shows that PTH response to vitamin D deficiency was sex-associated following a fracture of the hip. The higher prevalence of secondary hyperparathyroidism may play a role in the known prognostic disadvantage found in hip-fracture men.

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    inconclusive. The present cross-sectional study investigated the relationship between reduced bone mineral density (BMD), as a surrogate parameter of endogenous estrogen status assessed by digital x-ray radiogrammetry, and reduced minimum hip joint space width (JSW). DESIGN: Standardized hand radiographs...... of the Copenhagen Osteoarthritis Study cohort of 3,913 adults (1,470 male/2,443 female) with a mean age of 60 years (range, 18-92) were analyzed using X-Posure digital software, version 2.0 (Sectra-Pronosco). The system is operator independent. From 1,200 individual measurements per radiograph, mean BMD...... was calculated. Minimum hip JSW was assessed on standardized pelvic radiographs. RESULTS: Digital x-ray radiogrammetry BMD decreased in both men and women after the age of 45 years, progressively more so in women. Although minimum hip JSW in men remained relatively unaltered throughout life, a marked decline...

  18. Validation of a 5-year risk score of hip fracture in postmenopausal women. The Danish Nurse Cohort Study

    DEFF Research Database (Denmark)

    Hundrup, Y A; Jacobsen, R K; Andreasen, A H

    2010-01-01

    of 61.4%. INTRODUCTION: A new score based on data from the WHI has been designed to predict 5-year risk of hip fracture in postmenopausal women. The performance of the algorithm has not been validated in populations with different lifestyle characteristics and ethnicity. The aim of this study......We evaluated the Women's Health Initiative (WHI) hip fracture risk score in 15,648 postmenopausal Danish nurses. The algorithm was well calibrated for Denmark. However, the sensitivity was poor at common decision making thresholds. Obtaining sensitivity better than 80% led to a low specificity...... was to test the clinical performance of the algorithm in a large Danish cohort of postmenopausal Caucasian women against hip fracture. METHODS: The Danish Nurse Cohort is a prospective risk factor and hormone therapy (HT) study established in 1993. Participants in the present analysis were 15...

  19. Does the addition of hip strengthening exercises improve outcomes following total knee arthroplasty? A study protocol for a randomized trial.

    Science.gov (United States)

    Schache, Margaret B; McClelland, Jodie A; Webster, Kate E

    2016-06-13

    Total knee arthroplasty (TKA) is effective in reducing pain and improving function for end-stage knee osteoarthritis. However, muscle weakness and functional limitations persist despite assistance from post-operative rehabilitation programs that traditionally focus on quadriceps strengthening and range of movement exercises. Hip abductor muscle weakness is evident in knee osteoarthritis and hip muscle strengthening reduces knee pain in this group. Following TKA, people with weak hip abductor strength perform more poorly on measures of physical function. However, very little is known of the effectiveness of including hip abductor strengthening exercises in post-operative rehabilitation. The aim of this trial is to compare the effects of targeted hip abductor strengthening to those of traditional care in a TKA rehabilitation program on muscle strength, patient reported outcomes and functional performance measures. This protocol describes a single-blinded randomized controlled trial, where 104 participants referred for inpatient rehabilitation following TKA will be recruited. Participants will be randomized using computer-generated numbers to one of two groups: usual care or usual care with additional hip strengthening exercises. Participants will attend physiotherapy daily during their inpatient length of stay, and will then attend between six and eight physiotherapy sessions as an outpatient. Primary outcomes are isometric hip abductor strength and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcomes are stair climb test, 6 min walk test, timed up and go, 40 m fast-paced walk test, 30 second chair stand test, isometric quadriceps strength, Lower Extremity Functional Scale (LEFS) and SF-12. Outcome measures will be recorded at baseline (admission to inpatient rehabilitation), and then 3 weeks, 6 weeks and 6 months post admission to rehabilitation. The findings of this study will determine whether the addition of targeted hip strengthening

  20. Rose Hip

    Science.gov (United States)

    ... increase the chance of blood clots or another heart attack. Sickle cell disease: It is rare, but the vitamin C in rose hip might make blood more acidic. This could bring on a sickle cell crisis. It's best to avoid use. Stroke: Rose hip ...

  1. Changes in hip and ankle range of motion and hip muscle strength in 8–11 year old novice female ballet dancers and controls: a 12 month follow up study

    Science.gov (United States)

    Bennell, K; Khan, K; Matthews, B; Singleton, C

    2001-01-01

    Objectives—To evaluate in a 12 month longitudinal study changes in hip and ankle range of motion and hip muscle strength in young female novice ballet dancers. Methods—Fifty three of the original 77 (69%) female dancers aged 8–11 years and 40 of the original 49 (82%) controls returned for follow up measurements one year later. Supine right active hip external (ER) and internal (IR) rotation were measured using an inclinometer. A turnout protractor was used to assess standing active turnout range. Range of right weight bearing ankle dorsiflexion and calf muscle length were measured in a standing lunge position using an inclinometer. A manual muscle tester was used to assess right hip flexor, IR, ER, abductor and adductor strength. Results—The mean (SD) 12 month change in hip ER did not differ between dancers (11.7 (11.3)°) and controls (8.1 (17.6)°). Dancers gained 12.5 (13.5)° hip IR which was significantly greater than controls (0.5 (13.9)°). Greater IR change was associated with improved IR strength (r = 0.34, pballet students and controls at this young age. However, ankle dorsiflexion did not, which is probably due to this movement being blocked by bony apposition, rather than soft tissue stretch. This has implications for ballet teachers, as it has long been accepted that this movement could be improved with training. Dancers had greater increases in hip strength after 12 months compared with controls in muscles specific for ballet, suggesting that hip strength can be trained at this young age. Whether these gains are permanent requires further study. Key Words: dance; ballet; range of motion; muscle strength PMID:11157464

  2. INNOPLANT Total Hip Replacement System.

    Science.gov (United States)

    Harper, Tisha A M

    2017-07-01

    Total hip replacement is a salvage procedure that is done to alleviate discomfort secondary to osteoarthritis in the hip, which is most often a result of hip dysplasia. Commercially available total hip replacement implants for small animal patients are classified as cemented or cementless. The INNOPLANT Total Hip Replacement system includes modular, screw-in cementless components that were developed to improve implant stability by maintaining as much normal anatomic structure, and by extension biomechanics of the coxofemoral joint, as possible. As a newer system, there are few data and no long-term studies available in the veterinary literature. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Post-market Surveillance Study With the HYPERION Hip Endoprosthesis System in Defect Reconstruction

    Science.gov (United States)

    2017-12-19

    Osteoarthritis; Avascular Necrosis; Rheumatoid Arthritis; Functional Deformities; Pseudoarthrosis; Revision of Endoprosthesis-treated Hips; Fracture, Proximal Humeral; Provision of Non-endoprosthetic Previous Operations of the Hip Joint (e.g., Transposition Osteotomies); Femur Fracture; Pseudarthrosis; Trochanteric Fractures; Bridging of Large Bone Defects; Revisions

  4. Abductor Biomechanics Clinically Impact the Total Hip Arthroplasty Dislocation Rate: A Prospective Long-Term Study.

    Science.gov (United States)

    García-Rey, Eduardo; García-Cimbrelo, Eduardo

    2016-02-01

    Factors related to the patient, implant, and surgery have been associated to the rate of dislocation for total hip arthroplasty (THA). We ask if the position of the cup and the reconstruction of the abductor mechanism actually lower the THA dislocation rate. We evaluated 1318 patients (1414 hips) undergoing cementless THA between 1992 and 2012. All THAs had a 28- or a 32-mm femoral head size. Hip reconstruction was radiologically assessed evaluating cup position and the hip rotation center according to Ranawat. The reconstruction of the abductor mechanism was measured using 2 variables: the lever arm distance and the height of the greater trochanter. There were 38 dislocations (2.7%). After controlling the relevant confounding variables, such as demographic and implant data, multivariate regression analysis showed that the most important factors associated with dislocation were a greater distance to the anatomic hip rotation center and hips outside 2 safe windows for cup position (acetabular inclination and version angles) and abductor mechanism (lever arm distance and height of the greater trochanter). A proper reconstruction of the hip is essential to decrease the risk of dislocation after primary THA. The weakness of the abductor muscles of the hip may be one of the most important causes for dislocation. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. A qualitative study of Functioning, Disability, and Rehabilitation of patients after hip fracture surgery

    DEFF Research Database (Denmark)

    Ehlers, Monica Milter

    2013-01-01

    on the Model of the International Classification of Functioning, Disability and Health (The ICF model) (Figure 1) and White Paper of the Rehabilitation Concept. The method of the project is qualitative, and the design used to answer the research questions is qualitative deductive content analysis (Figure 2......A qualitative study of functioning, disability, and rehabilitation of patients after hip fracture surgery Monica Milter Ehlers PhD student, MSc in Nursing Merete Bender Bjerrum* PhD, MA, Associate Professor Claus Vinther Nielsen* Professor, PhD, MD, Specialist in Clinical Social Medicine...... fracture patients consists primarily of muscle training and daily mobilisation. Patients' functioning, disability, and involvement in their rehabilitation process have not been investigated in scientific studies. Aims To establish a specific research-based knowledge for functioning, disability...

  6. Fixation method does not affect restoration of rotation center in hip replacements: A single-site retrospective study

    Directory of Open Access Journals (Sweden)

    Wegner Alexander

    2012-06-01

    Full Text Available Abstract Background Aseptic loosening is one of the greatest problems in hip replacement surgery. The rotation center of the hip is believed to influence the longevity of fixation. The aim of this study was to compare the influence of cemented and cementless cup fixation techniques on the position of the center of rotation because cemented cup fixation requires the removal of more bone for solid fixation than the cementless technique. Methods We retrospectively compared pre- and post-operative positions of the hip rotation center in 25 and 68 patients who underwent artificial hip replacements in our department in 2007 using cemented or cementless cup fixation, respectively, with digital radiographic image analysis. Results The mean horizontal and vertical distances between the rotation center and the acetabular teardrop were compared in radiographic images taken pre- and post-operatively. The mean horizontal difference was −2.63 mm (range: -11.00 mm to 10.46 mm, standard deviation 4.23 mm for patients who underwent cementless fixation, and −2.84 mm (range: -10.87 to 5.30 mm, standard deviation 4.59 mm for patients who underwent cemented fixation. The mean vertical difference was 0.60 mm (range: -20.15 mm to 10.00 mm, standard deviation 3.93 mm and 0.41 mm (range: -9.26 mm to 6.54 mm, standard deviation 3.58 mm for the cementless and cemented fixation groups, respectively. The two fixation techniques had no significant difference on the position of the hip rotation center in the 93 patients in this study. Conclusions The hip rotation center was similarly restored using either the cemented or cementless fixation techniques in this patient cohort, indicating that the fixation technique itself does not interfere with the position of the center of rotation. To completely answer this question further studies with more patients are needed.

  7. Study of the interactions between proximal femur 3d bone shape, cartilage health, and biomechanics in patients with hip Osteoarthritis.

    Science.gov (United States)

    Pedoia, Valentina; Samaan, Michael A; Inamdar, Gaurav; Gallo, Matthew C; Souza, Richard B; Majumdar, Sharmila

    2017-07-08

    In this study quantitative MRI and gait analysis were used to investigate the relationships between proximal femur 3D bone shape, cartilage morphology, cartilage biochemical composition, and joint biomechanics in subject with hip Osteoarthritis (OA). Eighty subjects underwent unilateral hip MR-imaging: T1ρ and T2 relaxation times were extracted through voxel based relaxometry and bone shape was assessed with 3D MRI-based statistical shape modeling. In addition, 3D gait analysis was performed in seventy-six of the studied subjects. Associations between shape, cartilage lesion presence, severity, and cartilage T1ρ and T2 were analyzed with linear regression and statistical parametric mapping. An ad hoc analysis was performed to investigate biomechanics and shape associations. Our results showed that subjects with a higher neck shaft angle in the coronal plane (higher mode 1, coxa valga), thicker femoral neck and a less spherical femoral head (higher mode 5, pistol grip) exhibited more severe acetabular and femoral cartilage abnormalities, showing different interactions with demographics factors. Subjects with coxa valga also demonstrated a prolongation of T1ρ and T2. Subjects with pistol grip deformity exhibited reduced hip internal rotation angles and subjects with coxa valga exhibited higher peak hip adduction moment and moment impulse. The results of this study establish a clear relationship between 3D proximal femur shape variations and markers of hip joint degeneration-morphological, compositional, well as insight on the possible interactions with demographics and biomechanics, suggesting that 3D MRI-based bone shape maybe a promising biomarker of early hip joint degeneration. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  8. Microfocus study of metal distribution and speciation in tissue extracted from revised metal on metal hip implants

    Energy Technology Data Exchange (ETDEWEB)

    Hart, Alister J [Department of Orthopaedic Surgery, Imperial College and Imperial College Healthcare NHS Trust, Charing Cross Hospital Campus, Fulham Palace Rd, London W6 8RF (United Kingdom); Sandison, Ann [Department of Histopathology, Imperial College and Imperial College Healthcare NHS Trust, Charing Cross Hospital Campus, Fulham Palace Rd, London W6 8RF (United Kingdom); Quinn, Paul; Mosselmans, J Frederick W [Science Division, Diamond Light Source, Harwell Science and Innovation Campus, Didcot, Oxon, OX11 0DE (United Kingdom); Sampson, Barry [Department of Clinical Biochemistry, Imperial College and Imperial College Healthcare NHS Trust, Charing Cross Hospital Campus, Fulham Palace Rd, London W6 8RF (United Kingdom); Atkinson, Kirk D [8 Nuclear Department Defence Academy College of Management and Technology HMS Sultan Military Road Gosport PO12 3BY (United Kingdom); Skinner, John A [Department of Orthopaedics, Royal National Orthopaedic Hospital, HA7 4LP (United Kingdom); Goode, Angela [Dept of Materials, Imperial College London, SW7 2AZ (United Kingdom); Powell, Jonathan J, E-mail: Paul.Quinn@diamond.ac.u [Medical Research Council Human Nutrition Research Centre, Cambridge CB1 9NL (United Kingdom)

    2009-11-15

    Unexplained tissue inflammation in metal-on-metal hip replacements is suspected to be caused by implant-derived nanoparticles. The aim of this study was to investigate the nature of the metal particles in tissue surrounding metal-on-metal (MOM) hips that has been extracted during revision. Mapping of tissue surrounding the failed MOM hips was performed using microfocus X-ray Fluorescence (XRF). This revealed mainly Cr which was localized to the cellular regions. There was co-localisation of Co, were present, to areas of high Cr abundance. XANES of the tissue and appropriate standards revealed that the most common species were Cr(III) and Co(II). EXAFS analysis of the tissue and various metal standards revealed that the most abundant implant-related species was Cr(III) phosphate. Different tissue preparation methods, including frozen sectioning, were examined but were found not to affect the distribution or speciation of the metals in the tissue.

  9. A cadaveric study of posterior dislocation after total hip replacement-effects of head diameter and acetabular anteversion.

    Science.gov (United States)

    Ng, Fu Yuen; Zhang, Jiang Tao; Chiu, Kwong Yuen; Yan, Chun Hoi

    2011-03-01

    The size of the femoral head and acetabular anteversion are crucial for stability in total hip replacements. This study examined the effects of head diameter and acetabular anteversion on the posterior instability after total hip replacement in an in vivo setting. The acetabular shell was inserted at 0-20° of anteversion at five degree intervals. By using different head sizes (28 mm, 32 mm, 36 mm), the degrees of dislocation were recorded by computer navigation. The 36-mm group consistently showed better stability compared with the 32- and 28-mm groups, regardless of the degree of cup anteversion. Within each group of head size, the hip was significantly more stable when the cup anteversion increased from 0° to 10°. The difference became insignificant when it increased from 15° to 20°.

  10. The Relationship Between Body Mass Index and Fluoroscopy Time During Intraarticular Hip Injection: A Multicenter Cohort Study.

    Science.gov (United States)

    McCormick, Zachary L; Bhave, Meghan; Lee, David T; Scholten, Paul; Chu, Samuel K; Babu, Ashwin N; Caldwell, Mary; Ziegler, Craig; Ashraf, Humaira; Clark, Ryan; Gross, Claire; Cara, Jeffrey; McCormick, Kristen; Ross, Brendon; Press, Joel; Walega, David R; Cushman, Daniel

    2017-07-01

    Higher body mass index (BMI) is associated with difficulty in obtaining imaging studies. While there is a small body of literature regarding the relationship between fluoroscopy time and BMI during injections for pain management, this has not been studied for intraarticular (IA) hip injections. Further, in academic training centers, trainee involvement may affect this relationship. To determine the relationship between BMI and fluoroscopy time during IA hip injections, both with and without involvement of a trainee. Multicenter retrospective cohort study. Three academic, outpatient musculoskeletal and pain medicine centers. Patients who underwent fluoroscopically guided IA hip injections with encounter data regarding fluoroscopy time during the procedure and BMI were included. Mean and standard deviation fluoroscopy time were recorded. Comparisons were made between BMI categories of normal (18.5 - 24.9 kg/m2), overweight (25.0 - 29.9 kg/m2), and obese (greater than or equal to30.0 kg/m2). Statistical significance was set at P = 0.01 due to multiple comparisons. A total of 559 IA hip injections are represented in this cohort. Patients had a mean age of 58 (standard deviation [SD] 14) years and 63% were women. There was no significant difference in fluoroscopy time when comparing BMI categories (P = 0.02). However, when trainees were not involved in the injection, fluoroscopy times were significantly shorter with decreasing BMI category, with normal weight patients requiring the shortest fluoroscopy times (P = 0.01). This study evaluated total fluoroscopy time, not radiation dose exposure per injection, which provides more direct and precise information with regard to provider and patient radiation exposure and overall safety. Future study of the impact of BMI on radiation dose during fluoroscopically guided IA hip injections is needed. Fluoroscopy times during IA hip injections increase with higher BMI categories in a statistically significant manner when performed

  11. Prevalence of hip dislocation among children with cerebral palsy in regions with and without a surveillance programme: a cross sectional study in Sweden and Norway

    Directory of Open Access Journals (Sweden)

    Elkamil Areej I

    2011-12-01

    Full Text Available Abstract Background Hip dislocation is a serious complication among children with cerebral palsy (CP. The aim of this study was to compare the prevalence of hip dislocation among children with CP in an area providing regular care with an area providing hip surveillance services. Methods This is a cross-sectional study in seven Norwegian counties providing regular care and one Swedish healthcare region where a hip surveillance programme was introduced in 1994. Data were provided by the Norwegian Cerebral Palsy Register and the CP Register in Southern Sweden. Children born 1996 - 2003 with moderate to severe CP, defined as Gross Motor Classification System (GMFCS levels III - V, were included. In all, 119 Norwegian and 136 Swedish children fulfilled the criteria. In Norway, data on hip operations and radiographs of the hips were collected from medical records, while these data are collected routinely in the Swedish register. The hip migration percentage was measured on the recent radiographs. Hip dislocation was defined as a migration percent of 100%. Results The proportion of children at GMFCS levels III - V was 34% in the Norwegian and 38% in the Swedish population. In the Norwegian population, hip dislocation was diagnosed in 18 children (15.1%; CI: 9.8 - 22.6 compared with only one child (0.7%; 95% CI: 0.01 - 4.0 in Southern Sweden (p = Conclusions The surveillance programme reduced the number of hip dislocations and the proportion of children undergoing hip surgery was lower. However, with the surveillance programme the first operation was performed at a younger age. Our results strongly support the effectiveness of a specifically designed follow-up programme for the prevention of hip dislocation in children with CP.

  12. Can strength training predictably improve gait kinematics? A pilot study on the effects of hip and knee extensor strengthening on lower-extremity alignment in cerebral palsy.

    Science.gov (United States)

    Damiano, Diane L; Arnold, Allison S; Steele, Katherine M; Delp, Scott L

    2010-02-01

    Computer simulations have demonstrated that excessive hip and knee flexion during gait, as frequently seen in ambulatory children with cerebral palsy (CP), can reduce the ability of muscles to provide antigravity support and increase the tendency of hip muscles to internally rotate the thigh. These findings suggest that therapies for improving upright posture during gait also may reduce excessive internal rotation. The goal of this study was to determine whether strength training can diminish the degree of crouched, internally rotated gait in children with spastic diplegic CP. This was a pilot prospective clinical trial. Eight children with CP participated in an 8-week progressive resistance exercise program, with 3-dimensional gait analysis and isokinetic testing performed before and after the program. Secondary measures included passive range of motion, the Ashworth Scale, and the PedsQL CP Module. To identify factors that may have influenced outcome, individual and subgroup data were examined for patterns of change within and across variables. Strength (force-generating capacity) increased significantly in the left hip extensors, with smaller, nonsignificant mean increases in the other 3 extensor muscle groups, yet kinematic and functional outcomes were inconsistent. The first reported subject-specific computer simulations of crouch gait were created for one child who showed substantial benefit to examine the factors that may have contributed to this outcome. The sample was small, with wide variability in outcomes. Strength training may improve walking function and alignment in some patients for whom weakness is a major contributor to their gait deficits. However, in other patients, it may produce no change or even undesired outcomes. Given the variability of outcomes in this and other strengthening studies in CP, analytical approaches to determine the sources of variability are needed to better identify those individuals who are most likely to benefit from

  13. Prognosis of limitations in activities in osteoarthritis of the hip or knee: a 3-year cohort study.

    NARCIS (Netherlands)

    Dijk, G.M. van; Veenhof, C.; Spreeuwenberg, P.; Coene, N.; Burger, B.J.; Schaardenburg, D. van; Ende, C.H.M. van den; Lankhorst, G.J.; Dekker, J.

    2010-01-01

    van Dijk GM, Veenhof C, Spreeuwenberg P, Coene N, Burger BJ, van Schaardenburg D, van den Ende CH, Lankhorst GJ, Dekker J, on behalf of the CARPA Study Group. Prognosis of limitations in activities in osteoarthritis of the hip or knee: a 3-year cohort study. OBJECTIVE: To describe the course of

  14. Preoperative prediction of inpatient recovery of function after total hip arthroplasty using performance-based tests: a prospective cohort study

    NARCIS (Netherlands)

    Oosting, E.; Hoogeboom, T.J.; Appelman-de Vries, S.A.; Swets, A.; Dronkers, J.J.; Meeteren, N.L. van

    2016-01-01

    PURPOSE: The aim of this study was to evaluate the value of conventional factors, the Risk Assessment and Predictor Tool (RAPT) and performance-based functional tests as predictors of delayed recovery after total hip arthroplasty (THA). METHOD: A prospective cohort study in a regional hospital in

  15. Rivaroxaban for the prevention of venous thromboembolism after hip or knee arthroplasty. Pooled analysis of four studies

    DEFF Research Database (Denmark)

    Turpie, A G G; Lassen, M R; Eriksson, Birgit

    2011-01-01

    Four phase III studies compared oral rivaroxaban with subcutaneous enoxaparin for the prevention of venous thromboembolism (VTE) after total hip or knee arthroplasty (THA or TKA). A pooled analysis of these studies compared the effect of rivaroxaban with enoxaparin on symptomatic VTE plus all...

  16. Hip dysplasia and osteoarthrosis: a survey of 4151 subjects from the Osteoarthrosis Substudy of the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

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

    2005-01-01

    Acta Orthop. 2005 Apr;76(2):149-58. Related Articles, Links Hip dysplasia and osteoarthrosis: a survey of 4151 subjects from the Osteoarthrosis Substudy of the Copenhagen City Heart Study. Jacobsen S, Sonne-Holm S, Soballe K, Gebuhr P, Lund B. Department of Orthopaedic Surgery, Copenhagen...... angle, femoral head extrusion index and ADR. Odds ratios ranged from 1.0 to 6.2. Compared to subjects with OA in morphologically normal hips, a trend towards younger age in subjects with HD and OA was noted, but this was not strictly significant. INTERPRETATION: We found that HD is not uncommon...

  17. A retrospective study of canine hip dysplasia in 116 military working dogs. Part II: Clinical signs and performance data.

    Science.gov (United States)

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

    1996-01-01

    The progression of hip dysplasia was investigated in 116 military working dogs. Medical records were reviewed for any clinical history of hind-limb lameness. Pelvic radiographs were studied for evidence and degree of hip dysplasia, degenerative joint disease, or both. The number of months each dog worked was determined. Each dog's age at termination from service and cause of death (or euthanasia) were recorded. The mean months of work for normal and dysplastic dogs were evaluated using the Student's t-test. No significant difference was found in the total number of months worked between normal and dysplastic dogs (p greater than 0.05).

  18. Distribution of bone density and cortical thickness in the proximal femur and their association with hip fracture in postmenopausal women: a quantitative computed tomography study.

    Science.gov (United States)

    Yang, L; Udall, W J M; McCloskey, E V; Eastell, R

    2014-01-01

    The quantitative computed tomography (QCT) scans in an individually matched case-control study of women with hip fracture were analysed. There were widespread deficits in the femoral volumetric bone mineral density (vBMD) and cortical thickness of cases, and cortical vBMD and thickness discriminated hip fracture independently of BMD by dual-energy X-ray absorptiometry (DXA). Acknowledging the limitations of QCT associated with partial volume effects, we used QCT in an individually matched case-control study of women with hip fracture to better understand its structural basis. Fifty postmenopausal women (55-89 years) who had sustained hip fractures due to low-energy trauma underwent QCT scans of the contralateral hip within 3 months of the fracture. For each case, postmenopausal women, matched by age (±5 years), weight (±5 kg) and height (±5 cm), were recruited as controls. We quantified cortical, trabecular and integral vBMD and apparent cortical thickness (AppCtTh) in four quadrants of cross-sections along the length of the femoral head (FH), femoral neck (FN), intertrochanter and trochanter and examined their association with hip fracture. Women with hip or intracapsular (IC) fracture had significantly (p fractures independent of hip areal BMD (aBMD). The combination of AppCtTh and trabecular or integral vBMD discriminated hip fracture, whereas the combination of FH and FN AppCtTh discriminated IC fracture significantly (p fracture independently of aBMD by DXA.

  19. Do cadmium, lead, and aluminum in drinking water increase the risk of hip fractures? A NOREPOS study.

    Science.gov (United States)

    Dahl, Cecilie; Søgaard, Anne Johanne; Tell, Grethe S; Flaten, Trond Peder; Hongve, Dag; Omsland, Tone Kristin; Holvik, Kristin; Meyer, Haakon E; Aamodt, Geir

    2014-01-01

    The aim of this study was to investigate relations between cadmium, lead, and aluminum in municipality drinking water and the incidence of hip fractures in the Norwegian population. A trace metals survey in 566 waterworks was linked geographically to hip fractures from hospitals throughout the country (1994-2000). In all those supplied from these waterworks, 5,438 men and 13,629 women aged 50-85 years suffered a hip fracture. Poisson regression models were fitted, adjusting for age, region of residence, urbanization, and type of water source as well as other possibly bone-related water quality factors. Effect modification by background variables and interactions between water quality factors were examined (correcting for false discovery rate). Men exposed to a relatively high concentration of cadmium (IRR = 1.10; 95 % CI 1.01, 1.20) had an increased risk of fracture. The association between relatively high lead and hip fracture risk was significant in the oldest age group (66-85 years) for both men (IRR = 1.11; 95 % CI 1.02, 1.21) and women (IRR = 1.10; 95 % CI 1.04, 1.16). Effect modification by degree of urbanization on hip fracture risk in men was also found for all three metals: cadmium, lead, and aluminum. In summary, a relatively high concentration of cadmium, lead, and aluminum measured in drinking water increased the risk of hip fractures, but the associations depended on gender, age, and urbanization degree. This study could help in elucidating the complex effects on bone health by risk factors found in the environment.

  20. Primary total hip arthroplasty revision due to dislocation: prospective French multicenter study.

    Science.gov (United States)

    Girard, J; Kern, G; Migaud, H; Delaunay, C; Ramdane, N; Hamadouche, M

    2013-09-01

    Dislocation following total hip arthroplasty (THA) may require surgical revision, and is one of the most frequent causes for revision in national registers. The goals of this study were to determine the characteristics of revision THA for dislocation and identify the typical features of hips revised due to dislocation. A prospective multicenter study (30 centers) was performed in first revision THA performed between January 1, 2010 and December 31, 2011 (multiple revisions were excluded). Two hundred nineteen (10.4%) of all first revisions (2153 cases in 2107 patients) were for dislocation, which was the fifth cause of revision. There were 135 men and 84 women, mean age 65.9 years old (24.3-92.4) at primary THA and 72.9 years old (31.9-98.8) at revision. Revision surgery was performed a mean 7.1 years (± 7.1) after primary THA. The predictive risk factors for dislocation were: a 22.2mm diameter femoral head (risk × 2.4), a posterolateral approach (risk × 1.7), older age (risk × 1.1), an elevated rim liner for primary THA (risk × 6.6). The use of a dual mobility cup did not influence the rate of revision for dislocation (8.8%) compared to the use of a flat rim liner (9.1%). The 10.4% rate of revision of THA for dislocation seems markedly lower than the results in the literature both for frequency and ranking. The use of elevated rim or constrained liners designed to decrease the risk of dislocation does not improve results compared to standard liners. Level IV, prospective prognostic study without a control group. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  1. The effect of cement on hip stem fixation: a biomechanical study.

    Science.gov (United States)

    Çelik, Talip; Mutlu, İbrahim; Özkan, Arif; Kişioğlu, Yasin

    2017-06-01

    This study presents the numerical analysis of stem fixation in hip surgery using with/without cement methods since the use of cement is still controversial based on the clinical studies in the literature. Many different factors such as stress shielding, aseptic loosening, material properties of the stem, surgeon experiences etc. play an important role in the failure of the stem fixations. The stem fixation methods, cemented and uncemented, were evaluated in terms of mechanical failure aspects using computerized finite element method. For the modeling processes, three dimensional (3D) femur model was generated from computerized tomography (CT) images taken from a patient using the MIMICS Software. The design of the stem was also generated as 3D CAD model using the design parameters taken from the manufacturer catalogue. These 3D CAD models were generated and combined with/without cement considering the surgical procedure using SolidWorks program and then imported into ANSYS Workbench Software. Two different material properties, CoCrMo and Ti6Al4V, for the stem model and Poly Methyl Methacrylate (PMMA) for the cement were assigned. The material properties of the femur were described according to a density calculated from the CT images. Body weight and muscle forces were applied on the femur and the distal femur was fixed for the boundary conditions. The calculations of the stress distributions of the models including cement and relative movements of the contacts examined to evaluate the effects of the cement and different stem material usage on the failure of stem fixation. According to the results, the use of cement for the stem fixation reduces the stress shielding but increases the aseptic loosening depending on the cement crack formations. Additionally, using the stiffer material for the stem reduces the cement stress but increases the stress shielding. Based on the results obtained in the study, even when taking the disadvantages into account, the cement usage

  2. 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

  3. A Prospective, Randomized, Controlled Trial Comparing Conservative Treatment With Trunk Stabilization Exercise to Standard Hip Muscle Exercise for Treating Femoroacetabular Impingement: A Pilot Study.

    Science.gov (United States)

    Aoyama, Michihisa; Ohnishi, Yasuo; Utsunomiya, Hajime; Kanezaki, Shiho; Takeuchi, Hiroki; Watanuki, Makoto; Matsuda, Dean K; Uchida, Soshi

    2017-11-16

    To assess the efficacy of conservative management of women with femoroacetabular impingement (FAI) using trunk stabilization. Randomized controlled trial (level of evidence: I). Twenty FAI female patients who met the inclusion FAI criteria. A prospective, randomized, controlled study was performed on 20 female patients with symptomatic FAI comprising 2 groups (10 hips in trunk stabilization exercise group vs 10 hips in control group). We evaluated hip range of motion, isometric muscle strength using a handheld dynamometer (μ-TasMF-01; Anima, Co), and patient-reported outcome measures, including modified Harris hip score, Vail hip score, and international hip outcome tool 12 (iHOT12) before and at 4 weeks and 8 weeks after the intervention. There was a significant improvement in the range of motion of hip flexion in the trunk training group detected as early as 4 weeks after the intervention compared with the control group (P < 0.05). Hip abductor strength significantly improved in the trunk training group at 4 weeks after the intervention, whereas it did not improve in the control group (P < 0.05). Vail hip score and iHOT12 were significantly increased at 8 weeks after the intervention in the trunk training group compared with the control group (iHOT12: 78.7 ± 22.4 vs 53.0 ± 22.3; P < 0.01, Vail hip score: 81.6 ± 18.5 vs 61.1 ± 11.6; P < 0.05). There was no significant difference in the modified Harris hip score between both the groups at 4 and 8 weeks after the intervention. The addition of trunk stabilization exercise to a typical hip rehabilitation protocol improves short-term clinical outcomes and may augment nonoperative and postoperative rehabilitation.

  4. Biomechanical Study on Distal Filling Effects in Cementless Total Hip Replacement

    Science.gov (United States)

    Chae, Soo-Won; Lee, Jun-Hyoung; Choi, Hyung-Yun

    In cementless total hip replacement, initial stability of the femoral component is important in the long term fixation of the femoral stem. Initial stability is closely related to the relative displacement between the prosthesis and the cancellous bone of the proximal femur. After implantation of the prosthesis, the surrounding bone is partially shielded from load carrying and starts to resorb. Stress shielding causes the loss of the proximal bone. The stress distribution of femur must be assessed to predict stress shielding. The initial stability and the stress shielding were investigated for two loading conditions approximating a single leg stance and stair climbing. Two types of stems involving a distal filling and a distal short stem were studied by the finite element method to investigate the biomechanical distal filling effects. The distal short stem produced less stress shielding at the proximal bone than the distal filling stem, while both types of stems seemed to satisfy the initial stability requirement.

  5. The Influence of Chronic Pain on Postoperative Pain and Function After Hip Surgery: A Prospective Observational Cohort Study.

    Science.gov (United States)

    Erlenwein, Joachim; Przemeck, Michael; Degenhart, Astrid; Budde, Stefan; Falla, Deborah; Quintel, Michael; Pfingsten, Michael; Petzke, Frank

    2016-02-01

    Pre-existing or chronic pain is an established risk factor for severe postoperative pain. In this prospective observational cohort study, we investigated whether a history of chronic pain, beyond the presence of hip-related pain, affected other postoperative factors including early mobilization, function, and psychological distress after hip surgery. Patients who underwent total hip replacement surgery were observed from the preoperative day until the seventh postoperative day. Before surgery, they were characterized by their pain history, pain intensity, function, and psychological characteristics. Postoperatively, pain intensity was evaluated on day 1, 3, 5, and 7 and the analgesic consumption was recorded for each of these days. Measures of function (functional questionnaire, ability to mobilize and to climb stairs, and range of hip motion) and psychological distress were re-evaluated on day 7. A history of chronic pain was associated with slower postoperative mobilization, poorer physical function, and greater psychological distress in addition to increased postoperative pain intensity. The comorbidity of a chronic pain disorder resulted in greater pain intensity after surgery, and also impeded postoperative rehabilitation. Identification of patients with a chronic pain disorder is necessary preoperatively so that appropriate pain management and rehabilitation can be planned to facilitate recovery. Chronic pain, beyond the presence of hip-related pain, is associated with slower postoperative mobilization, poorer physical function, and greater psychological distress after total hip replacement surgery. Identification of patients with chronic pain and establishment of multiprofessional perioperative management might improve postoperative rehabilitation of patients with chronic pain. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  6. Risk factors for hip-related clinical signs in a prospective cohort study of four large dog breeds in Norway.

    Science.gov (United States)

    Krontveit, Randi I; Trangerud, Cathrine; Sævik, Bente K; Skogmo, Hege K; Nødtvedt, Ane

    2012-02-01

    We conducted a prospective cohort study including privately owned dogs from the breeds Newfondland (NF), Labrador Retriever (LR), Leonberger (LEO), and Irish Wolfhound (IW) followed from birth until age 9 yrs. We wanted to investigate whether radiological hip dysplasia status given at approximately age 12-18 mos and other factors during growth influenced development of clinical signs due to hip-joint disease necessitating veterinary consultation. Whether or not such signs occurred due to hip dysplasia or due to secondary or primary DJD could not be distinguished, and we therefore used the term "owner-reported veterinary-diagnosed hip-related clinical signs" ("the event"). The included dogs were followed from birth to the event or until a maximum of 9 yrs of age. Our objectives were to describe breed differences in time to incidence and to evaluate potential risk factors for the time to event. We used Kaplan-Meier curves to describe time to incidence, and potential risk factors were assessed by use of a Cox proportional-hazards model. We enrolled 494 dogs from 103 litters, and 46 dogs were reported as having had the event during the observation period. We observed a significant time-varying effect (TVE): LR and LEO developed clinical signs later in life than NF. If the radiological hip status was either mild, moderate, or severe the hazard of experiencing the event was significantly increased. Access to off-leash exercise at age 12 mos decreased the hazard of the event, and the hazard varied by litter. The findings supported the hypothesis that radiological hip status at screening and exercise conditions during growth influenced the time to incidence of the event and that there were breed differences in time to the event. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Frontal plane knee and hip kinematics during sit-to-stand and proximal lower extremity strength in persons with patellofemoral osteoarthritis: a pilot study.

    Science.gov (United States)

    Hoglund, Lisa T; Hillstrom, Howard J; Barr-Gillespie, Ann E; Lockard, Margery A; Barbe, Mary F; Song, Jinsup

    2014-02-01

    Increased joint stress and malalignment are etiologic factors in osteoarthritis. Static tibiofemoral frontal plane malalignment is associated with patellofemoral osteoarthritis (PFOA). Patellofemoral joint stress is increased by activities such as sit-to-stand (STS); this stress may be even greater if dynamic frontal plane tibiofemoral malalignment occurs. If hip muscle or quadriceps weakness is present in persons with PFOA, aberrant tibiofemoral frontal plane movement may occur, with increased patellofemoral stress. No studies have investigated frontal plane tibiofemoral and hip kinematics during STS in persons with PFOA or the relationship of hip muscle and quadriceps strength to these motions. Eight PFOA and seven control subjects performed STS from a stool during three-dimensional motion capture. Hip muscle and quadriceps strength were measured as peak isometric force. The PFOA group demonstrated increased peak tibial abduction angles during STS, and decreased hip abductor, hip extensor, and quadriceps peak force versus controls. A moderate inverse relationship between peak tibial abduction angle and peak hip abductor force was present. No difference between groups was found for peak hip adduction angle or peak hip external rotator force. Dynamic tibiofemoral malalignment and proximal lower extremity weakness may cause increased patellofemoral stress and may contribute to PFOA incidence or progression.

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

    Directory of Open Access Journals (Sweden)

    Jennifer R Prentice

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

  9. Hip extension during the come-out of multiple forward and inward pike somersaulting dives is controlled by eccentric contraction of the hip flexors.

    Science.gov (United States)

    Kong, Pui W

    2010-03-01

    A modelling approach was used in the present study to investigate the role of the hip muscles during the come-out of forward and inward multiple somersaulting dives in a pike position. A planar two-segment model was used to simulate the somersault and come-out of three commonly performed dives from a 3-m springboard: forward two-and-one-half somersault pike dive (105B), forward three-and-one-half somersault pike dive (107B), and inward two-and-one-half somersault pike dive (405B). Three simulations were run for each dive: (1) hip angle was constrained to be constant, (2) hip torque was removed after 0.1 s, and (3) hip angle was constrained to a typical come-out time history used by elite divers. Simulation results indicated that hip flexion torque was required both to maintain a rigid pike position during somersault (range = 205.5-282.3 Nm) and to control the hip extension movement during the come-out (peak torque range = 355.8-548.1 Nm) in forward and inward multiple somersaulting dives. Coaches and divers should be aware that dry-land exercise drills producing hip extension movement by concentric actions of the hip extensor muscles do not replicate the neuromuscular control during the come-out of fast rotating dives.

  10. Hip fracture risk estimation based on principal component analysis of QCT atlas: a preliminary study

    Science.gov (United States)

    Li, Wenjun; Kornak, John; Harris, Tamara; Lu, Ying; Cheng, Xiaoguang; Lang, Thomas

    2009-02-01

    We aim to capture and apply 3-dimensional bone fragility features for fracture risk estimation. Using inter-subject image registration, we constructed a hip QCT atlas comprising 37 patients with hip fractures and 38 age-matched controls. In the hip atlas space, we performed principal component analysis to identify the principal components (eigen images) that showed association with hip fracture. To develop and test a hip fracture risk model based on the principal components, we randomly divided the 75 QCT scans into two groups, one serving as the training set and the other as the test set. We applied this model to estimate a fracture risk index for each test subject, and used the fracture risk indices to discriminate the fracture patients and controls. To evaluate the fracture discrimination efficacy, we performed ROC analysis and calculated the AUC (area under curve). When using the first group as the training group and the second as the test group, the AUC was 0.880, compared to conventional fracture risk estimation methods based on bone densitometry, which had AUC values ranging between 0.782 and 0.871. When using the second group as the training group, the AUC was 0.839, compared to densitometric methods with AUC values ranging between 0.767 and 0.807. Our results demonstrate that principal components derived from hip QCT atlas are associated with hip fracture. Use of such features may provide new quantitative measures of interest to osteoporosis.

  11. Tight intra-operative blood pressure control versus standard care for patients undergoing hip fracture repair - Hip Fracture Intervention Study for Prevention of Hypotension (HIP-HOP) trial: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Moppett, Iain Keith; White, Stuart; Griffiths, Richard; Buggy, Donal

    2017-07-25

    Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control. We are conducting a three-centre, randomised, double-blinded pilot study in three hospitals in the United Kingdom. The sample size will be 75 patients (25 from each centre). Randomisation will be done using computer-generated concealed tables. Both participants and investigators will be blinded to group allocation. Participants will be aged >70 years, cognitively intact (Abbreviated Mental Test Score 7 or greater), able to give informed consent and admitted directly through the emergency department with a fractured neck of the femur requiring operative repair. Patients randomised to tight blood pressure control or avoidance of intra-operative hypotension will receive active treatment as required to maintain both of the following: systolic arterial blood pressure >80% of baseline pre-operative value and mean arterial pressure >75 mmHg throughout. All participants will receive standard hospital care, including spinal or general anaesthesia, at the discretion of the clinical team. The primary outcome is a composite of the presence or absence of defined cardiovascular, renal and delirium morbidity within 7 days of surgery (myocardial injury, stroke, acute kidney injury, delirium). Secondary endpoints will include the defined individual morbidities, mortality, early mobility and discharge to usual residence. This is a small-scale pilot study investigating the feasibility of a trial of tight intra-operative blood pressure control in a frail elderly patient group with known high morbidity

  12. 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); Blanco, F.J. (Francisco J.); 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 (Nicholas); L. Milani (Lili); G.W. Montgomery (Grant); 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 (Stuart); 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)

    2014-01-01

    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

  13. 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)

    2014-01-01

    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

  14. Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: A randomized placebo-controlled study

    NARCIS (Netherlands)

    Kalisvaart, Kees J.; de Jonghe, Jos F. M.; Bogaards, Marja J.; Vreeswijk, Ralph; Egberts, Toine C. G.; Burger, Bart J.; Eikelenboom, Piet; van Gool, Willem A.

    2005-01-01

    OBJECTIVES: To study the effectiveness of haloperidol prophylaxis on incidence, severity, and duration of postoperative delirium in elderly hip-surgery patients at risk for delirium. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Large medical school-affiliated general hospital

  15. Delirium after fast-track hip and knee arthroplasty – a cohort study of 6331 elderly patients

    DEFF Research Database (Denmark)

    Petersen, P. B.; Jørgensen, C. C.; Kehlet, H.

    2017-01-01

    BACKGROUND: Postoperative delirium (PD) is a well-known complication among elderly surgical patients and associated with increased morbidity, mortality and length of stay (LOS). In elective orthopedic surgery, including hip and knee arthroplasty (THA/TKA), most studies report incidences between 5...... without PD (P delirium symptoms contributing to LOS > 4 days in fast...

  16. Heavy Metal and Hip-Hop Style Preferences and Externalizing Problem Behavior: A Two-Wave Longitudinal Study

    Science.gov (United States)

    Selfhout, Maarten H. W.; Delsing, Marc J. M. H.; ter Bogt, Tom F. M.; Meeus, Wim H. J.

    2008-01-01

    This study examines (a) the stability of Dutch adolescents' preferences for heavy metal and hip-hop youth culture styles, (b) longitudinal associations between their preferences and externalizing problem behavior, and (c) the moderating role of gender in these associations. Questionnaire data were gathered from 931 adolescents between the ages of…

  17. Hip Hop Therapy: An Exploratory Study of a Rap Music Intervention with At-Risk and Delinquent Youth.

    Science.gov (United States)

    Tyson, Edgar H.

    2002-01-01

    Presents an exploratory study of the therapeutic potential of "Hip-Hop" therapy, an "innovative synergy of rap music, bibliotherapy, and music therapy." Finds that the quantitative and qualitative results partially supported the hypothesis that under a specific set of conditions rap music would improve the therapeutic…

  18. 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...

  19. The Effect of Rap/Hip-Hop Music on Young Adult Smoking: An Experimental Study.

    Science.gov (United States)

    Harakeh, Zeena; Bogt, Tom F M Ter

    2018-02-16

    Music may influence young people's behavior through its lyrics. Substance use references occur more frequently in rap/hip-hop than in other music genres. The aim was to examine whether the exposure to rap/hip-hop lyrics referring to substance use affected cigarette smoking. An experiment with a 3-group between subject design was conducted among 74 daily-smoking young adults ranging in age from 17 to 25 years old. Three conditions were tested in a mobile lab (camper vehicle) from May to December 2011, i.e., regular chart pop music (N = 28), rap/hip-hop with non-frequent references to substance use (N = 24), and rap/hip-hop with frequent references to substance use (N = 22). One-way ANOVA showed that participants listening to substance use infused rap/hip-hop songs felt significantly less pleasant, liked the songs less, and comprehended the songs less compared to participants listening to pop songs. Poisson loglinear analyses revealed that compared to the pop music condition, none of the two rap/hip-hop music conditions had a significant effect on acute smoking. Thus, contrary to expectations, the two different rap/hip-hop conditions did not have a significantly different effect on acute smoking. Listening to rap/hip-hop, even rap hip/hop with frequent referrals to substance use (primarily alcohol and drug use, and general smoking referrals), does not seem to encourage cigarette smoking among Dutch daily-smoking young adults, at least short term.

  20. Coxa vara in chondrodysplasia: prognosis study of 35 hips in 19 children.

    Science.gov (United States)

    Trigui, Moez; Pannier, Stéphanie; Finidori, Georges; Padovani, Jean Paul; Glorion, Christophe

    2008-09-01

    To better understand anatomical and functional outcomes of coxa vara in chondrodysplasia according to the initial presenting hip morphology, disease type, and impact of surgery. Clinical and radiographic records of 19 children (35 hips) diagnosed with coxa vara and with osteochondrodysplasia were reviewed. We classified the hip radiographic findings into 2 groups: (a) group I, coxa vara with a fragmented and/or nonossified head; and (b) group II, coxa vara with a regular femoral head. Surgical indications in coxa vara included decreased range of hip motion (usually diminished abduction, extension, and internal rotation), coxa vara with progression documented on regular follow-up hip radiographs, and/or severe coxa vara with a Hilgenreiner epiphyseal angle (HEA) of 60 degrees or more. Follow-up was until the completion of growth and, for some patients, into early adulthood. Mean follow-up was 8 years. Twenty-five hips were operated on in 13 patients. In 23 hips, the procedure was a valgus osteotomy fixed by pins and wire. A pelvic extension osteotomy without valgus osteotomy was performed in one patient (2 hips). Coxa vara recurred in 7 hips. In 4 of these hips, repeat surgery with hypervalgus osteotomy was indicated to stop epiphyseal slipping (3 hips) or to improve the arc of motion (1 hip). Functional outcomes were poor in coxa vara associated with poor epiphyseal development (nonossified or fragmented epiphysis) as seen in spondyloepiphyseal dysplasia congenita, spondyloepimetaphyseal dysplasia, Kniest disease, and multiple epiphyseal dysplasia. Coxa vara with physeal instability as observed in spondylometaphyseal dysplasia resulted in deformity recurrence postoperatively during growth. In contrast, outcome was better in cases of coxa vara with nonphyseal/nonepiphyseal involvement, that is, good femoral head morphology, stable physis, and good articular cartilage, as seen in cases of metaphyseal dysplasia and cleidocranial dysplasia. Coxa vara with physeal and

  1. Exposure to Fluoride in Drinking Water and Hip Fracture Risk: A Meta-Analysis of Observational Studies

    Science.gov (United States)

    Yin, Xin-Hai; Huang, Guang-Lei; Lin, Du-Ren; Wan, Cheng-Cheng; Wang, Ya-Dong; Song, Ju-Kun; Xu, Ping

    2015-01-01

    Background Many observational studies have shown that exposure to fluoride in drinking water is associated with hip fracture risk. However, the findings are varied or even contradictory. In this work, we performed a meta-analysis to assess the relationship between fluoride exposure and hip fracture risk. Methods PubMed and EMBASE databases were searched to identify relevant observational studies from the time of inception until March 2014 without restrictions. Data from the included studies were extracted and analyzed by two authors. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were pooled using random- or fixed-effects models as appropriate. Sensitivity analyses and meta-regression were conducted to explore possible explanations for heterogeneity. Finally, publication bias was assessed. Results Fourteen observational studies involving thirteen cohort studies and one case-control study were included in the meta-analysis. Exposure to fluoride in drinking water does not significantly increase the incidence of hip fracture (RRs, 1.05; 95% CIs, 0.96–1.15). Sensitivity analyses based on adjustment for covariates, effect measure, country, sex, sample size, quality of Newcastle–Ottawa Scale scores, and follow-up period validated the strength of the results. Meta-regression showed that country, gender, quality of Newcastle–Ottawa Scale scores, adjustment for covariates and sample size were not sources of heterogeneity. Little evidence of publication bias was observed. Conclusion The present meta-analysis suggests that chronic fluoride exposure from drinking water does not significantly increase the risk of hip fracture. Given the potential confounding factors and exposure misclassification, further large-scale, high-quality studies are needed to evaluate the association between exposure to fluoride in drinking water and hip fracture risk. PMID:26020536

  2. CLINICAL MEASURES OF HIP RANGE OF MOTION DO NOT CORRELATE WITH THE DEGREE OF CAM MORPHOLOGY IN SEMI-ELITE AUSTRALIAN FOOTBALLERS: A CROSS-SECTIONAL STUDY.

    Science.gov (United States)

    Murphy, Myles; Kemp, Joanne; Smith, Anne; Charlesworth, Jonathon; Briffa, Kathy

    2017-12-01

    Clinical testing to determine the presence of a cam morphology is becoming more common however the correlation between hip range of motion and the degree of cam morphology remains controversial in the literature. The prevalence of a cam morphology in athletes has been reported as higher than in the general population but the prevalence of cam morphology has not been reported in Australian Football (AF). The purpose of this study was to determine the correlation between hip range of motion and hip alpha angle and report the proportion of players with a cam morphology in a sample of AF players. Cross-sectional Study. Twenty-one semi-elite AF players (42 hips) from the Peel Thunder Football Club were included in this study. A hip Flexion Internal Rotation (IR) test and a modified maximal squat test using the difference in depth of squat in hip internal and external rotation were used. These measures were then compared to alpha angles on 90 degree Dunn view x-rays. Four of the 42 hips (9.5%) had a cam morphology (alpha angle > 60 degrees). There was no significant correlation between alpha angle and ROM in a Flexion IR test or the difference in modified maximal squat test depth within this sample of players. The proportion of cam morphology seems to be lower in this sample than the previously reported prevalence in other sports. The lack of correlations between hip range and hip alpha angle in players means that screening hips using clinical measures to detect cam morphology associated with poor hip range of motion may be inaccurate. Level 3a.

  3. Effect of molecular weight, calcium stearate, and sterilization methods on the wear of ultra high molecular weight polyethylene acetabular cups in a hip joint simulator.

    Science.gov (United States)

    McKellop, H A; Shen, F W; Campbell, P; Ota, T

    1999-05-01

    Orthopaedic surgeons must currently choose from several types of ultra high molecular weight polyethylene acetabular cups that differ in their material properties and in the methods used for their sterilization. Information on the wear resistance of these different cups may help in the selection process. This study included two separate tests for wear run on a hip simulator to investigate the effect of molecular weight, calcium stearate, and sterilization methods on the wear resistance of ultra high molecular weight polyethylene acetabular cups. Test 1 revealed nearly identical wear rates for acetabular cups with molecular weights in two distinct ranges, as well as for cups with molecular weights in the same range but with or without calcium stearate added. In Test 2, cups that were sterilized in air with gamma irradiation exhibited lower rates of wear than those sterilized with ethylene oxide, presumably due to the crosslinking induced by the irradiation. In addition, cups that were irradiated while packed in a partial vacuum to minimize oxygen absorbed in the surface layer initially showed lower rates of wear than those irradiated in air, with the wear rates becoming similar as wear penetrated the more oxidized surface layer and the more crosslinked subsurface region. Because these tests were run a few months after the irradiation, the potential effects of long-term oxidation of any residual free radicals in the irradiated materials could not be taken into account. After artificial aging to accelerate oxidative degradation of the materials, the wear rates could be markedly different. Analyses performed after wear indicated that the irradiated (i.e., crosslinked) cups exhibited a smaller proportion of, as well as shorter, fibrils in the wear debris and an increased crystallinity and melting temperature and that gamma irradiation in the low-oxygen environment reduced the level of oxidation and increased the level of crosslinking in the surface region of the cups.

  4. 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 minimum......, 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....... 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...

  5. Hip arthroscopy

    Science.gov (United States)

    ... Hip impingement syndrome - arthroscopy; Femora-acetabular impingement - arthroscopy; FAI - arthroscopy; Labrum - arthroscopy ... impingement syndrome (also called femora-acetabular impingement, or FAI). This procedure is done when other treatment has ...

  6. Hip ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Martinoli, Carlo, E-mail: carlo.martinoli@libero.it [Radiologia, DISC, Università di Genova, Largo Rosanna Benzi 8, I-16132 Genoa (Italy); Garello, Isabella; Marchetti, Alessandra; Palmieri, Federigo; Altafini, Luisa [Radiologia, DISC, Università di Genova, Largo Rosanna Benzi 8, I-16132 Genoa (Italy); Valle, Maura [Radiologia, Gaslini Children Hospital, Genova (Italy); Tagliafico, Alberto [Radiologia, National Institute for Cancer Research, Genoa (Italy)

    2012-12-15

    In newborns, US has an established role in the detection and management of developmental dysplasia of the hip. Later in childhood, when the limping child is a major diagnostic dilemma, US is extremely helpful in the identification of the varied disease processes underlying this condition, as transient synovitis, septic arthritis, Perthes disease and slipped femoral capital epiphysis. In adolescent practicing sporting activities, US is an excellent means to identify apophyseal injures about the pelvic ring, especially when avulsions are undisplaced and difficult-to-see radiographically. Later on, in the adulthood, US is an effective modality to diagnose tendon and muscle injuries about the hip and pelvis, identify effusion or synovitis within the hip joint or its adjacent bursae and guide the treatment of these findings. The aim of this article is to provide a comprehensive review of the most common pathologic conditions about the hip, in which the contribution of US is relevant for the diagnostic work-up.

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

    Science.gov (United States)

    2012-01-01

    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 (phip flexion moment at midstance and peak hip extension (pjoint space ≤/>2 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 a reduced hip flexion moment in

  8. Prediction of incident hip fracture by femoral neck bone mineral density and neck-shaft angle: a 5-year longitudinal study in post-menopausal females.

    Science.gov (United States)

    Gnudi, S; Sitta, E; Pignotti, E

    2012-08-01

    To compare hip fracture incidence in post-menopausal females who were differently stratified for the fracture risk according to bone mineral density and proximal femur geometry. In a 5 year follow-up study, the hip fracture incidence in 729 post-menopausal females (45 of whom suffered from incident hip fracture) was assessed and compared. Forward logistic regression was used to select independent predictors of hip fracture risk, including age, age at menopause, height, weight, femoral neck bone mineral density (FNBMD), neck-shaft angle (NSA), hip axis length, femoral neck diameter and femoral shaft diameter as covariates. Fracture incidence was then calculated for the categories of young/old age, high/low FNBMD and wide/narrow NSA, which were obtained by dichotomising each hip fracture independent predictor at the value best separating females with and without a hip fracture. The hip fracture incidence of the whole cohort was significantly higher in females with a wide NSA (8.52%) than in those with a narrow NSA (3.51%). The combination of wide NSA and low FNBMD had the highest hip fracture incidence in the whole cohort (17.61%) and each age category. The combinations of narrow/wide NSA with low/high FNBMD, respectively, gave a significantly higher fracture incidence in older than in younger women, whereas women with a combined wide NSA and low FNBMD had no significantly different fracture incidence in young (14.60%) or old age (21.62%). Our study showed that NSA is effective at predicting the hip fracture risk and that the detection in early post-menopause of a wide NSA together with a low FNBMD should identify females at high probability of incident hip fracture.

  9. 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

    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...

  10. Survival, clinical and radiological outcome of the Zweymuller SL/Bicon-Plus total hip arthroplasty : a 15-year follow-up study

    NARCIS (Netherlands)

    Ottink, Karsten; Barnaart, Lex; Westerbeek, Robin; van Kampen, Karin; Bulstra, Sjoerd; van Jonbergen, Hans-Peter

    2015-01-01

    Aim: The primary aim of this study is to analyse the long-term results of the third generation of the " Zweymuller" total hip arthroplasty (THA) comprising the SL-Plus Stem and the Bicon-Plus cup. Methods: We evaluated 208 patients with a SL/Bicon-Plus primary THA (218 hips). Survival analysis was

  11. Digital tomosynthesis with metal artifact reduction for assessing cementless hip arthroplasty: a diagnostic cohort study of 48 patients

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Hao; Yang, Dejin; Guo, Shengjie; Tang, Jing; Liu, Jian; Wang, Dacheng; Zhou, Yixin [Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Department of Orthopaedic Surgery, Beijing (China)

    2016-11-15

    For postoperative imaging assessment of cementless hip arthroplasty, radiography and computed tomography (CT) were restricted by overlapping structures and metal artifacts, respectively. A new tomosynthesis with metal artifact reduction (TMAR) is introduced by using metal extraction and ordered subset-expectation maximization (OS-EM) reconstruction. This study investigated the effectiveness of TMAR in assessing fixation stability of cementless hip arthroplasty components. We prospectively included 48 consecutive patients scheduled for revision hip arthroplasty in our hospital, with 41 femoral and 35 acetabular cementless components available for evaluation. All patients took the three examinations of radiography, CT, and TMAR preoperatively, with intraoperative mechanical tests, and absence or presence of osteointegration on retrieved prosthesis as reference standards. Three senior surgeons and four junior surgeons evaluated these images independently with uniform criteria. For TMAR, 82 % diagnoses on the femoral side and 84 % diagnoses on the acetabular side were accurate. The corresponding values were 44 and 67 % for radiography, and 39 % and 74 % for CT. Senior surgeons had significantly higher accuracy than junior surgeons by radiography (p < 0.05), but not by TMAR or CT. By minimizing metal artifacts in the bone-implant interface and clearly depicting peri-implant trabecular structures, the TMAR technique improved the diagnostic accuracy of assessing fixation stability of cementless hip arthroplasty, and shortened the learning curve of less experienced surgeons. Level II, diagnostic cohort study. (orig.)

  12. NHS Scotland reduces the postcode lottery for hip arthroplasty: an ecological study of the impact of waiting time initiatives.

    Science.gov (United States)

    Kirkwood, Graham; Pollock, Allyson M; Howie, Colin; Wild, Sarah

    2014-06-01

    Following the election of the Labour government in 1997, policies were developed in England to reduce waiting times for NHS treatment with commitments to reduce health inequalities. Similar policies were adopted in Scotland but with less emphasis on the use of the private sector to deliver NHS treatments than in England. This study uses routinely collected NHS Scotland data to analyse geographical and socioeconomic inequalities in elective hip arthroplasty treatment before and after the introduction of the waiting time initiatives in Scotland in 2003. Ecological study design. Scotland. NHS-funded patients receiving elective hip arthroplasty delivered by the NHS and private hospitals between 1 April 1998 and 31 March 2008. Directly standardised treatment rates and incidence rate ratios calculated using Poisson regression. There was a 42% increase in NHS-funded hip arthroplasties carried out in Scotland from 4095 in 2002-2003 (1 April 2002-31 March 2003) to 5829 in 2007-2008. There is evidence of a statistically significant reduction in geographical inequality (likelihood ratio test p lottery', in hip arthroplasty treatment in Scotland may be due to increased NHS capacity, in particular the development of the NHS Golden Jubilee National Hospital in Clydebank, Greater Glasgow as a dedicated centre to reduce surgery waiting times. © The Royal Society of Medicine.

  13. "Is there an Association Between Self-Reported Sleep Duration, Body Mass Index and Waist-Hip Ratio in Young Adults? A Cross-Sectional Pilot Study".

    Science.gov (United States)

    Kamath, M Ganesh; Prakash, Jay; Dash, Sambit; Chowdhury, Sudipta; Ahmed, Zuhilmi Bin; Yusof, Muhammad Zaim Zharif Bin Mohd

    2014-09-01

    Sleep is vital for mental and physical health of an individual. Duration of sleep influences the metabolism and regulates body weight. To assess the cross-sectional association of sleep duration with body mass index (BMI) and waist-hip ratio in Malaysian students. Eighty-nine Malaysian students of both genders, and with a mean (standard deviation) age of 21.2 (0.9) years were included. Institutional Ethics Committee clearance was obtained prior to the start of study. The subjects were interviewed regarding the average hours of sleep/day, their self-reported sleep duration was categorized as sleep duration), 6-7hour/day and > 7hour/day. Their height (in meters), weight (in kilograms), waist and hip circumference (in centimetre) were measured. BMI and waist-hip ratio were calculated using appropriate formulas and expressed as mean (standard deviation). The duration of sleep was compared with BMI and waist-hip ratio using one way ANOVA. No statistical significance was observed when sleep duration was associated with BMI (p=0.65) and waist-hip ratio (p=0.95). Duration of sleep did not affect BMI and waist hip ratio in the Malaysian students in our study. The age and healthy lifestyle of the subjects in this study may have been a reason for no significant influence of short sleep duration on the BMI and waist-hip ratio. No association was found between sleep duration with BMI and waist hip ratio in the Malaysian students.

  14. Bilateral symmetry in lower extremity mechanics during stair ascent and descent following a total hip arthroplasty: a one-year longitudinal study.

    Science.gov (United States)

    Queen, Robin M; Attarian, David E; Bolognesi, Michael P; Butler, Robert J

    2015-01-01

    Total hip arthroplasty is the standard treatment to reduce pain and improve function in people with advanced hip osteoarthritis; however, persisting asymmetrical gait patterns have been identified in level walking. Therefore, this study evaluated limb asymmetries during stair ascent and descent in patients pre-operatively through 1 year after a hip replacement. It was hypothesized that lower extremity mechanics would improve on the surgical side, but asymmetries would persist through one year. Kinematics and kinetics were collected during seven ascending and descending trials pre-operatively, 6 weeks, and 1 year post-operatively for 42 hip replacement patients. Data were analyzed using 2 ∗ 3 (Limb ∗ Time) within-subject repeated measures analyses of variance (ANOVAs) to determine significant differences between limbs across time (P<.05). Significant changes across time, independent of limb included: peak hip flexion, extension, and adduction during ascent. Peak hip flexion and extension, hip flexion moment, adduction and abduction moments, and propulsive vertical ground reaction force were different during descent (P<.05). Independent of time, significant asymmetries between limbs were observed in peak hip flexion, hip abduction, and hip extension moments during ascent, and in peak hip abduction moment during descent (P<.05). Abnormal movement patterns on the surgical side increase demands on other joints and could lead to permanent joint damage. These side-to-side differences in joint mechanics should be addressed during the early post-operative period through additional interventions in an attempt to normalize the differences and potentially improve long-term joint health throughout the lower extremity. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Risk factors and epidemiological profile of hip fractures in Indian population: A case-control study

    Directory of Open Access Journals (Sweden)

    Kaustubh Ahuja

    2017-09-01

    Conclusions: Hip fractures in the elderly population are on a rising trend especially in the Indian subcontinent due to a number of factors both hereditary and acquired. Simple measures like routine usage of bedside railing, wall-side railings at an appropriate height, high friction tiles inside rooms and washrooms, and adequate lighting indoors can play a significant role in reducing falls and hip fractures among the elderly.

  16. Plasma dimethylglycine, nicotine exposure and risk of low bone mineral density and hip fracture: the Hordaland Health Study.

    Science.gov (United States)

    Øyen, J; Svingen, G F T; Gjesdal, C G; Tell, G S; Ueland, P M; Lysne, V; Apalset, E M; Meyer, K; Vollset, S E; Nygård, O K

    2015-05-01

    In the large community-based Hordaland Health Study, low plasma dimethylglycine was associated with low bone mineral density in both middle-aged and elderly subjects and to an increased risk of subsequent hip fracture among the elderly. These associations seemed to be particularly strong among subjects exposed to nicotine. Dimethylglycine (DMG) is a product of the choline oxidation pathway and formed from betaine during the folate-independent remethylation of homocysteine (Hcy) to methionine. Elevated plasma DMG levels are associated with atherosclerotic cardiovascular disease and inflammation, which in turn are related to osteoporosis. High plasma total Hcy and low plasma choline are associated with low bone mineral density (BMD) and hip fractures, but the role of plasma DMG in bone health is unknown. We studied the associations of plasma DMG with BMD among 5315 participants (46-49 and 71-74 years old) and with hip fracture among 3310 participants (71-74 years old) enrolled in the Hordaland Health Study. In age and sex-adjusted logistic regression models, subjects in the lowest versus highest DMG tertile were more likely to have low BMD (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.43-1.99). The association was stronger in participants exposed compared to those unexposed to nicotine (OR 2.31, 95% CI 1.73-3.07 and OR 1.43, 95% CI 1.16-1.75, respectively, p interaction = 0.008). In the older cohort, Cox regression analyses adjusted for sex showed that low plasma DMG was associated with an increased risk of hip fracture (hazard ratio [HR] 1.70, 95% CI 1.28-2.26). A trend toward an even higher risk was found among women exposed to nicotine (HR 3.41, 95% CI 1.40-8.28). Low plasma DMG was associated with low BMD and increased risk of hip fractures. A potential effect modification by nicotine exposure merits particular attention.

  17. Soft tissues, areal bone mineral density and hip geometry estimates in active young boys: the PRO-BONE study.

    Science.gov (United States)

    Wilkinson, Kelly; Vlachopoulos, Dimitris; Klentrou, Panagiota; Ubago-Guisado, Esther; De Moraes, Augusto César Ferreira; Barker, Alan R; Williams, Craig A; Moreno, Luis A; Gracia-Marco, Luis

    2017-04-01

    Soft tissues, such as fat mass (FM) and lean mass (LM), play an important role in bone development but this is poorly understood in highly active youths. The objective of this study was to determine whether FM or LM is a stronger predictor of areal bone mineral density (aBMD) and hip geometry estimates in a group of physically active boys after adjusting for height, chronological age, moderate-to-vigorous physical activity (MVPA), FM, and LM. Participants included 121 boys (13.1 ± 1.0 years) from the PRO-BONE study. Bone mineral content (BMC) and aBMD were measured at total body, femoral neck and lumbar spine using dual-energy X-ray absorptiometry (DXA), and hip structural analysis was used to estimate bone geometry at the femoral neck. Body composition was assessed using DXA. The relationships of FM and LM with bone outcomes were analysed using simple and multiple linear regression analyses. Pearson correlation coefficients showed that total body (less head) aBMD was significantly correlated with LM but not FM. Multiple linear regression analyses showed that FM, after accounting for height, age, MVPA and LM had no significant relationship with aBMD or hip geometry estimates, except for arms aBMD. By contrast, there were positive associations between LM and most aBMD and hip geometry estimates, after accounting height, age, MVPA and FM. The results of this study suggest that LM, and not FM, is the stronger predictor of aBMD and hip geometry estimates in physically active boys. ClinicalTrials.gov ISRCTN17982776.

  18. Dislocation of hip hemiarthroplasty following posterolateral surgical approach: a nested case-control study.

    Science.gov (United States)

    Madanat, Rami; Mäkinen, Tatu J; Ovaska, Mikko T; Soiva, Martti; Vahlberg, Tero; Haapala, Jussi

    2012-05-01

    Hip hemiarthroplasty dislocation is a serious complication in treatment of displaced intracapsular hip fractures. We investigated factors associated with an increased risk of dislocation after cemented hip hemiarthroplasty following the posterolateral approach. Between January 2002 and December 2008, 602 hip fractures were treated with cemented unipolar hip hemiarthroplasty. A registry-based analysis was carried out to determine the total number of hemiarthroplasty dislocations in these patients. A control group of 96 patients without dislocation was randomly selected. Logistic regression analysis was performed to evaluate clinical and operative factors associated with dislocation. Thirty-four patients (5.6%) experienced at least one dislocation. Most were the result of a fall and occurred within two months after surgery. There was a trend for increased dislocation in patients who had been operated on more than 48 hours after admission and in patients who had a longer operative time. Smaller centre-edge angle and hip offset were observed in patients with dislocation. Recurrent dislocation was a significant problem, as 18 patients (62%) experienced multiple dislocations. The risk of hemiarthroplasty dislocation following the posterolateral surgical approach may be reduced by prompt surgical treatment and fall prevention in the early postoperative period. Patients with smaller acetabular coverage seem more predisposed to dislocation after the posterolateral approach and may be more suitable for other surgical approaches.

  19. Contemporary risk of hip fracture in type 1 and type 2 diabetes: a national registry study from Scotland.

    Science.gov (United States)

    Hothersall, Eleanor J; Livingstone, Shona J; Looker, Helen C; Ahmed, S Faisal; Cleland, Steve; Leese, Graham P; Lindsay, Robert S; McKnight, John; Pearson, Donald; Philip, Sam; Wild, Sarah H; Colhoun, Helen M

    2014-01-01

    The purpose of this study was to compare contemporary risk of hip fracture in type 1 and type 2 diabetes with the nondiabetic population. Using a national diabetes database, we identified those with type 1 and type 2 diabetes who were aged 20 to 84 years and alive anytime from January 1, 2005 to December 31, 2007. All hospitalized events for hip fracture in 2005 to 2007 for diabetes patients were linked and compared with general population counts. Age- and calendar-year-adjusted incidence rate ratios were calculated by diabetes type and sex. One hundred five hip fractures occurred in 21,033 people (59,585 person-years) with type 1 diabetes; 1421 in 180,841 people (462,120 person-years) with type 2 diabetes; and 11,733 hip fractures over 10,980,599 person-years in the nondiabetic population (3.66 million people). Those with type 1 diabetes had substantially elevated risks of hip fracture compared with the general population incidence risk ratio (IRR) of 3.28 (95% confidence interval [CI] 2.52-4.26) in men and 3.54 (CI 2.75-4.57) in women. The IRR was greater at younger ages, but absolute risk difference was greatest at older ages. In type 2 diabetes, there was no elevation in risk among men (IRR 0.97 [CI 0.92-1.02]) and the increase in risk in women was small (IRR 1.05 [CI 1.01-1.10]). There remains a substantial elevation relative risk of hip fracture in people with type 1 diabetes, but the relative risk is much lower than in earlier studies. In contrast, there is currently little elevation in overall hip fracture risk with type 2 diabetes, but this may mask elevations in risk in particular subgroups of type 2 diabetes patients with different body mass indexes, diabetes duration, or drug exposure. © 2014 American Society for Bone and Mineral Research.

  20. Risk factors for mortality in geriatric hip fractures: a compressional study of different surgical procedures in 785 consecutive patients.

    Science.gov (United States)

    Ercin, Ersin; Bilgili, M Gokhan; Sari, Cihangir; Basaran, S Hakan; Tanriverdi, Bulent; Edipoglu, Erdem; Celen, K Mumtaz; Cetingok, Halil; Kural, Cemal

    2017-01-01

    Only a little is known about whether type of surgical intervention has an effect on mortality of these patients. Our primary objective was to assess whether different type of surgical procedures has an effect on mortality among elderly patients with hip fracture. A secondary objective was to examine factors that are related to mortality in our patient population. Our hypothesis is that type of surgical procedure, especially external fixation, should have an influence on mortality outcomes. We included 785 patients age 65 years or older, with hip fractures. Operative treatment consisted of external fixation, internal fixation, total hip arthroplasty and hip hemiarthroplasty. Age, gender, type of fracture, type of surgery performed, American Society of Anesthesiology (ASA) grade, clinical comorbidities, anesthesia type, blood transfusion requirement, time to surgery, intensive care unit requirement, operation length and length of hospital stay and number of comorbidities were documented. During the study period, 785 patients (262 male, 523 female) were included to study, Overall mortality rate was 37.2 % (292/785). Their age ranged between 65 and 100 years (mean 81). Surgery type Kaplan-Meier cumulative mortality curves suggested no significant difference between four different types of surgery groups (p = 0.064). Transfusion requirement was significantly lower in external fixation group comparing to other groups (p = 0.014). Cox regression analysis showed the number of comorbidities 2 and ≥ 3 (p = 0.0027, p = 0.015), transfusion requirement (p = 0.0001), ASA 4 (p = 0.016) to be significant predictors of mortality. Transfusion requirement, ASA grade 4 and having more than two comorbidities are risk factors for mortality in geriatric hip fractures. Type of surgical intervention and fracture type had similar mortality rates in our patient population.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    NARCIS (Netherlands)

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

    2004-01-01

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

  3. [Effects of long-term fluoride in drinking water on risks of hip fracture of the elderly: an ecologic study based on database of hospitalization episodes].

    Science.gov (United States)

    Park, Eun Young; Hwang, Seung Sik; Kim, Jai Yong; Cho, Soo Hun

    2008-05-01

    Fluoridation of drinking water is known to decrease dental caries, particularly in children. However, the effects of fluoridated water on bone over several decades are still in controversy. To assess the risk of hip fracture related to water fluoridation, we evaluated the hip fracture-related hospitalizations of the elderly between a fluoridated city and non-fluoridated cities in Korea. Cheongju as a fluoridated area and Chungju, Chuncheon, Suwon, Wonju as non-fluoridated areas were chosen for the study. We established a database of hip fracture hospitalization episode based on the claims data submitted to the Health Insurance Review Agency from January 1995 to December 2002. The hip fracture hospitalization episodes that satisfied the conditions were those that occurred in patients over 65 years old, the injuries had a hip fracture code (ICD-9 820, ICD-10 S72) and the patients were hospitalized for at least 7days. A total of 80,558 cases of hip fracture hospitalization episodes were analyzed. The admission rates for hip fracture increased with the age of the men and women in both a fluoridated city and the non-fluoridated cities (pfluoridated city and the nonfluoridated cities. We cannot conclude that fluoridation of drinking water increases the risk of hip fracture in the elderly.

  4. Is physical activity a risk factor for primary knee or hip replacement due to osteoarthritis? A prospective cohort study.

    Science.gov (United States)

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

    2011-02-01

    To estimate prospectively any association between measures of physical activity and the risk of either primary knee or hip replacement due to osteoarthritis (OA). Eligible subjects (n = 39,023) were selected from participants in a prospective cohort study recruited 1990-1994. Primary knee and hip replacement for OA during 2001-2005 was determined by linking the cohort records to the National Joint Replacement Registry. A total physical activity level was computed, incorporating both intensity and frequency for different forms of physical activity obtained by questionnaire at baseline attendance. There was a dose-response relationship between total physical activity level and the risk of primary knee replacement [hazards ratio (HR) 1.04, 95% CI 1.01-1.07 for an increase of 1 level in total physical activity]. Although vigorous activity frequency was associated with an increased risk of primary knee replacement (HR 1.42, 95% CI 1.08-1.86) for 1-2 times/week and HR 1.24 (95% CI 0.90-1.71) for ≥ 3 times/week), the p for trend was marginal (continuous HR 1.08, 95% CI 1.00-1.16, p = 0.05). The frequency of less vigorous activity or walking was not associated with the risk of primary knee replacement, nor was any measure of physical activity associated with the risk of primary hip replacement. Increasing levels of total physical activity are positively associated with the risk of primary knee but not hip replacement due to OA. Physical activity might affect the knee and hip joints differently depending on the preexisting health status and anatomy of the joint, as well as the sort of physical activity performed.

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

    Science.gov (United States)

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

    2015-09-02

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

  6. Distal extension of the direct anterior approach to the hip poses risk to neurovascular structures: an anatomical study.

    Science.gov (United States)

    Grob, Karl; Monahan, Rebecca; Gilbey, Helen; Yap, Francis; Filgueira, Luis; Kuster, Markus

    2015-01-21

    The anterior approach to the hip gained popularity for total hip arthroplasty in recent years. Distal extension of the anterior approach, sometimes needed intraoperatively, potentially endangers neurovascular structures to the quadriceps. The aim of this study was to determine the anatomical structures placed at risk by distal extension of the anterior approach to the hip. Seventeen cadaveric hemipelves from twelve human specimens were dissected. The femoral nerve and its branches and the vessels arising from the lateral femoral circumflex artery were assessed in relation to the distal extension of the anterior approach. The damage caused by the introduction of a cerclage cable passer was also investigated. The area immediately distal to the intertrochanteric line is a common entry point for several nerve branches and is a useful distal landmark for surgeons to use to protect important neurovascular structures. The distal extension of the anterior approach compromises the nerve supply to the anterolateral portions of the quadriceps. Introduction of a cerclage cable passer through the anterior access also jeopardizes nerve branches to the vastus lateralis, lateral parts of the vastus intermedius, and branches of the lateral femoral circumflex artery. Distal extension of the direct anterior approach to the hip is challenging to accomplish without neurovascular injury to anterolateral parts of the quadriceps muscle group. In addition, important neurovascular structures are endangered with the introduction of a cable passer through the anterior approach. Distal extension of the direct anterior approach to the hip beyond the intertrochanteric line may compromise neurovascular structures supplying the quadriceps muscle. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  7. Variability of indication criteria in knee and hip replacement: an observational study

    Directory of Open Access Journals (Sweden)

    Sarasqueta Cristina

    2010-10-01

    Full Text Available Abstract Background Total knee (TKR and hip (THR replacement (arthroplasty are effective surgical procedures that relieve pain, improve patients' quality of life and increase functional capacity. Studies on variations in medical practice usually place the indications for performing these procedures to be highly variable, because surgeons appear to follow different criteria when recommending surgery in patients with different severity levels. We therefore proposed a study to evaluate inter-hospital variability in arthroplasty indication. Methods The pre-surgical condition of 1603 patients included was compared by their personal characteristics, clinical situation and self-perceived health status. Patients were asked to complete two health-related quality of life questionnaires: the generic SF-12 (Short Form and the specific WOMAC (Western Ontario and Mcmaster Universities scale. The type of patient undergoing primary arthroplasty was similar in the 15 different hospitals evaluated. The variability in baseline WOMAC score between hospitals in THR and TKR indication was described by range, mean and standard deviation (SD, mean and standard deviation weighted by the number of procedures at each hospital, high/low ratio or extremal quotient (EQ5-95, variation coefficient (CV5-95 and weighted variation coefficient (WCV5-95 for 5-95 percentile range. The variability in subjective and objective signs was evaluated using median, range and WCV5-95. The appropriateness of the procedures performed was calculated using a specific threshold proposed by Quintana et al for assessing pain and functional capacity. Results The variability expressed as WCV5-95 was very low, between 0.05 and 0.11 for all three dimensions on WOMAC scale for both types of procedure in all participating hospitals. The variability in the physical and mental SF-12 components was very low for both types of procedure (0.08 and 0.07 for hip and 0.03 and 0.07 for knee surgery patients

  8. Hip protectors for preventing hip fractures in older people.

    Science.gov (United States)

    Santesso, Nancy; Carrasco-Labra, Alonso; Brignardello-Petersen, Romina

    2014-03-31

    Older people living in nursing care facilities or older adults living at home are at high risk of falling and a hip fracture may occur after a fall. Hip protectors have been advocated as a means to reduce the risk of hip fracture. Hip protectors are plastic shields (hard) or foam pads (soft), usually fitted in pockets in specially designed underwear.This is an update of a Cochrane review first published in 1999, and updated several times, most recently in 2010. To determine if the provision of external hip protectors (sometimes referred to as hip pads or hip protector pads) reduces the risk of fracturing the hip in older people. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (December 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 12), MEDLINE (1950 to week 3 November 2012), MEDLINE In-Process (18 December 2012), EMBASE (1988 to 2012 Week 50), CINAHL (1982 to December 2012), BioMed Central (January 2010), trial registers and reference lists of relevant articles. All randomised or quasi-randomised controlled trials comparing an intervention group provided with hip protectors with a control group not provided with hip protectors. Two review authors independently assessed risk of bias and extracted data. We sought additional information from trialists. Data were pooled using fixed-effect or random-effects models as appropriate. This review includes 19 studies, nine of which were cluster randomised. These included approximately 17,000 people (mean age range 78 to 86 years). Most studies were overall at low risk of bias for fracture outcomes. Trials tested hard or soft hip protectors enclosed in special underwear in 18 studies.Pooling of data from 14 studies (11,808 participants) conducted in nursing or residential care settings found moderate quality evidence for a small reduction in hip fracture risk (risk ratio (RR) 0.82, 95% confidence interval (CI) 0.67 to 1.00); the absolute

  9. Rupture of the ilio-psoas tendon after a total hip arthroplasty: an unusual cause of radio-lucency of the lesser trochanter simulating a malignancy

    Directory of Open Access Journals (Sweden)

    Pitcher J David

    2010-02-01

    Full Text Available Abstract Avulsion fracture or progressive radiolucency of lesser trochanter is considered a pathognomic finding in patients with malignancies. Although surgical release of the iliopsoas tendon may be required during a total hip arthroplasty (THA, there is no literature on spontaneous rupture of the ilio-psoas tendon after a THA causing significant functional impairment. We report here such a case, which developed progressive radiolucency of the lesser trochanter over six years after a THA, simulating a malignancy. The diagnosis was confirmed by MRI. Because of the chronic nature of the lesion, gross retraction of the tendon into the pelvis, and low demand of our patient, he was treated by physiotherapy and gait training. Injury to the ilio-psoas tendon can occur in various steps of the THA and extreme care should be taken to avoid this injury. Prevention during surgery is better, although there are no reports of repair in the THA setting. This condition should be considered in patients who present with progressive radioluceny of the lesser trochanter, especially in the setting of a hip/pelvic surgery. Awareness and earlier recognition of the signs and symptoms of this condition will aid in diagnosis and will direct appropriate management.

  10. Influence of the hip flexion angle on isokinetic hip rotator torque and acceleration time of the hip rotator muscles.

    Science.gov (United States)

    Baldon, Rodrigo de M; Furlan, Leonardo; Serrão, Fábio V

    2013-10-01

    The purpose of this study was to verify the influence of the hip flexion angle on isokinetic rotator torque and acceleration times of the hip medial and lateral rotator muscles. Twenty-one healthy women were included in this study. The hip rotator function was evaluated at 3 different hip flexion angles (10°, 40°, and 90°). The results showed that both eccentric and concentric hip lateral rotator torques were greater at 40° of hip flexion when compared with 90°. Moreover, both the eccentric and concentric hip medial rotator torques were greater at 90° of hip flexion than at 40° and 10°, and greater at 40° than at 10°. In addition, both the eccentric and concentric hip medial to lateral rotator torque ratios were greater at 90° of hip flexion than at 40° and 10°, and greater at 40° than at 10°. Finally, the acceleration times of the hip medial rotator muscles were smaller at 90° of hip flexion than at 10° and smaller at 40° than at 10°. The current results highlight the importance of evaluating the hip rotator muscles at different hip flexion angles to comprehensively assess their functions.

  11. Aberrant pelvis and hip kinematics impair hip loading before and after total hip replacement.

    Science.gov (United States)

    Lenaerts, G; Mulier, M; Spaepen, A; Van der Perre, G; Jonkers, I

    2009-10-01

    Musculoskeletal loading is an important factor affecting the development of osteoarthritis, bone remodelling and primary fixation of total hip replacement (THR). In this study, we analyzed the relation between muscular force, gait kinematics and kinetics and hip loading in 20 patients before and six weeks after THR. Hip contact forces were calculated from gait analysis data using musculoskeletal modelling, inverse dynamics and static optimization. We found aberrant pelvis and hip kinematics and kinetics before and six weeks after surgery, confirming previous findings in literature. Furthermore, we found a decrease in the total contact force and its vertical component. These changes result in a decrease of the associated inclination angles of the total hip contact force in the sagittal and transverse planes, changing the orientation towards more vertical implant loading after THR. These changes in hip loading were related to observed gait kinematics and kinetics. Most importantly, excessive pelvic obliquity and associated hip adduction related to impaired implant loading. We concluded, therefore, that physical therapy in the early post-operative phase should primarily focus on stretching of anterior and medial structures and strengthening of hip flexors and abductors to achieve normalization of the hip and pelvis kinematics and consequently normalize hip loading.

  12. Genetic evaluation of hip score in UK Labrador Retrievers.

    Directory of Open Access Journals (Sweden)

    Thomas W Lewis

    2010-10-01

    Full Text Available Hip dysplasia is an important and complex genetic disease in dogs with both genetic and environmental influences. Since the osteoarthritis that develops is irreversible the only way to improve welfare, through reducing the prevalence, is through genetic selection. This study aimed to evaluate the progress of selection against hip dysplasia, to quantify potential improvements in the response to selection via use of genetic information and increases in selection intensity, and to prepare for public provision of estimated breeding values (EBV for hip dysplasia in the UK. Data consisted of 25,243 single records of hip scores of Labrador Retrievers between one and four years old, from radiographs evaluated between 2000 and 2007 as part of the British Veterinary Association (BVA hip score scheme. A natural logarithm transformation was applied to improve normality and linear mixed models were evaluated using ASREML. Genetic correlations between left and right scores, and total hip scores at one, two and three years of age were found to be close to one, endorsing analysis of total hip score in dogs aged one to three as an appropriate approach. A heritability of 0.35±0.016 and small but significant litter effect (0.07±0.009 were estimated. The observed trends in both mean hip score and mean EBV over year of birth indicate that a small genetic improvement has been taking place, approximately equivalent to avoiding those dogs with the worst 15% of scores. Deterministic analysis supported by simulations showed that a 19% greater response could be achieved using EBV compared to phenotype through increases in accuracy alone. This study establishes that consistent but slow genetic improvement in the hip score of UK Labrador Retrievers has been achieved over the previous decade, and demonstrates that progress may be easily enhanced through the use of EBVs and more intense selection.

  13. Genetic Evaluation of Hip Score in UK Labrador Retrievers

    Science.gov (United States)

    Lewis, Thomas W.; Blott, Sarah C.; Woolliams, John A.

    2010-01-01

    Hip dysplasia is an important and complex genetic disease in dogs with both genetic and environmental influences. Since the osteoarthritis that develops is irreversible the only way to improve welfare, through reducing the prevalence, is through genetic selection. This study aimed to evaluate the progress of selection against hip dysplasia, to quantify potential improvements in the response to selection via use of genetic information and increases in selection intensity, and to prepare for public provision of estimated breeding values (EBV) for hip dysplasia in the UK. Data consisted of 25,243 single records of hip scores of Labrador Retrievers between one and four years old, from radiographs evaluated between 2000 and 2007 as part of the British Veterinary Association (BVA) hip score scheme. A natural logarithm transformation was applied to improve normality and linear mixed models were evaluated using ASREML. Genetic correlations between left and right scores, and total hip scores at one, two and three years of age were found to be close to one, endorsing analysis of total hip score in dogs aged one to three as an appropriate approach. A heritability of 0.35±0.016 and small but significant litter effect (0.07±0.009) were estimated. The observed trends in both mean hip score and mean EBV over year of birth indicate that a small genetic improvement has been taking place, approximately equivalent to avoiding those dogs with the worst 15% of scores. Deterministic analysis supported by simulations showed that a 19% greater response could be achieved using EBV compared to phenotype through increases in accuracy alone. This study establishes that consistent but slow genetic improvement in the hip score of UK Labrador Retrievers has been achieved over the previous decade, and demonstrates that progress may be easily enhanced through the use of EBVs and more intense selection. PMID:21042573

  14. Direct health-care costs attributed to hip fractures among seniors: a matched cohort study.

    Science.gov (United States)

    Nikitovic, M; Wodchis, W P; Krahn, M D; Cadarette, S M

    2013-02-01

    Using a matched cohort design, we estimated the mean direct attributable cost in the first year after hip fracture in Ontario to be $36,929 among women and $39,479 among men. These estimates translate into an annual $282 million in direct attributable health-care costs in Ontario and $1.1 billion in Canada. Osteoporosis is a major public health concern that results in substantial fracture-related morbidity and mortality. It is well established that hip fractures are the most devastating consequence of osteoporosis, yet the health-care costs attributed to hip fractures in Canada have not been thoroughly evaluated. We determined the 1- and 2-year direct attributable costs and cost drivers associated with hip fractures among seniors in comparison to a matched non-hip fracture cohort using health-care administrative data from Ontario (2004-2008). Entry into long-term care and deaths attributable to hip fracture were also determined. We successfully matched 22,418 female (mean age = 83.3 years) and 7,611 male (mean age = 81.3 years) hip fracture patients. The mean attributable cost in the first year after fracture was $36,929 (95 % CI $36,380-37,466) among women and $39,479 (95 % CI $38,311-$40,677) among men. These estimates translate into an annual $282 million in direct attributable health-care costs in Ontario and $1.1 billion in Canada. Primary cost drivers were acute and post-acute institutional care. Approximately 24 % of women and 19 % of men living in the community at the time of fracture entered a long-term care facility, and 22 % of women and 33 % of men died within the first year following hip fracture. Attributable costs remained elevated into the second year ($9,017 among women, $10,347 among men) for patients who survived the first year. We identified significant health-care costs, entry into long-term care, and mortality attributed to hip fractures. Results may inform health economic analyses and policy decision-making in Canada.

  15. Quantification of material loss from the neck piece taper junctions of a bimodular primary hip prosthesis. A retrieval study from 27 failed Rejuvenate bimodular hip arthroplasties.

    Science.gov (United States)

    Buente, D; Huber, G; Bishop, N; Morlock, M

    2015-10-01

    The early failure and revision of bimodular primary total hip arthroplasty prostheses requires the identification of the risk factors for material loss and wear at the taper junctions through taper wear analysis. Deviations in taper geometries between revised and pristine modular neck tapers were determined using high resolution tactile measurements. A new algorithm was developed and validated to allow the quantitative analysis of material loss, complementing the standard visual inspection currently used. The algorithm was applied to a sample of 27 retrievals (in situ from 2.9 to 38.1 months) of the withdrawn Rejuvenate modular prosthesis. The mean wear volumes on the flat distal neck piece taper was 3.35 mm(3) (0.55 to 7.57), mainly occurring in a characteristic pattern in areas with high mechanical loading. Wear volume tended to increase with time to revision (r² = 0.423, p = 0.001). Implant and patient specific data (offset, stem size, patient's mass, age and body mass index) did not correlate with the amount of material loss observed (p > 0.078). Bilaterally revised implants showed higher amounts of combined total material loss and similar wear patterns on both sides. The consistent wear pattern found in this study has not been reported previously, suggesting that the device design and materials are associated with the failure of this prosthesis. ©2015 The British Editorial Society of Bone & Joint Surgery.

  16. Evaluating recovery following hip fracture : a qualitative interview study of what is important to patients\\ud

    OpenAIRE

    Griffiths, Frances; Mason, Victoria; Boardman, Felicity K.; Dennick, Kathryn J.; Haywood, Kirstie L.; Achten, Juul; Parsons, Nicholas R; Griffin, Xavier L.; Costa, Matthew L.

    2015-01-01

    Objective: \\ud To explore what patients consider important when evaluating their recovery from hip fracture and to consider how these priorities could be used in the evaluation of the quality of hip fracture services.\\ud \\ud Design:\\ud Semistructured interviews exploring the experience of recovery from hip fracture at two time points—4 weeks and 4 months postoperative hip fixation. Two approaches to analysis: thematic analysis of data specifically related to recovery from hip fracture; summar...

  17. High hip fracture risk in men with severe aortic calcification - MrOS study

    Science.gov (United States)

    Szulc, Pawel; Blackwell, Terri; Schousboe, John T.; Bauer, Douglas C.; Cawthon, Peggy; Lane, Nancy E.; Cummings, Steven R.; Orwoll, Eric S.; Black, Dennis M.; Ensrud, Kristine E.

    2013-01-01

    A significant link between cardiovascular disease and osteoporosis is established in postmenopausal women, but data in men are scarce. We tested the hypothesis that greater severity of abdominal aortic calcification (AAC) was associated with an increased risk of non-spine fracture in 5994 men aged ≥65 years. AAC wasassessed on 5400 baseline lateral thoraco-lumbar radiographs using a validated visual semi-quantitative score. Total hip bone mineral density (BMD) was measured using dual energy X-ray absorptiometry. Incident non-spine fractures were centrally adjudicated. After adjustment for age, BMI, total hip BMD, fall history, prior fracture, smoking status, co-morbidities, race and clinical center, the risk of non-spine fracture (n=805) was increased among men with higher AAC (HR Q4 (AAC score ≥9) vs Q1 (0-1): 1.36, 96%CI: 1.10-1.68). This association was due to an increased risk of hip fracture (n=178) among men with higher AAC (HR Q4 vs Q1: 2.33, 95%CI: 1.41-3.87). By contrast, the association between AAC and the risk of non-spine-non-hip fracture was weaker and not significant (HR Q4 vs Q1: 1.22, 95%CI: 0.96-1.55). The findings regarding higher AAC and increased risk of fracture were not altered in additional analyses accounting for degree of trauma, estimated glomerular filtration rate, presence of lumbar vertebral fractures (which may bias AAC assessment), preexisting cardiovascular disease, ankle brachial index or competing risk of death. Thus, in this large cohort of elderly men, greater AAC was independently associated with an increased risk of hip fracture, but not with other non-spine fractures. These findings suggest that AAC assessment may be a useful method for identification of older men at high risk of hip fracture. PMID:23983224

  18. Improving peri-prosthetic bone adaptation around cementless hip stems: A clinical and finite element study

    NARCIS (Netherlands)

    ten Broeke, R.H.M.; Tarala, M.; Arts, J.J.; Janssen, D.W.; Verdonschot, Nicolaas Jacobus Joseph; Geesink, R.G.T.

    2014-01-01

    This study assessed whether the Symax™ implant, a modification of the Omnifit® stem (in terms of shape, proximal coating and distal surface treatment), would yield improved bone remodelling in a clinical DEXA study, and if these results could be predicted in a finite element (FE) simulation study.

  19. Evaluating recovery following hip fracture: a qualitative interview study of what is important to patients.

    Science.gov (United States)

    Griffiths, Frances; Mason, Victoria; Boardman, Felicity; Dennick, Katherine; Haywood, Kirstie; Achten, Juul; Parsons, Nicholas; Griffin, Xavier; Costa, Matthew

    2015-01-06

    To explore what patients consider important when evaluating their recovery from hip fracture and to consider how these priorities could be used in the evaluation of the quality of hip fracture services. Semistructured interviews exploring the experience of recovery from hip fracture at two time points-4 weeks and 4 months postoperative hip fixation. Two approaches to analysis: thematic analysis of data specifically related to recovery from hip fracture; summarising the participant's experience overall. 31 participants were recruited, of whom 20 were women and 12 were cognitively impaired. Mean age was 81.5 years. Interviews were provided by 19 patients, 14 carers and 8 patient/carer dyad; 10 participants were interviewed twice. Single major trauma centre in the West Midlands of the UK. Stable mobility (without falls or fear of falls) for valued activities was considered most important by participants who had some prefracture mobility and were able to articulate what they valued during recovery. Mobility was important for managing personal care, for day-to-day activities such as shopping and gardening, and for maintenance of mental well-being. Some participants used assistive mobility devices or adapted to their limitations. Others maintained their previous limited function through increased care provision. Many participants were unable to articulate what they valued as hip fracture was perceived as part of their decline with age. The fracture and problems from other health conditions were an inseparable part of one health experience. Prefracture mobility, adaptations to reduced mobility before or after fracture, and whether or not patients perceive themselves to be declining with age influence what patients consider important during recovery from hip fracture. No single patient-reported outcome measure could evaluate quality of care for all patients following hip fracture. General health-related quality of life tools may provide useful information within

  20. Health-related quality of life after vertebral or hip fracture: a seven-year follow-up study

    Directory of Open Access Journals (Sweden)

    Toss Göran

    2009-11-01

    Full Text Available Abstract Background The negative impact of vertebral and hip low-energy fractures on health-related quality-of-life (HRQOL has been demonstrated previously, but few prospective long-term follow-up studies have been conducted. This study aims to (i investigate the changes and long-term impact of vertebral or hip fracture and between fracture groups on HRQOL in postmenopausal women prospectively between two and seven years after the inclusion fracture, (ii compare HRQOL results between fracture and reference groups and (iii study the relationship between HRQOL and physical performance, spinal deformity index and bone mineral density at seven-year follow-up. Methods Ninety-one women examined two years after a low-energy vertebral or hip fracture were invited to a new examination seven years after the diagnosis. HRQOL was examined using the SF-36 questionnaire and was compared with an age and sex-matched reference group. Physical function was assessed using tests and questionnaires. Bone mineral density was measured. Radiographs of the spine were evaluated using the visual semiquantitative technique. A longitudinal and cross-sectional design was used in this study. Statistical analyses included descriptive statistics, Student's t-tests, ANCOVA, and partial correlation. Results Sixty-seven women participated. In the 42 women (mean age 75.8, SD 4.7 with vertebral fracture as inclusion fracture, bodily pain had deteriorated between two and seven years and might be explained by new fracture. Remaining pronounced reduction of HRQOL was seen in all domains except general health and mental health at seven-year follow-up in women with vertebral fractures compared to the reference group (p Conclusion The long-term reduction of HRQOL in women with vertebral fracture emerged clearly in this study. The relationships between HRQOL and physical performance in women with vertebral and hip fracture raise questions for more research.

  1. Comparison of patients in three different rehabilitation settings after knee or hip arthroplasty: a natural observational, prospective study

    OpenAIRE

    Benz, T; Angst, F.; Oesch, P.; Hilfiker, R.; Lehmann, S; Mebes, Christine; Kramer, E.; Verra, Martin

    2015-01-01

    BACKGROUND Patients after primary hip or knee replacement surgery can benefit from postoperative treatment in terms of improvement of independence in ambulation, transfers, range of motion and muscle strength. After discharge from hospital, patients are referred to different treatment destination and modalities: intensive inpatient rehabilitation (IR), cure (medically prescribed stay at a convalescence center), or ambulatory treatment (AT) at home. The purpose of this study was to 1) meas...

  2. Health-related quality of life after surgery for hip fracture: a multicentric study in Mexican population

    Directory of Open Access Journals (Sweden)

    Esperanza Ramírez-Pérez

    2014-06-01

    Full Text Available INTRODUCTION Hip fractures are an important cause of morbidity and mortality and one of the main causes of disability in the older population. The lifetime risk for any type of osteoporotic fracture is very high and falls within the range of 40–50% in women and 13–22% for men. In Mexico, the lifetime likelihood of having a hip fracture at 50 years of age is 8.5% in Mexican women and 3.8% in Mexican men, but this is expected to rise in upcoming years. AIM This study aims to report the Health-Related Quality of Life over the first six months after a hip fracture in two public and two private tertiary care hospitals in Mexico City. METHOD Changes over time were evaluated through visual observation of each patient’s development trajectory using the graphic representation of the EQ-5D global score. The trajectories were grouped by affinity into five levels of progress according to clinical course. The identified descriptive options were analyzed using the multinomial logistic regression model (LR. RESULTS One-hundred-and-thirty-six (136 patients with a hip fracture were followed after surgery. Their mean age was 77 ± 10 years. During the first month, mobility, daily activities, and self-care were the most affected. The group aged between 80 and 84 years reported extreme problems regarding anxiety and depression (21%, and those aged between 50 and 74 years described having issues concerning pain and discomfort (27%. At the 6-month follow-up, only those aged > 85 years of age showed worsening of their condition, a high proportion of these ranking at level 3 in mobility, self-care, and anxiety/depression. Toward the end of the follow-up period, this last group reported having extreme problems (being unable to carry out everyday activities and worsening of their mobility (9.2% (inability to walk about (LR test, p = 0.06. DISCUSSION Patients with hip fracture showed difficulties in different areas during the first month after surgery, with steady

  3. 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 ...

  4. Objectively-Verified Parental Non-Hip Major Osteoporotic Fractures and Offspring Osteoporotic Fracture Risk: A Population-Based Familial Linkage Study.

    Science.gov (United States)

    Yang, Shuman; Leslie, William D; Walld, Randy; Roos, Leslie L; Morin, Suzanne N; Majumdar, Sumit R; Lix, Lisa M

    2017-04-01

    Parental hip fracture (HF) is associated with increased risk of offspring major osteoporotic fractures (MOFs; comprising hip, forearm, clinical spine or humerus fracture). Whether other sites of parental fracture should be used for fracture risk assessment is uncertain. The current study tested the association between objectively-verified parental non-hip MOF and offspring incident MOF. Using population-based administrative healthcare data for the province of Manitoba, Canada, we identified 255,512 offspring with linkage to at least one parent (238,054 mothers and 209,423 fathers). Parental non-hip MOF (1984-2014) and offspring MOF (1997-2014) were ascertained with validated case definitions. Time-dependent multivariable Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs). During a median of 12 years of offspring follow-up, we identified 7045 incident MOF among offspring (3.7% and 2.5% for offspring with and without a parental non-hip MOF, p hip MOF (HR 1.27; 95% CI, 1.19 to 1.35), paternal non-hip MOF (HR 1.33; 95% CI, 1.20 to 1.48), and any parental non-hip MOF (HR 1.28; 95% CI, 1.21 to 1.36) were significantly associated with offspring MOF after adjusting for covariates. The risk of MOF was even greater for offspring with both maternal and paternal non-hip MOF (adjusted HR 1.61; 95% CI, 1.27 to 2.02). All HRs were similar for male and female offspring (all pinteraction >0.1). Risks associated with parental HF only (adjusted HR 1.26; 95% CI, 1.13 to 1.40) and non-hip MOF only (adjusted HR 1.26; 95% CI, 1.18 to 1.34) were the same. The strength of association between any parental non-hip MOF and offspring MOF decreased with older parental age at non-hip MOF (ptrend  = 0.028). In summary, parental non-hip MOF confers an increased risk for offspring MOF, but the strength of the relationship decreases with older parental age at fracture. © 2016 American Society for Bone and

  5. What are the risk factors for dislocation in primary total hip arthroplasty? A multicenter case-control study of 128 unstable and 438 stable hips.

    Science.gov (United States)

    Fessy, M H; Putman, S; Viste, A; Isida, R; Ramdane, N; Ferreira, A; Leglise, A; Rubens-Duval, B; Bonin, N; Bonnomet, F; Combes, A; Boisgard, S; Mainard, D; Leclercq, S; Migaud, H

    2017-09-01

    Dislocation after total hip arthroplasty (THA) is a leading reason for surgical revision. The risk factors for dislocation are controversial, particularly those related to the patient and to the surgical procedure itself. The differences in opinion on the impact of these factors stem from the fact they are often evaluated using retrospective studies or in limited patient populations. This led us to carry out a prospective case-control study on a large population to determine: 1) the risk factors for dislocation after THA, 2) the features of these dislocations, and 3) the contribution of patient-related factors and surgery-related factors. Risk factors for dislocation related to the patient and procedure can be identified using a large case-control study. A multicenter, prospective case-control study was performed between January 1 and December 31, 2013. Four patients with stable THAs were matched to each patient with a dislocated THA. This led to 566 primary THA cases being included: 128 unstable, 438 stable. The primary matching factors were sex, age, initial diagnosis, surgical approach, implantation date and type of implants (bearing size, standard or dual-mobility cup). The patients with unstable THAs were 67±12 [37-73]years old on average; there were 61 women (48%) and 67 men (52%). Hip osteoarthritis (OA) was the main reason for the THA procedure in 71% (91/128) of the unstable group. The dislocation was posterior in 84 cases and anterior in 44 cases. The dislocation occurred within 3 months of the primary surgery in 48 cases (38%), 3 to 12 months after in 23 cases (18%), 1 to 5years after in 20 cases (16%), 5 to 10years after in 17 cases (13%) and more than 10years later in 20 cases. The dislocation recurred within 6 months of the initial dislocation in 23 of the 128 cases (18%). The risk factors for instability were a high ASA score with an odds ratio (OR) of 1.93 (95% CI: 1.4-2.6), neurological disability (cognitive, motor or psychiatric disorders) with

  6. Improving 6061-Al Grain Growth and Penetration across HIP-Bonded Clad Interfaces in Monolithic Fuel Plates: Initial Studies

    Energy Technology Data Exchange (ETDEWEB)

    Hackenberg, Robert E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); McCabe, Rodney J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Montalvo, Joel D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Clarke, Kester D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dvornak, Matthew J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Edwards, Randall L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Crapps, Justin M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Trujillo, R. Ralph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Aikin, Beverly [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Vargas, Victor D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Hollis, Kendall J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Lienert, Thomas J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Forsyth, Robert T. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Harada, Kiichi L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2013-05-06

    Grain penetration across aluminum-aluminum cladding interfaces in research reactor fuel plates is desirable and was obtained by a legacy roll-bonding process, which attained 20-80% grain penetration. Significant grain penetration in monolithic fuel plates produced by Hot Isostatic Press (HIP) fabrication processing is equally desirable but has yet to be attained. The goal of this study was to modify the 6061-Al in such a way as to promote a much greater extent of crossinterface grain penetration in monolithic fuel plates fabricated by the HIP process. This study documents the outcomes of several strategies attempted to attain this goal. The grain response was characterized using light optical microscopy (LOM) electron backscatter diffraction (EBSD) as a function of these prospective process modifications done to the aluminum prior to the HIP cycle. The strategies included (1) adding macroscopic gaps in the sandwiches to enhance Al flow, (2) adding engineering asperities to enhance Al flow, (3) adding stored energy (cold work), and (4) alternative cleaning and coating. Additionally, two aqueous cleaning methods were compared as baseline control conditions. The results of the preliminary scoping studies in all the categories are presented. In general, none of these approaches were able to obtain >10% grain penetration. Recommended future work includes further development of macroscopic grooving, transferred-arc cleaning, and combinations of these with one another and with other processes.

  7. Improving peri-prosthetic bone adaptation around cementless hip stems: A clinical and finite element study

    NARCIS (Netherlands)

    Broeke, R.H. Ten; Tarala, M.; Arts, J.J.C.; Janssen, D.W.; Verdonschot, N.J.J.; Geesink, R.G.T.

    2014-01-01

    This study assessed whether the Symax implant, a modification of the Omnifit((R)) stem (in terms of shape, proximal coating and distal surface treatment), would yield improved bone remodelling in a clinical DEXA study, and if these results could be predicted in a finite element (FE) simulation

  8. Frictional heating of total hip implants. Part 2: finite element study.

    NARCIS (Netherlands)

    Bergmann, G.; Graichen, F.; Rohlmann, A.; Verdonschot, N.J.J.; Lenthe, G.H. van

    2001-01-01

    Due to higher friction artificial hip joints warm up more than natural joints during walking and other continuous activities. This could lead to thermal damage in the surrounding tissues and be a reason for long-term implant loosening, an effect which has not yet been investigated. In vivo

  9. The Femoral Neck Mechanoresponse to Hip Extensors Exercise: A Case Study

    Directory of Open Access Journals (Sweden)

    Saulo Martelli

    2017-01-01

    Full Text Available Physical activity is recommended to prevent age-related bone loss. However, the proximal femur mechanoresponse is variable, possibly because of a muscle-dependant mechanoresponse. We compared the proximal femur response with the femoral strain pattern generated by the hip extensor muscles. A healthy participant underwent a six-month unilateral training of the hip extensor muscles using a resistance weight regularly adjusted to the 80% of the one-repetition maximum weight. DXA-based measurements of the areal Bone Mineral Density (aBMD in the exercise leg were adjusted for changes in the control leg. The biomechanical stimulus for bone adaptation (BS was calculated using published models of the musculoskeletal system and the average hip extension moment in elderly participants. Volumetric (ΔvBMD and areal (ΔaBMD BMD changes were calculated. The measured and calculated BMD changes consistently showed a positive and negative effect of exercise in the femoral neck (ΔaBMD = +0.7%; ΔvBMD = +0.8% and the trochanter region (ΔaBMD = −4.1%; ΔvBMD = −0.5%, respectively. The 17% of the femoral neck exceeded the 75th percentile of the spatially heterogeneous BS distribution. Hip extensor exercises may be beneficial in the proximal femoral neck but not in the trochanteric region. DXA-based measurements may not capture significant aBMD local changes.

  10. Characteristics of acute groin injuries in the hip flexor muscles - a detailed MRI study in athletes

    DEFF Research Database (Denmark)

    Serner, A; Weir, A; Tol, J L

    2017-01-01

    acute hip flexor muscle injury were included. A total of 156 athletes presented with acute groin pain of which 33 athletes were included, median age 26 years (range 18-35). There were 16 rectus femoris, 12 iliacus, 7 psoas major, 4 sartorius, and 1 tensor fascia latae injury. Rectus femoris injuries...

  11. Study on the Ascorbic Acid Content of rose Hip fruit Depending on Stationary Conditions

    Directory of Open Access Journals (Sweden)

    Sorina Ropciuc

    2011-10-01

    Full Text Available The dog rose area includes southern and central Europe, reaching southern Scandinavia; it is also found in Asia Minor, Central Asia and North Africa. In our country, Rosa canina is the most widespread of the many species of Rosa, common in all areas. The components of the station, known also as the „stationary factors” affect differently the plant life and their chemical composition. Cynosbati fructus is the false fruit of Rosa canina L. (Rosaceae, known in Romanian as rose hip. The rose hip contain as active ingredients 500-1000 % vitamin C, 600-10000 mg% carotenoids, pectin, dextrin, vitamins B2, E, PP, flavone, sugars, organic acids, tannins, volatile oil, vanillin, triterpenoid saponosides, beta-sitosterol, fat (lecithin, glycerides of fatty acids in seeds, minerals (potassium, calcium, magnesium, iron. Vitamin C (ascorbic acid plays an important role in human body. The greatest amount is found in plants which reached maturity. It is concentrated in the rose hip flesh. Solutions easily destroyit in the presence of UV, of copper, silver, iron and oxidative enzymes traces. Vitamin C participates actively in all processes of oxidoreductions of the living cell. Its lack in food causes the disease called scurvy which manifests itself by inflammated and bleeding gums, tooth loss. Rose hip fruits are known as medicines since prehistoric times.

  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

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

    Science.gov (United States)

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

    2016-03-01

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

  14. SIGN HIP construct: Achieving hip fracture fixation without using an ...

    African Journals Online (AJOL)

    Objective: The aim of this study was to assess outcomes of using the SIGN Hip Construct (SHC) to achieve hip fracture fixation without the use of an image intensifier. Design: Prospective case series. Setting: Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania. Outcome measures: Radiographic union, callus formation ...

  15. Risk factors for complications and in-hospital mortality following hip fractures: a study using the National Trauma Data Bank.

    Science.gov (United States)

    Belmont, Philip J; Garcia, E'Stephan J; Romano, David; Bader, Julia O; Nelson, Kenneth J; Schoenfeld, Andrew J

    2014-05-01

    Retrospective review of prospectively collected data. To describe the impact of patient demographics, injury-specific factors, and medical co-morbidities on outcomes after hip fracture using the National Sample Program (NSP) of the National Trauma Data Bank (NTDB). The 2008 NSP-NTDB was queried to identify patients sustaining hip fractures. Patient demographics, co-morbidities, injury-specific factors, and outcomes (including mortality and complications) were recorded and a national estimate model was developed. Unadjusted differences for risk factors were evaluated using t test/Wald Chi square analyses. Weighted logistic regression and sensitivity analyses were performed to control for all factors in the model. The weighted sample contained 44,419 incidents of hip fracture. The average age was 72.7. Sixty-two percent of the population was female and 80 % was white. The mortality rate was 4.5 % and 12.5 % sustained at least one complication. Seventeen percent of patients who sustained at least one complication died. Dialysis, presenting in shock, cardiac disease, male sex, and ISS were significant predictors of mortality, while dialysis, obesity, cardiac disease, diabetes, and a procedure delay of ≥2 days influenced complications. The major potential modifiable risk factor appears to be time to procedure, which had a significant impact on complications. This is the first study to postulate predictors of morbidity and mortality following hip fracture in a US national model. While many co-morbidities appear to be influential in predicting outcome, some of the more significant factors include the presence of shock, dialysis, obesity, and time to surgery. Prognostic study, Level II.

  16. 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.

  17. Comparison of restrictive and liberal transfusion strategy on postoperative delirium in aged patients following total hip replacement: a preliminary study.

    Science.gov (United States)

    Fan, Yun-Xia; Liu, Fang-Fang; Jia, Min; Yang, Jiao-Jiao; Shen, Jin-Chun; Zhu, Guang-Ming; Zhu, Si-Hai; Li, Wei-Yan; Yang, Jian-Jun; Ji, Mu-Huo

    2014-01-01

    Few studies have examined the association between perioperative blood transfusion and postoperative delirium (POD) in aged patients undergoing total hip replacement surgery. In this prospective study, 186 patients older than 65 years undergoing elective unilateral total hip replacement surgery were enrolled. Of those, 94 patients were randomly assigned to the restrictive strategy transfusion strategy group, in which red blood cells were transfused in order to maintain 10.0 g/dL>hemoglobin≧8.0 g/dL. Ninety-two patients were randomly assigned to the liberal transfusion strategy group, in which red blood cells were transfused in order to maintain hemoglobin≧10.0 g/dL. POD was diagnosed by confusion assessment method. The baseline characteristics of patients, the length of hospital stay, the incidence of POD, myocardial infarction, stroke, wound infection, pulmonary embolism, and the transfusion volume were recorded. No difference was observed in the baseline characteristics, the length of hospital stay, and the incidence of POD, myocardial infarction, stroke, wound infection, and pulmonary embolism between the two groups (P>0.05). The proportion of patients transfused with red blood cell and frozen plasma was decreased in the restrictive transfusion group compared with the liberal transfusion group (Pstrategy for aged patients following total hip replacement. Copyright © 2014. Published by Elsevier Ireland Ltd.

  18. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients

    National Research Council Canada - National Science Library

    Beswick, Andrew David; Wylde, Vikki; Gooberman-Hill, Rachael; Blom, Ashley; Dieppe, Paul

    2012-01-01

    .... However, some people experience long-term pain. To review published studies in representative populations with total hip or knee replacement for the treatment of osteoarthritis reporting proportions of people by pain intensity...

  19. Application of a model based on dual-energy X-ray absorptiometry and finite element simulation for predicting the probability of osteoporotic hip fractures to a sample of people over 60 years.

    Science.gov (United States)

    López, Enrique; Casajús, José A; Ibarz, Elena; Gómez-Cabello, Alba; Ara, Ignacio; Vicente-Rodríguez, Germán; Mateo, Jesús; Herrera, Antonio; Gracia, Luis

    2015-05-01

    The aim of this work is the application of a mechanical predictive model to a sample of people over 60 years of age, in order to analyze the fracture probability related to age and sex. A total of 223 elderly people (63 men, aged 63-88, 72.32±6.10; 157 women, aged 61-89, 73.28±5.73) participated in the study. A dual-energy X-ray absorptiometry scanner was used to measure the bone mineral content and bone mineral density at total hip and femoral neck. The application of the predictive model also required a finite element simulation of the proximal femur, obtaining the mechanical damage and fracture probability maps corresponding to each sex and age groups analyzed. Statistical analysis shows higher values of bone mineral density, and consequently of Young's modulus, for men than for women. In general, a decrease of BMD is observed since 65 years old. The maximum mechanical damage value is always located at the femoral neck. The results indicate that mechanical damage tends to increase with age. Coherently with mechanical damage, the maximum fracture probability value is always located at the femoral neck and tends to increase with age. The simulation model to determine the probability of fracture is more complete than the simple measurement of bone mineral density, because provides additional information about mechanical properties of bone, and allows for a prospective detection of fracture risk. The model may be used for risk evaluation in specific patients, if anatomical and dual-energy X-ray absorptiometry measurements are available, helping us to decide about preventive pharmacological treatment for hip fracture. © IMechE 2015.

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

    Science.gov (United States)

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

    2012-11-01

    To assess acetabular and femoral hip joint cartilage with three-dimensional (3D) delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) in patients with degeneration of hip joint cartilage and asymptomatic controls with morphologically normal appearing cartilage. A total of 40 symptomatic patients (18 males, 22 females; mean age: 32.8±10.2 years, range: 18-57 years) with different hip joint deformities including femoroacetabular impingement (n=35), residual hip dysplasia (n=3) and coxa magna due to Legg-Calve-Perthes disease in childhood (n=2) underwent high-resolution 3D dGEMRIC for the evaluation of acetabular and femoral hip joint cartilage. Thirty-one asymptomatic healthy volunteers (12 males, 19 females; mean age: 24.5±1.8 years, range: 21-29 years) without underlying hip deformities were included as control. MRI was performed at 3 T using a body matrix phased array coil. Region of interest (ROI) analyses for T1Gd assessment was performed in seven regions in the hip joint, including anterior to superior and posterior regions. T1Gd mapping demonstrated the typical pattern of acetabular cartilage consistent with a higher glycosaminoglycan (GAG) content in the main weight-bearing area. T1Gd values were significantly higher in the control group than in the patient group whereas significant differences in T1Gd values corresponding to the amount of cartilage damage were noted both in the patient group and in the control group. Our study demonstrates the potential of high-resolution 3D dGEMRIC at 3 T for separate acetabular and femoral hip joint cartilage assessment in various forms of hip joint deformities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    Zilkens, Christoph, E-mail: christoph.zilkens@med.uni-duesseldorf.de [Univ. Dusseldorf, Medical Faculty, Department of Orthopaedic Surgery, Moorenstrasse 5, D-40225 Dusseldorf (Germany); Miese, Falk, E-mail: falk.miese@med.uni-duesseldorf.de [Univ. Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstrasse 5, D-40225 Dusseldorf (Germany); Kim, Young-Jo, E-mail: young-jo.kim@childrens.harvard.edu [Department of Orthopaedic Surgery, The Children' s Hospital Boston, 300 Longwood Ave., Boston, MA 02115 (United States); Hosalkar, Harish, E-mail: hhosalkar@rchsd.org [Department of Orthopaedic Surgery, Rady Children' s Hospital San Diego, 3030 Childrens Way Ste 410, San Diego, CA 92123 (United States); Antoch, Gerald, E-mail: antoch@med.uni-duesseldorf.de [Univ. Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstrasse 5, D-40225 Dusseldorf (Germany); Krauspe, Ruediger, E-mail: krauspe@med.uni-duesseldorf.de [Univ. Dusseldorf, Medical Faculty, Department of Orthopaedic Surgery, Moorenstrasse 5, D-40225 Dusseldorf (Germany); Bittersohl, Bernd, E-mail: bbittersohl@partners.org [Univ. Dusseldorf, Medical Faculty, Department of Orthopaedic Surgery, Moorenstrasse 5, D-40225 Dusseldorf (Germany)

    2012-11-15

    Purpose: To assess acetabular and femoral hip joint cartilage with three-dimensional (3D) delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) in patients with degeneration of hip joint cartilage and asymptomatic controls with morphologically normal appearing cartilage. Methods and materials: A total of 40 symptomatic patients (18 males, 22 females; mean age: 32.8 {+-} 10.2 years, range: 18-57 years) with different hip joint deformities including femoroacetabular impingement (n = 35), residual hip dysplasia (n = 3) and coxa magna due to Legg-Calve-Perthes disease in childhood (n = 2) underwent high-resolution 3D dGEMRIC for the evaluation of acetabular and femoral hip joint cartilage. Thirty-one asymptomatic healthy volunteers (12 males, 19 females; mean age: 24.5 {+-} 1.8 years, range: 21-29 years) without underlying hip deformities were included as control. MRI was performed at 3 T using a body matrix phased array coil. Region of interest (ROI) analyses for T1{sub Gd} assessment was performed in seven regions in the hip joint, including anterior to superior and posterior regions. Results: T1{sub Gd} mapping demonstrated the typical pattern of acetabular cartilage consistent with a higher glycosaminoglycan (GAG) content in the main weight-bearing area. T1{sub Gd} values were significantly higher in the control group than in the patient group whereas significant differences in T1{sub Gd} values corresponding to the amount of cartilage damage were noted both in the patient group and in the control group. Conclusions: Our study demonstrates the potential of high-resolution 3D dGEMRIC at 3 T for separate acetabular and femoral hip joint cartilage assessment in various forms of hip joint deformities.

  2. Hierarchical structure and importance of patients' reasons for treatment choices in knee and hip osteoarthritis: a concept mapping study.

    Science.gov (United States)

    Selten, Ellen M H; Geenen, Rinie; van der Laan, Willemijn H; van der Meulen-Dilling, Roelien G; Schers, Henk J; Nijhof, Marc W; van den Ende, Cornelia H M; Vriezekolk, Johanna E

    2017-02-01

    To improve patients' use of conservative treatment options of hip and knee OA, in-depth understanding of reasons underlying patients' treatment choices is required. The current study adopted a concept mapping method to thematically structure and prioritize reasons for treatment choice in knee and hip OA from a patients' perspective. Multiple reasons for treatment choices were previously identified using in-depth interviews. In consensus meetings, experts derived 51 representative reasons from the interviews. Thirty-six patients individually sorted the 51 reasons in two card-sorting tasks: one based on content similarity, and one based on importance of reasons. The individual sortings of the first card-sorting task provided input for a hierarchical cluster analysis (squared Euclidian distances, Ward's method). The importance of the reasons and clusters were examined using descriptive statistics. The hierarchical structure of reasons for treatment choices showed a core distinction between two categories of clusters: barriers [subdivided into context (e.g. the healthcare system) and disadvantages] and outcome (subdivided into treatment and personal life). At the lowest level, 15 clusters were identified of which the clusters Physical functioning, Risks and Prosthesis were considered most important when making a treatment decision for hip or knee OA. Patients' treatment choices in knee and hip OA are guided by contextual barriers, disadvantages of the treatment, outcomes of the treatment and consequences for personal life. The structured overview of reasons can be used to support shared decision-making. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Acetabular Abduction and Dislocations in Direct Anterior vs Posterior Total Hip Arthroplasty: A Retrospective, Matched Cohort Study.

    Science.gov (United States)

    Tripuraneni, Krishna R; Munson, Natalie R; Archibeck, Michael J; Carothers, Joshua T

    2016-10-01

    There is purported improvement in component positioning and hip stability with the use of direct anterior approach (DAA) total hip arthroplasty (THA). We sought to determine if there is a difference in acetabular component position or dislocation frequency between DAA and posterior THA. One arthroplasty fellowship-trained surgeon introduced DAA THA into his practice. From the initiation of DAA in 4/2012-8/2015, this comparative series resulted in 66 DAA THAs. A matched cohort (age, gender, body mass index [BMI], and comorbidities) was then created for posterior THA, 66 hips. DAA THA used fluoroscopy with anterior capsular excision; posterior group used no image guidance and had capsular repair. Posterior group BMI was 27.8 and DAA group BMI was 27.6 (P = .36). Minimum 3-month follow-up occurred in both groups. Average acetabular abduction angle in the posterior group was 41.9° (range, 32°-60°; standard deviation [sdev], 6.24) and DAA group 43.8° (range, 30°-62°; sdev 6.9), P = .12. The percentage of outliers (outside Lewinnek safe zone, 30°-50°) was 9.1% (6 of 66) in posterior group and 13.6% (9 of 66) in DAA group. There were 2 anterior dislocations in the DAA THA group and 1 anterior dislocation in the posterior THA group, resulting in P = .56. The DAA dislocation frequency in this group was overall higher at 3.0% (2 of 66) compared with the matched posterior (1.5%, 1 of 66) and unmatched posterior larger series (.8%, 3 of 360). We demonstrated no observable difference in hip stability or acetabular abduction. This study provides realistic outcomes for surgeons implementing DAA THA into their practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. HIP DYSPLASIA IN TORNJAK

    Directory of Open Access Journals (Sweden)

    Hrvoje Milošević

    2012-07-01

    Full Text Available Canine hip dysplasia (CHD is a hereditary developmental anomaly, most frequent in large dog breeds. Clinical confirmation of the disorder is based on hip X-ray imaging. Twenty Tornjak dogs aged between 9-36 months, and weighted from 35-42 kg were examined for CHD. Scoring was performed according to six clearly defined radiographic parameters by Flueckiger method (5. Dysplastic changes of various severity were observed in 11 dogs, while in 9 dogs changes were absent. The study describes 4 CHD cases of varying degrees of severity. The results indicate the presence of CHD in Bosnian Tornjak. Determining the incidence of dysplasia in this autochthonous breed requires a more detailed study, which will enable determination of the prevalence of dysplasia and analysis of the relationship to other dog breeds. Key words: canine hip dysplasia, Bosnian Tornjak

  5. Effectiveness of an innovative hip energy storage walking orthosis for improving paraplegic walking: A pilot randomized controlled study.

    Science.gov (United States)

    Yang, Mingliang; Li, Jianjun; Guan, Xinyu; Gao, Lianjun; Gao, Feng; Du, Liangjie; Zhao, Hongmei; Yang, Degang; Yu, Yan; Wang, Qimin; Wang, Rencheng; Ji, Linhong

    2017-09-01

    The high energy cost of paraplegic walking using a reciprocating gait orthosis (RGO) is attributed to limited hip motion and excessive upper limb loading for support. To address the limitation, we designed the hip energy storage walking orthosis (HESWO) which uses a spring assembly on the pelvic shell to store energy from the movements of the healthy upper limbs and flexion-extension of the lumbar spine and hip and returns this energy to lift the pelvis and lower limb to assist with the swing and stance components of a stride. Our aim was to evaluate gait and energy cost indices for the HESWO compared to the RGO in patients with paraplegia. The cross-over design was used in the pilot study. Twelve patients with a complete T4-L5 chronic spinal cord injury underwent gait training using the HESWO and RGO. Gait performance (continuous walking distance, as well as the maximum and comfortable walking speeds) and energy expenditure (at a walking speed of 3.3m/min on a treadmill) were measured at the end of the 4-week training session. Compared to the RGO, the HESWO increased continuous walking distance by 24.7% (Penergy expenditure by 13.9% (P<0.05). Our preliminary results provide support for the use of the HESWO as an alternative support for paraplegic walking. Copyright © 2017. Published by Elsevier B.V.

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

    African Journals Online (AJOL)

    DR OKE

    For evaluation of building performance, Tsou et al. (2001) presented the development process and results of several research projects for applying computational fluid dynamics (CFD) to architectural design. Studies done by He et al. (1997), Lien et al. (2004), Zhang et al. (2005) focus on simulating flow in different building ...

  7. Effect of Cigarette Smoking on Risk of Hip Fracture in Men: A Meta-Analysis of 14 Prospective Cohort Studies.

    Science.gov (United States)

    Wu, Zhen-Jie; Zhao, Peng; Liu, Bin; Yuan, Zhen-Chao

    2016-01-01

    Several observational studies have suggested an association between cigarette smoking and risk of hip fracture. However, no formal systematic review or meta-analysis was performed to summarize this risk in men. A search was applied to MEDLINE, EMBASE, and web of science (up to November 1 2016). All prospective cohort studies assessing risk of hip fracture with the factor of cigarette smoking in men without language restriction were reviewed, and qualities of all included studies were assessed using the Newcastle-Ottawa Scale. Two authors independently assessed literatures and extracted information eligibility, and any disagreement was resolved by consensus. Newcastle-Ottawa quality assessment scale was used to evaluate studies' quality in meta-analyses. We calculated the RR with 95% CIs in a random-effects model as well as the fixed-effects model using the metan command in the STATA version 12.0 (StataCorp, USA). Fourteen prospective cohort studies were eligible for the present analysis. A meta-analysis of 12 prospective studies showed that the relative risk (RR) for current male smoking was 1.47 [95% confidence interval (CI) (1.28-1.66), p = 0.54; I2 = 0%]. Subgroup analyses show study characteristics (including geography region, length of follow-up, size of cohorts and study quality) did not substantially influence these positive associations. Eight studies reported the RRs for former smokers compared with never smokers and the pooled RR was 1.15 [95% CI, (0.97-1.34), (I2 = 0%, p = 0.975)]. The present meta-analysis of 14 prospective studies suggests that, compared with never smokers, cigarette smoking increases risk of hip fracture in man, specifically in current smokers. However, further larger prospective cohorts with more power or meta-analysis of individual patient data are needed to confirm this association.

  8. The role of rose hip (Rosa canina L powder in alleviating arthritis pain and inflammation – part II animal and human studies

    Directory of Open Access Journals (Sweden)

    Marstr

    2016-05-01

    Full Text Available Kristian Marstrand,1 Joan Campbell-Tofte2 1Department of Orthopaedic Surgery, Elverum Hospital, Elverum, Norway; 2Coordinating Research Unit, Frederiksberg University Hospital, Frederiksberg, Copenhagen, Denmark Abstract: Rosa canina fruits (often known as rose hip have been used in herbal remedies since ancient times. On the basis of anecdotal reports about the effects of rose hip preparations on human health and citations to the same in ancient texts, in vitro and in vivo studies have been conducted that have made it possible to learn about some active ingredients in rose hip, as well as how the component compounds might exert their effects. From such studies, it has been documented that there is a great variation in active ingredients when comparing different rose hip products. Factors which affect the quality and quantity of active ingredients in the rose hip products include the subspecies of the particular R. canina from which the fruits are harvested, the environment during plant growth, time of harvesting, and the amount of seeds and shells/husks incorporated into the preparation. Studies in animals and in humans are of great importance for determining the true bio-effects of rose hip. Such in vivo studies that have only been performed during the last 2 decades indicate that the treatment of patients with different types of joint disease with rose hip powder based on a subspecies of R. canina (Lito containing a certain galactolipid (GOPO can alleviate pain, improve daily activity, and even reduce the consumption of regular pain relievers. As several rose hip components have been shown to be anti-inflammatory, it is suggested that anti-inflammatory mechanisms might explain some reductions in symptoms associated with administering rose hip to arthritic conditions. Although the number of publications of randomized and placebo-controlled clinic studies with rose hip is small, the overriding evidence is that the anti-inflammatory effects from

  9. The role of rose hip (Rosa canina L) powder in alleviating arthritis pain and inflammation – part II animal and human studies

    OpenAIRE

    Marstrand, Kristian; Campbell-Tofte, Joan

    2016-01-01

    Kristian Marstrand,1 Joan Campbell-Tofte2 1Department of Orthopaedic Surgery, Elverum Hospital, Elverum, Norway; 2Coordinating Research Unit, Frederiksberg University Hospital, Frederiksberg, Copenhagen, Denmark Abstract: Rosa canina fruits (often known as rose hip) have been used in herbal remedies since ancient times. On the basis of anecdotal reports about the effects of rose hip preparations on human health and citations to the same in ancient texts, in vitro and in vivo studies have bee...

  10. The role of rose hip (Rosa canina L) powder in alleviating arthritis pain and inflammation – part II animal and human studies

    OpenAIRE

    Marstr; De, K.; Campbell-Tofte J

    2016-01-01

    Kristian Marstrand,1 Joan Campbell-Tofte2 1Department of Orthopaedic Surgery, Elverum Hospital, Elverum, Norway; 2Coordinating Research Unit, Frederiksberg University Hospital, Frederiksberg, Copenhagen, Denmark Abstract: Rosa canina fruits (often known as rose hip) have been used in herbal remedies since ancient times. On the basis of anecdotal reports about the effects of rose hip preparations on human health and citations to the same in ancient texts, in vitro and in vivo studies have bee...

  11. An osteoprotegerin gene polymorphism is associated with an increased risk of hip fracture in Japanese patients with rheumatoid arthritis: results from the IORRA Observational Cohort Study.

    Directory of Open Access Journals (Sweden)

    Shinji Yoshida

    Full Text Available Patients with rheumatoid arthritis (RA have a higher prevalence of osteoporosis and hip fracture than healthy individuals. Multiple genetic loci for osteoporotic fracture were identified in recent genome-wide association studies. The purpose of this study was to identify genetic variants associated with the occurrence of hip fracture in Japanese patients with RA.DNA samples from 2,282 Japanese patients with RA were obtained from the DNA collection of the Institute of Rheumatology Rheumatoid Arthritis cohort (IORRA study. Six single nucleotide polymorphisms (SNPs that have been reported to be associated with fractures in recent studies were selected and genotyped. Forty hip fractures were identified with a maximum follow-up of 10 years. The genetic risk for hip fracture was examined using a multivariate Cox proportional hazards regression model.The risk analyses revealed that patients who are homozygous for the major allele of SNP rs6993813, in the OPG locus, have a higher risk for hip fracture (hazard ratio [95% CI] = 2.53 [1.29-4.95], P = 0.0067. No association was found for the other SNPs.Our results indicate that an OPG allele is associated with increased risk for hip fracture in Japanese patients with RA.

  12. Hip joint pathology

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  13. Post-operative rounds by anaesthesiologists after hip fracture surgery: a pilot study

    DEFF Research Database (Denmark)

    Foss, Nicolai Bang; Christensen, Dorte Stig; Krasheninnikoff, Michael

    2006-01-01

    a multidisciplinary effort between anaesthesiologists and orthopaedic surgeons. METHODS: During the first 25 weeks of 2004, 98 consecutive community-residing patients admitted to a hip fracture unit received daily rounds by anaesthesiologists during the first four post-operative days, on weekdays only, focusing...... in the intervention group (P = 0.02). There was no significant difference between post-operative morbidity and hospital stay in the control and intervention groups; in-hospital mortality was 12% in the control group and 7% in the intervention group (P = 0.24). The rounds by anaesthesiologists improved nursing care......BACKGROUND: Efforts to optimize the peri-operative care of hip fracture patients through multidisciplinary intervention have focused on orthopaedic-geriatric liaisons, which have not resulted in significant outcome changes. The early phase of rehabilitation could potentially be optimized through...

  14. Residual hip dysplasia at 1 year after treatment for neonatal hip instability is not related to degenerative joint disease in young adulthood: a 21-year follow-up study including dGEMRIC.

    Science.gov (United States)

    Wenger, D; Siversson, C; Dahlberg, L E; Tiderius, C J

    2016-03-01

    Developmental dysplasia of the hip (DDH) is associated with an increased risk of early hip osteoarthritis (OA). We aimed to examine the outcome at the completion of growth in a cohort of children who had residual acetabular dysplasia at age 1 year following early treatment for neonatal instability of the hip (NIH). We examined 21 of 30 subjects who had been treated with the von Rosen splint neonatally for NIH and had residual acetabular dysplasia at age 1 year. Mean follow-up time was 21 years (range 17-24). Signs of OA and acetabular dysplasia were assessed by radiography. Cartilage quality was assessed by delayed Gadolinium Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC), a tool for molecular imaging of cartilage quality, at 1.5 T. Patient reported outcome (PRO) was assessed by the 12-item WOMAC score. No study participant had radiographic OA (defined as Kellgren-Lawrence grade ≥2) or minimum joint space width (JSW) ≤2 mm. The mean dGEMRIC index was 630 ms (95% CI: 600-666, range: 516-825) suggesting good cartilage quality. The mean 12-item WOMAC score was 1.2. Two of three radiographic measurements of DDH correlated positively to the dGEMRIC index. Children treated neonatally for NIH have good hip function and no signs of cartilage degeneration at 21-year follow-up, despite residual dysplasia at age 1 year. Unexpectedly, radiographic signs of dysplasia were associated with better cartilage quality, as assessed with dGEMRIC. This may indicate cartilage adaptation to increased mechanical stress in mild hip dysplasia. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  15. Trends in reporting of mechanisms and incidence of hip injuries in males playing minor ice hockey in Canada: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Ayeni OR

    2014-06-01

    Full Text Available Olufemi R Ayeni,1 Marcin Kowalczuk,1 Jordan Farag,1 Forough Farrokhyar,1,2 Raymond Chu,1 Asheesh Bedi,3 Kevin Willits,4 Mohit Bhandari1,2 1Division of Orthopaedic Surgery, Department of Surgery, 2Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; 3Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA; 4Department of Orthopaedic Surgery, University of Western Ontario, London, ON, Canada Background: There has been a noted increase in the diagnosis and reporting of sporting hip injuries and conditions in the medical literature but reporting at the minor hockey level is unknown. The purpose of this study is to investigate the trend of reporting hip injuries in amateur ice hockey players in Canada with a focus on injury type and mechanism. Methods: A retrospective review of the Hockey Canada insurance database was performed and data on ice hockey hip injuries reported between January 2005 and June 2011 were collected. The study population included all male hockey players from Peewee (aged 11–12 years to Senior (aged 20+ years participating in amateur level competition sanctioned by Hockey Canada. Reported cases of ice hockey hip injuries were analyzed according to age, mechanism of injury, and injury subtype. Annual injury reporting rates were determined and using a linear regression analysis trended to determine the change in ice hockey hip injury reporting rate over time. Results: One hundred and six cases of ice hockey-related hip injuries were reported in total. The majority of injuries (75.5% occurred in players aged 15–20 years playing at the Junior level. Most injuries were caused by a noncontact mechanism (40.6% and strains were the most common subtype (50.0%. From 2005 to 2010, the number of reported hip injuries increased by 5.31 cases per year and the rate of reported hip injury per 1,000 registered players increased by 0.02 cases annually. Conclusion: Reporting of

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  18. The fall descriptions and health characteristics of older adults with hip fracture: a mixed methods study.

    Science.gov (United States)

    Leavy, Breiffni; Byberg, Liisa; Michaëlsson, Karl; Melhus, Håkan; Åberg, Anna Cristina

    2015-04-08

    In light of the multifactorial etiology of fall-related hip fracture, knowledge of fall circumstances may be especially valuable when placed in the context of the health of the person who falls. We aimed to investigate the circumstances surrounding fall-related hip fractures and to describe fall circumstances in relation to participants' health and functional characteristics. The fall circumstances of 125 individuals (age ≥ 50 years) with hip fracture were investigated using semi-structured interviews. Data concerning participants' health (comorbidities and medications) and function (self-reported performance of mobility, balance, personal activities of daily living and physical activity, previous falls and hand grip strength) were collected via medical records, questionnaires and dynamometry. Using a mixed methods design, both data sets were analysed separately and then merged in order to provide a comprehensive description of fall events and identify eventual patterns in the data. Fall circumstances were described as i) Activity at the time of the fall: Positional change (n = 24, 19%); Standing (n = 16, 13%); Walking (n =71, 57%); Balance challenging (n = 14, 11%) and ii) Nature of the fall: Environmental (n = 32, 26%); Physiological (n = 35, 28%); Activity-related indoor (n = 8, 6%) and outdoor (n = 8, 6%); Trips and slips on snow (n = 20, 16%) and in snow-free conditions (n = 12, 10%) and Unknown (n = 10, 8%). We observed the following patterns regarding fall circumstances and participants' health: those who fell i) during positional change had the poorest functional status; ii) due to environmental reasons (indoors) had moderate physical function, but high levels of comorbidity and fall risk increasing medications; iii) in snow-free environments (outdoors) appeared to have a poorer health and functional status than other outdoor groups. Our findings indicate that patterns exist in relation to the falls circumstances and health characteristics of people with

  19. Grave fraudulence in medical device research: a narrative review of the PIN seeding study for the Pinnacle hip system.

    Science.gov (United States)

    Steffen, Joan E; Fassler, Ella A; Reardon, Kevin J; Egilman, David S

    2018-01-01

    In 2001, DePuy, a wholly-owned subsidiary of Johnson & Johnson (J&J/DePuy), initiated a seeding study called the "Multi-center, Prospective, Clinical Evaluation of Pinnacle Acetabular Implants in Total Hip Arthroplasty" (PIN Study). J&J/DePuy designed this study to develop new business opportunities during the launch of their Pinnacle Hip System (PHS) and generate survivorship data for marketing. This article, the first review of a seeding trial for a medical device, examines internal company documents relating to the PIN Study; the analysis herein focuses on the integrity of J&J/DePuy's research practices in conception, implementation, and analysis. J&J/DePuy violated the study protocol and manipulated data; consented participants in violation of standards protecting human subjects; and did not secure Institutional Review Board approval for all study sites. J&J/DePuy used PIN Study results as the "fundamental selling point" for the PHS. Medical device seeding trials are distinct from previously-documented pharmaceutical seeding trials because companies can profit directly from device sales and because these studies may be the first clinical evaluation of the device (as was the case for the PIN Study). Seeding trials are malleable marketing projects, not rigorous scientific studies. Regulatory bodies, physicians, and others should be vigilant for persuasive marketing accounts disguised as science.

  20. Results of hip resurfacing

    Science.gov (United States)

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

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    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...

  2. Secondary hip dysplasia in Legg-Calvé-Perthes disease - a long-term case-control study

    DEFF Research Database (Denmark)

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

    The Copenhagen City Heart Study. The following exclusion criteria were applied: bilateral involvement, emigrated persons, persons lost to follow-up, diseased persons, patients who refused to participate, surgery at pelvis or the lower limb before follow-up, foramen obturator index 1.8 and missing or destroyed......-affected hip was significantly increased evaluated from the CE angle and AA angle in Stulberg class III/IV/V. The strengths of our study were that the same conservative treatment regime was applied to all the children regardless of gender, age at debut and degree of femoral head involvement. 118 patients were...

  3. STUDY REGARDING THE EFFICIENCY OF A PHYSIOTHERAPY PROGRAM IN PAIN REDUCTION, PHYSICAL FUNCTION AND QUALITY OF LIFE IMPROVEMENT IN PATIENTS WITH HIP OSTHEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    Doriana Ioana CIOBANU

    2016-12-01

    Full Text Available Hip osteoarthritis is mainly characterized by articular cartilage lesisons (distrophy, erosions, lack of articular surfaces shape and contour due to femoral head distruction.Aim. This paperwork aims to emphasize the efficiency of a comprehensive rehabilitation program in functional and quality of life improvement and pain reduction, in patients with hip osteoarthritis.Subjects. This study was conducted in Clinical Rehabilitation Hospital from Baile Felix, on a group of 10 patiants with hip arthrosis, aged between 50 and 80 years old, 50% man, 50% woman, average weight &2 kg, IMC 25.6, duration of affection average 17 years, 50% retired from activity, 50% workers.Metods. As assessment tools were used: goniometry, 0-5 scale for muscular force and Womac index for pain and quality of life assessment. The exercise program aimed to increase hip muscle tonus and the increasing of hip jount mobility and stability due to a better crossing of femorla head in the acetabular cavity.Results. After following rehabilitation program, we found the reduction of pain (11±8.18 baseline versus 9±8.18 final, the improvement of hip joint moiblity (4.60±3.28 pretest versus 3.7±3.27 posttest, of physical functioning (43.20±26.75 pretest versus 40.30±26.42 posttest and of quality of life (59.8±38.12 pretest versus 53±37.70 posttest. Conclusions: A rehabilitation program followed 5 times/ week, for two weeks, can lead to the improvement of hip joint mobility, to an increased muscular force of pelvic girdle and to the impovement of quality of life in patients with hip osteoarthritis

  4. 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

  5. Calcaneal BMD Obtained by Dual X-Ray and Laser Predicts Future Hip Fractures—A Prospective Study on 4 398 Swedish Women

    Directory of Open Access Journals (Sweden)

    Torkel B. Brismar

    2010-01-01

    Full Text Available The predictive value of dual X-ray and laser (DXL calcaneal BMD (BMDDXL on hip fractures was prospectively studied in 4,398 females aged 55 to 99 years. The average follow-up period was 3 years and 11 months with a total of 17,270 person years. Fractures were identified from the national patient register. After inclusion, 130 females sustained a hip fracture. The age adjusted hazard ratio for T-score −2.5 was 2.64. Of all patients who sustained a hip fracture 78% had a T-score of −2.5 or below. The annual hip fracture rate was 0.26% at T-scores ≥−2, but 1.5% at T-scores ≤−2.5. The area under curve for the model including calcaneal BMDDXL, follow-up time, and age to prospectively predict hip fractures was 0.84. Conclusions. Calcaneal BMDDXL obtained by DXL Calscan predicts hip fractures and may therefore be suitable for diagnosing osteoporosis and for predicting fracture risk.

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

    Science.gov (United States)

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

    2016-08-01

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

  7. Perceived loading and muscle activity during hip strengthening exercises

    DEFF Research Database (Denmark)

    Brandt, Mikkel; Jakobsen, Markus Due; Thorborg, Kristian

    2013-01-01

    OBJECTIVE: Decreased hip muscle strength is frequently reported in patients with hip injury or pathology. Furthermore, soccer players suffering from groin injury show decreased strength of hip muscles. Estimating 10-repetition maximum can be time-consuming and difficult, thus, using the Borg...... category rating 10 scale (Borg CR10 scale) can be a useful tool for estimating the intensity of exercise. The aims of this study were 1) to investigate the feasibility of the use of the Borg CR10 scale for rating strength training intensity of the hip abductor and hip adductor muscles, and 2) to compare...... hip muscle activity during hip abduction and hip adduction exercises using elastic resistance and isotonic machines, using electromyography (EMG). METHODS: EMG activity was recorded from 11 muscles at the hip, thigh and trunk during hip adduction and hip abduction exercises in 16 untrained women...

  8. Association of incident hip fracture with the estimated femoral strength by finite element analysis of DXA scans in the Osteoporotic Fractures in Men (MrOS) study.

    Science.gov (United States)

    Yang, L; Parimi, N; Orwoll, E S; Black, D M; Schousboe, J T; Eastell, R

    2017-11-22

    Finite element model can estimate bone strength better than BMD. This study used such a model to determine its association with hip fracture risk and found that the strength estimate provided limited improvement over the hip BMDs in predicting femoral neck (FN) fracture risk only. Bone fractures occur only when it is loaded beyond its ultimate strength. The goal of this study was to determine the association of femoral strength, as estimated by finite element (FE) analysis of DXA scans, with incident hip fracture as a single condition or with femoral neck (FN) and trochanter (TR) fractures separately in older men. This prospective case-cohort study included 91 FN and 64 TR fracture cases and a random sample of 500 men (14 had a hip fracture) from the Osteoporotic Fractures in Men study during a mean ± SD follow-up of 7.7 ± 2.2 years. We analysed the baseline DXA scans of the hip using a validated plane-stress, linear-elastic FE model of the proximal femur and estimated the femoral strength during a sideways fall. The estimated strength was significantly (P fracture independent of the TR and total hip (TH) BMDs but not FN BMD, and combining the strength with BMD did not improve the hip fracture prediction. The strength estimate was associated with FN fractures independent of the FN, TR and TH BMDs; the age-BMI-BMD adjusted hazard ratio (95% CI) per SD decrease of the strength was 1.68 (1.07-2.64), 2.38 (1.57, 3.61) and 2.04 (1.34, 3.11), respectively. This association with FN fracture was as strong as FN BMD (Harrell's C index for the strength 0.81 vs. FN BMD 0.81) and stronger than TR and TH BMDs (0.8 vs. 0.78 and 0.81 vs. 0.79). The strength's association with TR fracture was not independent of hip BMD. Although the strength estimate provided additional information over the hip BMDs, its improvement in predictive ability over the hip BMDs was confined to FN fracture only and limited.

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

    Science.gov (United States)

    Evangelou, Evangelos; Kerkhof, Hanneke J; Styrkarsdottir, Unnur; Ntzani, Evangelia E; Bos, Steffan D; Esko, Tonu; Evans, Daniel S; Metrustry, Sarah; Panoutsopoulou, Kalliope; Ramos, Yolande F M; Thorleifsson, Gudmar; Tsilidis, Konstantinos K; Arden, Nigel; Aslam, Nadim; Bellamy, Nicholas; Birrell, Fraser; Blanco, Francisco J; Carr, Andrew; Chapman, Kay; Day-Williams, Aaron G; Deloukas, Panos; Doherty, Michael; Engström, Gunnar; Helgadottir, Hafdis T; Hofman, Albert; Ingvarsson, Thorvaldur; Jonsson, Helgi; Keis, Aime; Keurentjes, J Christiaan; Kloppenburg, Margreet; Lind, Penelope A; McCaskie, Andrew; Martin, Nicholas G; Milani, Lili; Montgomery, Grant W; Nelissen, Rob G H H; Nevitt, Michael C; Nilsson, Peter M; Ollier, William ER; Parimi, Neeta; Rai, Ashok; Ralston, Stuart H; Reed, Mike R; Riancho, Jose A; Rivadeneira, Fernando; Rodriguez-Fontenla, Cristina; Southam, Lorraine; Thorsteinsdottir, Unnur; Tsezou, Aspasia; Wallis, Gillian A; Wilkinson, J Mark; Gonzalez, Antonio; Lane, Nancy E; Lohmander, L Stefan; Loughlin, John; Metspalu, Andres; Uitterlinden, Andre G; Jonsdottir, Ingileif; Stefansson, Kari; Slagboom, P Eline; Zeggini, Eleftheria; Meulenbelt, Ingrid; Ioannidis, John PA; Spector, Tim D; van Meurs, Joyce B J; Valdes, Ana M

    2014-01-01

    Objectives 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 on more than 78 000 participants. In stage 1, we synthesised data from eight GWAS whereas data from 10 centres were used for ‘in silico’ or ‘de novo’ replication. Besides the main analysis, a stratified by sex analysis was performed to detect possible sex-specific signals. Meta-analysis was performed using inverse-variance fixed effects models. A random effects approach was also used. Results We accumulated 11 277 cases of radiographic and symptomatic hip OA. We prioritised eight single nucleotide polymorphism (SNPs) for follow-up in the discovery stage (4349 OA cases); five from the combined analysis, two male specific and one female specific. One locus, at 20q13, represented by rs6094710 (minor allele frequency (MAF) 4%) near the NCOA3 (nuclear receptor coactivator 3) gene, reached genome-wide significance level with p=7.9×10−9 and OR=1.28 (95% CI 1.18 to 1.39) in the combined analysis of discovery (p=5.6×10−8) and follow-up studies (p=7.3×10−4). We showed that this gene is expressed in articular cartilage and its expression was significantly reduced in OA-affected cartilage. Moreover, two loci remained suggestive associated; rs5009270 at 7q31 (MAF 30%, p=9.9×10−7, OR=1.10) and rs3757837 at 7p13 (MAF 6%, p=2.2×10−6, OR=1.27 in male specific analysis). Conclusions Novel genetic loci for hip OA were found in this meta-analysis of GWAS. PMID:23989986

  10. Dislocation of bipolar hip hemiarthroplasty through a postero-lateral approach for femoral neck fractures: A cohort study.

    Science.gov (United States)

    Mukka, Sebastian; Lindqvist, Jenny; Peyda, Sara; Brodén, Cyrus; Mahmood, Sarwar; Hassany, Hamid; Sayed-Noor, Arkan

    2015-07-01

    To analyze postoperative global femoral offset (FO), leg length discrepancy (LLD) and Wiberg angle as risk factors for prosthetic dislocation after treatment with bipolar hemiarthoplasty (HA) through a postero-lateral approach for femoral neck fracture (FNF). Three hundred and seventy three patients treated with a cemented bipolar HA through a postero-lateral approach between January 2006 and December 2013 were included in a cohort study with a follow-up time ranging from 6 months to 7 years. Radiographs and all surgical records were reviewed regarding Global FO, LLD and Wiberg angle. We compared stable hips without dislocation to those with either a single dislocation and those with recurrent instability. Three hundred and twenty eight hips fulfilled the inclusion criteria and were analyzed in the study. The incidence of prosthetic dislocation was 10.7% (36/373). The mean time from surgery to first dislocation was 3.9 months (0-47) and 62.5% had recurrent dislocations. Patients with dislocation had a statistically significantly decreased postoperative global FO (-6.4 mm vs. -2.8 mm, p = 0.04), LLD (-2 vs. 1.5 mm, p = 0.03) and smaller Wiberg angle (40° vs. 46°, p = 0.01) on the operated side compared with the rest of cohort. In comparison to age and sex-matched control groups from the cohort, the difference in the radiographic parameters were significant in patients with recurrent dislocations but not in patients with a single dislocation. Patients with recurrent dislocations had a decreased postoperative global FO, shorter leg and shallower acetabulum on the operated side compared with their controls. These factors might decrease the soft-tissue tension around the operated hip and predispose to dislocation. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  11. 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.

  12. Dynamic Ultrasonography of the Deep External Rotator Musculature of the Hip: A Descriptive Study.

    Science.gov (United States)

    Battaglia, Patrick J; Mattox, Ross; Haun, Daniel W; Welk, Aaron B; Kettner, Norman W

    2016-07-01

    No detailed reports exist describing the methodology of ultrasound image acquisition of the deep external rotator muscles of the hip. Because gluteal pain and sciatica are common, ultrasound may be a useful dynamic imaging adjunct in the evaluation of these patients. To describe dynamic ultrasonography of the deep external rotator muscles of the hip for diagnostic purposes. Descriptive. University radiology department. Participants (n = 25; 14 male) without gluteal pain or sciatica were enrolled (mean age 27.6 ± 4.7 years; mean body mass index 26.0 ± 4.1 kg/m(2)). Ultrasonographic cine clips oriented to the long axis of each deep external rotator muscle were captured. In addition, cine clips of the piriformis tendon and obturator internus tendon were obtained. Cine clips were analyzed approximately 1 week after completion of image acquisition independently by 2 blinded raters. A 5-point Likert scale to evaluate the diagnostic utility of the ultrasound image. The modal Likert scores for rater 1 were as follows: piriformis muscle = 4; piriformis tendon = 4; superior gemellus muscle = 3; obturator internus muscle = 4; obturator internus tendon = 4; inferior gemellus muscle = 4; quadratus femoris muscle = 4. The modal scores for rater 2 were: piriformis muscle = 4; piriformis tendon = 3; superior gemellus muscle = 4; obturator internus muscle = 3; obturator internus tendon = 4; inferior gemellus muscle = 3; quadratus femoris muscle = 4. Dynamic ultrasonography may be useful to image the hip deep external rotator musculature for diagnostic purposes and therefore aid in the evaluation of gluteal pain and sciatica. Future work should investigate the reliability and validity of ultrasonography in the evaluation of pathology of these muscles. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  13. Management of older adults with hip fractures in India: a mixed methods study of current practice, barriers and facilitators, with recommendations to improve care pathways.

    Science.gov (United States)

    Rath, Santosh; Yadav, Lalit; Tewari, Abha; Chantler, Tracey; Woodward, Mark; Kotwal, Prakash; Jain, Anil; Dey, Aparajit; Garg, Bhavuk; Malhotra, Rajesh; Goel, Ashish; Farooque, Kamran; Sharma, Vijay; Webster, Premila; Norton, Robyn

    2017-12-01

    Evidence-based management can reduce deaths and suffering of older adults with hip fractures. This study investigates the evidence-practice gaps in hip fracture care in three major hospitals in Delhi, potential barriers and facilitators to improving care, and consequently, identifies contextually appropriate interventions for implementing best practice for management of older adults with hip fractures in India. Hip fracture in older adults is a significant public health issue in India. The current study sought to document current practices, identify barriers and facilitators to adopting best practice guidelines and recommend improvements in the management of older adults with hip fractures in Delhi, India. This mixed methods observational study collected data from healthcare providers, patients, carers and medical records from three major public tertiary care hospitals in Delhi, India. All patients aged ≥50 years with an X-ray confirmed hip fracture that were admitted to these hospitals over a 10-week period were recruited. Patients' data were collected at admission, discharge and 30 days post-injury. Eleven key informant interviews and four focus group discussions were conducted with healthcare providers. Descriptive data for key quantitative variables were computed. The qualitative data were analysed and interpreted using a behaviour change wheel framework. A total of 136 patients, 74 (54%) men and 62 women, with hip fracture were identified in the three participating hospitals during the recruitment period and only 85 (63%) were admitted for treatment with a mean age of 66.5 years (SD 11.9). Of these, 30% received surgery within 48 h of hospital admission, 95% received surgery within 39 days of hospital admission and two (3%) had died by 30 days of injury. According to the healthcare providers, inadequate resources and overcrowding prevent adequate caring of the hip fracture patients. They unanimously felt the need for protocol-based management of hip

  14. Microgrid Modeling and Simulation Study

    Science.gov (United States)

    2016-09-01

    lightning , and other scenarios need to be simulated and hardware tested to characterize system robustness. The reviewed M&S tools were divided into the...5 capability categories for tactical microgrids: Demand Management, Power Distribution, Source Management, Communications, and Smart Controls. In...requires a short-term investment to produce results. • Component Metadata is the use of digital information from equipment for microgrid Smart

  15. Dietary patterns explaining differences in bone mineral density and hip structure in the elderly: the Rotterdam Study.

    Science.gov (United States)

    de Jonge, Ester Al; Kiefte-de Jong, Jessica C; Hofman, Albert; Uitterlinden, André G; Kieboom, Brenda Ct; Voortman, Trudy; Franco, Oscar H; Rivadeneira, Fernando

    2017-01-01

    Evidence on the association between dietary patterns, measures of hip bone geometry, and subsequent fracture risk are scarce. The objective of this study was to evaluate whether dietary patterns that explain most variation in bone mineral density (BMD) and hip bone geometry are associated with fracture risk. We included 4028 subjects aged ≥55 y from the Rotterdam study. Intake of 28 food groups was assessed with the use of food-frequency questionnaires. BMD, bone width, section modulus (SM; reflecting bending strength) and cortical buckling ratio (BR; reflecting bone instability) were measured with the use of dual-energy X-ray absorptiometry. BMD and geometry-specific dietary patterns were identified with the use of reduced rank regression. Fracture data were reported by general practitioners (median follow-up 14.8 y). We identified 4 dietary patterns. Of the 4, we named 2 patterns "fruit, vegetables, and dairy" and "sweets, animal fat, and low meat," respectively. These 2 patterns were used for further analysis. Independently of confounders, adherence to the fruit, vegetables, and dairy pattern was associated with high BMD, high SM, low BR, and low risk of fractures [HR (95% CI) for osteoporotic fractures: 0.90 (0.83, 0.96); for hip fractures: 0.85 (0.81, 0.89) per z score of dietary pattern adherence]. Adherence to the sweets, animal fat, and low meat pattern was associated with high bone width, high SM, high BR, and high risk of fractures [HR (95% CI) for osteoporotic fractures: 1.08 (1.00, 1.06); for hip fractures: 1.06 (1.02, 1.12) per z score]. The fruit, vegetables, and dairy pattern might be associated with lower fracture risk because of high BMD, high bending strength, and more stable bones. The sweets, animal fat, and low meat pattern might be associated with higher fracture risk because of widened, unstable bones, independently of BMD. Dietary recommendations associated with bone geometry in addition to BMD might influence risk of fractures. © 2017

  16. Non-hip, non-spine fractures drive healthcare utilization following a fracture: the Global Longitudinal study of Osteoporosis in Women (GLOW)

    Science.gov (United States)

    Ioannidis, G.; Flahive, J.; Pickard, L.; Papaioannou, A.; Chapurlat, R. D.; Saag, K. G.; Silverman, S.; Anderson, F. A.; Gehlbach, S. H.; Hooven, F. H.; Boonen, S.; Compston, J. E.; Cooper, C.; Díez-Perez, A.; Greenspan, S. L.; LaCroix, A. Z.; Lindsay, R.; Netelenbos, J. C.; Pfeilschifter, J.; Rossini, M.; Roux, C.; Sambrook, P. N.; Siris, E. S.; Watts, N. B.

    2016-01-01

    Summary We evaluated healthcare utilization associated with treating different fracture types in over 51,000 women aged ≥55 years. Over the course of 1 year, there were five times more non-hip, non-spine fractures than hip or spine fractures, resulting in twice as many days of hospitalization and rehabilitation/nursing home care for non-hip, non-spine fractures. Purpose To evaluate the medical healthcare utilization associated with treating several types of fractures in women aged 55 years or older from various geographic regions. Methods Information from the Global Longitudinal study of Osteoporosis in Women (GLOW) was collected via self-administered patient questionnaires at baseline and year 1 (n=51,491). Self-reported clinically recognized low-trauma fractures at year 1 were classified as incident spine, hip, wrist/hand, arm/shoulder, pelvis, rib, leg, and other fractures. Healthcare utilization data were self-reported and included whether the fracture was treated at a doctor’s office/clinic or at a hospital. Patients were also asked if they had undergone surgery or been treated at a rehabilitation center or nursing home. Results Over the 1-year study period, there were 195 spine, 134 hip, and 1,654 non-hip, non-spine fractures. In the GLOW cohort, clinical vertebral fractures resulted in 617 days of hospitalization and 512 days of rehabilitation/nursing home care, while hip fractures accounted for 1,306 days of hospitalization and 1,650 days of rehabilitation/nursing home care. Of particular interest is the result that non-hip, non-spine fractures resulted in 3,805 days in hospital and 5,186 days of rehabilitation/nursing home care. Conclusions While hip and vertebral fractures are well recognized for their associated increase in health resource utilization, non-hip, non-spine fractures, by virtue of their 5-fold greater number, require significantly more healthcare resources. PMID:22525976

  17. [Metal/metal--a new (old) hip bearing system in clinical evaluation. Prospective 7-year follow-up study].

    Science.gov (United States)

    Jessen, N; Nickel, A; Schikora, K; Büttner-Janz, K

    2004-05-01

    The problems of wear debris of bearing systems containing polyethylene used in hip arthroplasty have led to an increased trend to hard on hard bearing surfaces. Based on our own good experiences with the cementless Zweymüller-Alloclassic system, we implanted the same system with metal-on-metal bearing surfaces (Metasul) in 100 cases between October 1993 and November 1994. In order to record potential side effects, specific questioning and a clinical and radiological survey were carried out before surgery and in regular intervals thereafter. Up to date almost all of the patients have had good and excellent results with an average of more than 90 points in the Harris hip score (47.8 before surgery). There were no cases of revision surgery as a result of aseptic loosening. Two revisions were performed for other reasons (change of the insert, deep infection). No disadvantageous phenomena related to Metasul in the surrounding tissue were found on macroscopic and histologic investigation. The radiological examination did not show any specific signs pertaining to the use of a metal-on-metal bearing system. We also have no grounds to suppose that there are systemic reactions due to chromium or cobalt ions. Up to now, the new metal-on-metal bearing system in connection with a proven hip arthroplasty system has lived up to clinical expectations. With regard to less wear debris, it is justified to implant it in younger patients as well. Other open questions, in particular the possibly improved long-term results, have to be answered by continuation of the study.

  18. Comparative study of the results of heel ultrasound screening and DXA findings (lumbar spine and left hip of postmenopausal women

    Directory of Open Access Journals (Sweden)

    Amila Jaganjac

    2012-04-01

    Full Text Available Introduction: Osteoporosis is a silent and invisible disease of bone, great presence and is considered to suffer from osteoporosis at least 200 million women worldwide. The goal of this paper is to show average ageof postmenopausal respondents, values of anthropometric parameters (weight, height, BMI, anamnestic data on clinical symptoms, fractures of women in menopause, analysis of heel ultrasound screening results,analysis of lumbar spine DXA results, analysis of left hip DXA results.Methods: In retrospective study 61 respondents were involved, 33 to 79 years old, treated in u Center for Physical Medicine and Acupuncture “AD” in Sarajevo during the period from 01.01.2008 till 31.12.2009. Alldate are shown numerically and percentage account with calculation of mean value, expressed in the form of tables and charts.Results: Finding of heel ultrosound screening compared to T values of postmenopausal respondents indicates on osteoporosis in case of 17 (27,87%, in case of 44 (72,13% respondents osteopenia, while normalvalues were not found. T value with lumbar spine DXA method in postmenopausal female respondents correspond to 43 (70,5% respondents, in 15 respondents (24,6% finding corresponded to osteopenia, while 3 respondents (4,9% had physiological finding. Left hip DXA finding shows 36 (59% respondents corresponded osteoporosis, 19 (31,2% respondents corresponded osteopenia, while physiological finding was found in 6 respondents (9,8%. T value of lumbar spine DXA finding was - 2,71 ± 1,16; DXA finding of left hip -2,35 ±1,36; heel ultrasound screening -2,19 ± 0,54.Conclusion: Research results indicate that DXA finding in relation to the heel ultrasound screening confirms gold standard in diagnosing osteoporosis.

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

    Science.gov (United States)

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

    2018-02-20

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

  20. A STUDY OF PRIMARY CEMENTED BIPOLAR HEMIARTHROPLASTY OF HIP IN ELDERLY PATIENTS WITH OSTEOPOROTIC, UNSTABLE INTERTROCHANTERIC FRACTURE

    Directory of Open Access Journals (Sweden)

    Maheshwar

    2015-08-01

    Full Text Available BACKGROUND: Intertrochanteric fractures are a major cause of morbidity and mortality in geriatric population. Osteoporosis contributes significantly to the comminution and instability in such fractures. Internal fixations in unstable intertrochanteric fractures are a ssociated with high rates of implant failures and gross restriction of hip movements. This study was undertaken to evaluate the efficacy of cemented bipolar hemiart h roplasty in elderly patients with osteoporotic, unstable intertrochanteric fractures. PATIE NTS AND METHODS: 52 patients aged above 60 years with unstable, comminuted intertrochanteric fractures with Singh’s index < 4 were operated with primary cemented bipolar hemireplacement arthroplasty. All the patients were mobilized early with full weight b earing in the post - operative period as permitted. 50 patients were evaluated for the functional outcome with Harris Hip score. RESULTS: The average age of patients was 65 years with female predominance (64%. Left side (56% was commonly involved and the c ommonest mode of injury was due to a trivial fall at home. Hypertension (30% was the commonest co - morbid condition. Limb shortening was the commonest complication (8%. The mean ± S.D. of the Harris Hip score was 85.6 ± 10.59 with a range from 56 to 96. Resul ts were excellent in 62%, good in 22%, fair in 12% and poor in 4% of cases. CONCLUSION: Elderly osteoporotic patients with comminuted, unstable intertrochanteric fractures have an increased prevalence of unsatisfactory functional results with conventional internal fixation devices. Primary cemented bipolar hemiarthroplasty with anatomical reconstruction of the trochanters allows early mobilization, improved functional outcome with relatively low incidence of associated complications.

  1. Prophylactic administration of fibrinogen concentrate in perioperative period of total hip arthroplasty: a randomized clinical trial study.

    Directory of Open Access Journals (Sweden)

    Atabak Najafi

    2014-11-01

    Full Text Available According to limitations in blood product resources and to prevent unnecessary transfusions and afterwards complications in perioperative period of total hip arthroplasty, authors administered fibrinogen concentrate in a pilot randomized clinical trial to evaluate bleeding and need to blood transfusion in preoperative period. Thirty patients (3-75 years old with ASA physical status class I or II and candidate for total hip arthroplasty consequently enrolled in this study and randomly assigned into two groups: taking fibrinogen concentrate and control. Two groups were similar in serum concentration of fibrinogen, hemoglobin, and platelet preoperatively. After induction of general anesthesia 30 mg/kg fibrinogen concentrate was administered in the fibrinogen group. Blood loss, need to blood transfusion and probable complications were compared between two groups. The mean operation time was 3.3 ± 0.8 hours in the fibrinogen group and 2.8 ± 0.6 hours in the placebo group, and this difference was statistically significant (P=0.04. There was a significant correlation between operation time and blood loss during surgery (P=0.002. The mean transfused blood products in the fibrinogen and control group was 0.8 ± 1.01 units and 1.06 ± 1.2 units respectively (P=0.53. The mean of perioperative blood loss was 976 ± 553 ml in the fibrinogen group and 1100 ± 350 ml in the control group, but this difference was not significant between two groups. By adjusting time factor for two groups, we identified that the patients in fibrinogen group had lower perioperative bleeding after adjusting time factor for two groups (P=0.046. None of the patients had complications related to fibrinogen concentrate administration. The prophylactic administration of fibrinogen concentrate was safe and effective in reducing bleeding in the perioperative period of total hip arthroplasty.

  2. Identification of hip fracture patients from radiographs using Fourier analysis of the trabecular structure: a cross-sectional study

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    Reid David M

    2004-10-01

    Full Text Available Abstract Background This study presents an analysis of trabecular bone structure in standard radiographs using Fourier transforms and principal components analysis (PCA to identify contributions to hip fracture risk. Methods Radiographs were obtained from 26 hip fracture patients and 24 controls. They were digitised and five regions of interest (ROI were identified from the femoral head and neck for analysis. The power spectrum was obtained from the Fourier transform of each region and three profiles were produced; a circular profile and profiles parallel and perpendicular to the preferred orientation of the trabeculae. PCA was used to generate a score from each profile, which we hypothesised could be used to discriminate between the fracture and control groups. The fractal dimension was also calculated for comparison. The area under the receiver operating characteristic curve (Az discriminating the hip fracture cases from controls was calculated for each analysis. Results Texture analysis of standard radiographs using the fast Fourier transform yielded variables that were significantly associated with fracture and not significantly correlated with age, body mass index or femoral neck bone mineral density. The anisotropy of the trabecular structure was important; both the perpendicular and circular profiles were significantly better than the parallel-profile (P Az = 0.84 – 0.93, there were no significant correlations with femoral neck bone mineral density, age, or body mass index. PCA analysis was found to perform better than fractal analysis (P = 0.019. Conclusions Both PCA and fractal analysis of the FFT data could discriminate successfully between the fracture and control groups, although PCA was significantly stronger than fractal dimension. This method appears to provide a powerful tool for the assessment of bone structure in vivo with advantages over standard fractal methods.

  3. Results of total hip arthroplasty using a bionic hip stem.

    Science.gov (United States)

    Fokter, Samo K; Sarler, Taras; Strahovnik, Andrej; Repše-Fokter, Alenka

    2015-06-01

    The trabecular-orientated bionic hip stem was designed to mimic the natural force transmission through the femur in total hip arthroplasty, resulting in supposedly longer prosthesis survivability. The aim of this study was to compare the second-generation bionic hip stem to a standard uncemented hip stem. A group of 18 patients (21 hips) who underwent total hip arthroplasty with a bionic stem (bionic group) was compared with a historic group of 12 patients (12 hips) treated with standard anatomic hip stem (control group). During the first year after the procedure, the densitometric measurements of the bone around the prosthesis were taken. Radiographic and clinical assessments were additionally performed preoperatively and at the three month, six month, one year and three year follow-ups in the bionic group. In the bionic group, one patient was revised for aseptic loosening and 16 patients (19 hips) were available to the final follow-up. A significant decrease of bone mineral density was found in Gruen zones 3, 4 and 5 in the bionic group, and in zone 7 in both groups. The bionic group had a significantly higher bone mineral density in Gruen zone 1 at the one year follow-up. At the final follow-up, all prostheses were radiologically stable in both groups. Provided that a good implant position is achieved, comparable short-term results can be obtained using a bionic stem. Still, a decrease of bone mineral density in Gruen zone 7 occurred in both groups. Further studies are required to determine survivability of the bionic stem.

  4. Incidence of hip osteonecrosis among renal transplantation recipients: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Lopez-Ben, R.; Mikuls, T.R.; Moore, D.S.; Julian, B.A.; Bernreuter, W.K.; Elkins, M.; Saag, K.G. E-mail: kenneth.saag@ccc.uab.edu

    2004-05-01

    AIM: To investigate whether a lessened glucocorticoid cumulative dose would lead to a decreased incidence of femoral head osteonecrosis. METHODS: Newly transplanted in-patients (n=49) underwent hip radiographs and magnetic resonance imaging (MRI) a mean of 17.0{+-}4.3 (range 8-29) days after renal transplantation. For the 48 patients without evidence of prevalent osteonecrosis, imaging at a mean of 5.9{+-}0.8 (range 4.8-8.7) months after renal transplantation was graded for presence/absence of femoral head osteonecrosis by two blinded radiologists. Sociodemographic and disease characteristics of patients were compared to identify potential associations with incident osteonecrosis. RESULTS: At 6-month follow-up, only two patients (4%) had osteonecrosis of the femoral head (three hips). The two primary radiologists had excellent agreement between osteonecrosis diagnosis (kappa coefficient=0.78). Both cases of a definite MRI diagnosis of osteonecrosis occurred in patients who were in the highest tertile of glucocorticoid dosage. CONCLUSION: Osteonecrosis was uncommon among a prospective cohort of renal transplant recipients within 6 months after engraftment.

  5. Time-based analysis of total cost of patient episodes: a case study of hip replacement.

    Science.gov (United States)

    Peltokorpi, Antti; Kujala, Jaakko

    2006-01-01

    Healthcare in the public and private sectors is facing increasing pressure to become more cost-effective. Time-based competition and work-in-progress have been used successfully to measure and improve the efficiency of industrial manufacturing. Seeks to address this issue. Presents a framework for time based management of the total cost of a patient episode and apply it to the six sigma DMAIC-process development approach. The framework is used to analyse hip replacement patient episodes in Päijät-Häme Hospital District in Finland, which has a catchment area of 210,000 inhabitants and performs an average of 230 hip replacements per year. The work-in-progress concept is applicable to healthcare--notably that the DMAIC-process development approach can be used to analyse the total cost of patient episodes. Concludes that a framework, which combines the patient-in-process and the DMAIC development approach, can be used not only to analyse the total cost of patient episode but also to improve patient process efficiency. Presents a framework that combines patient-in-process and DMAIC-process development approaches, which can be used to analyse the total cost of a patient episode in order to improve patient process efficiency.

  6. The effects of treadmill exercise training on hip bone density and tibial bone geometry in stroke survivors: a pilot study.

    Science.gov (United States)

    Pang, Marco Y C; Lau, Ricky W K

    2010-05-01

    Individuals with stroke often sustain bone loss on the hemiparetic side and are prone to fragility fractures. Exercise training may be a viable way to promote bone mineral density (BMD) and geometry in this population. This was a pilot study to evaluate the effects of a 6-month treadmill exercise program on hip BMD and tibial bone geometry in chronic stroke survivors. Twenty-one individuals with chronic stroke, with a mean age of 64.5 years and mean post-stroke duration of 8.3 years participated in the study. The treatment group underwent a treadmill gait exercise program (two 1-hour sessions per week for 6 months), whereas the control group participated in their usual self-selected activities in the community. The primary outcomes were hip BMD and bone geometry of the midshaft tibia on the paretic side, whereas the secondary outcomes were gait velocity, endurance, leg muscle strength, balance self-efficacy, and physical activity level. Mann-Whitney U tests were used to compare the change in all outcome variables between the 2 groups after treatment. Significant between-group differences in change scores of tibial cortical thickness (P = .016), endurance ( P = .029), leg muscle strength on the paretic side (P exercise program induced a modest improvement in tibial bone geometry in individuals with chronic stroke. Further studies are required to explore the optimal training protocol for promoting favorable changes in bone parameters following stroke.

  7. The Hip Fracture Surgery in Elderly Patients (HIPELD study: protocol for a randomized, multicenter controlled trial evaluating the effect of xenon on postoperative delirium in older patients undergoing hip fracture surgery

    Directory of Open Access Journals (Sweden)

    Coburn Mark

    2012-09-01

    Full Text Available Abstract Background Strategies to protect the brain from postoperative delirium (POD after hip fracture are urgently needed. The development of delirium often is associated with the loss of independence, poor functional recovery, and increased morbidity, as well as increases in length of hospital stay, discharges to nursing facilities, and healthcare costs. We hypothesize that xenon may reduce the burden of POD, (i by avoiding the need to provide anesthesia with a drug that targets the γ-amino-butyric acid (GABAA receptor and (ii through beneficial anesthetic and organ-protective effects. Methods and design An international, multicenter, phase 2, prospective, randomized, blinded, parallel group and controlled trial to evaluate the incidence of POD, diagnosed with the Confusion Assessment Method (CAM, in older patients undergoing hip fracture surgery under general anesthesia with xenon or sevoflurane, for a period of 4 days post surgery (primary outcome is planned. Secondary objectives are to compare the incidence of POD between xenon and sevoflurane, to evaluate the incidence of POD from day 5 post surgery until discharge from hospital, to determine the time to first POD diagnosis, to evaluate the duration of POD, to evaluate the evolution of the physiological status of the patients in the postoperative period, to evaluate the recovery parameters, to collect preliminary data to evaluate the economical impact of POD in the postoperative period and to collect safety data. Patients are eligible if they are older aged (≥ 75 years and assigned to a planned hip fracture surgery within 48 h after the hip fracture. Furthermore, patients need to be willing and able to complete the requirements of this study including the signature of the written informed consent. A total of 256 randomized patients in the 10 participating centers will be recruited, that is, 128 randomized patients in each of the 2 study groups (receiving either xenon or sevoflurane

  8. Feasibility of using administrative data for identifying medical reasons to delay hip fracture surgery: a Canadian database study.

    Science.gov (United States)

    Guy, Pierre; Sheehan, Katie J; Morin, Suzanne N; Waddell, James; Dunbar, Michael; Harvey, Edward; Sirett, Susan; Sobolev, Boris; Kuramoto, Lisa; Tang, Michael

    2017-10-05

    Failure to account for medically necessary delays may lead to an underestimation of early surgery benefits. This study investigated the feasibility of using administrative data to identify the National Institute for Health and Care Excellence (NICE) 124 guideline list of conditions that appropriately delay hip fracture surgery. We assembled a list of diagnosis and procedure codes to reflect the NICE 124 conditions. The list was reviewed and updated by an advanced clinical coder. The list was refined by five clinical experts. We then screened Canadian Institute for Health Information discharge abstracts for 153 918 patients surgically treated for a non-pathological first hip fracture between 1 January 2004 and 31 December 2012 for diagnosis codes present on admission and procedure codes that antedated hip fracture surgery. We classified abstracts as having medical reasons for delaying surgery based on the presence of these codes. In total, 10 237 (6.7%; 95% CI 6.5% to 6.8%) patients had diagnostic and procedure codes indicating medical reasons for delay. The most common reasons for medical delay were exacerbation of a chronic chest condition (35.9%) and acute chest infection (23.2%). The proportion of patients with reasons for medical delays increased with time from admission to surgery: 3.9% (95% CI 3.6% to 4.1%) for same day surgery; 4.7% (95% CI 4.5% to 4.8%) for surgery 1 day after admission; 7.1% (95% CI 6.9% to 7.4%) for surgery 2 days after admission; and 15.5% (95% CI 15.1% to 16.0%) for surgery more than 2 days after admission. The trend was seen for admissions on weekday working hours, weekday after hours and on weekends. Administrative data can be considered to identify conditions that appropriately delay hip fracture surgery. Accounting for medically necessary delays can improve estimates of the effectiveness of early surgery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  9. Associations between the dietary intake of antioxidant nutrients and the risk of hip fracture in elderly Chinese: a case-control study.

    Science.gov (United States)

    Sun, Li-li; Li, Bao-lin; Xie, Hai-li; Fan, Fan; Yu, Wei-zhong; Wu, Bao-hua; Xue, Wen-qiong; Chen, Yu-ming

    2014-11-28

    The role of oxidative stress in skeletal health is unclear. The present study investigated whether a high dietary intake of antioxidant nutrients (vitamins C and E, β-carotene, animal-derived vitamin A, retinol equivalents, Zn and Se) is associated with a reduced risk of hip fracture in elderly Chinese. This 1:1 matched case-control study involved 726 elderly Chinese with hip fracture and 726 control subjects, recruited between June 2009 and May 2013. Face-to-face interviews were conducted to determine habitual dietary intakes of the above-mentioned seven nutrients based on a seventy-nine-item FFQ and information on various covariates, and an antioxidant score was calculated. After adjustment for potential covariates, dose-dependent inverse associations were observed between the dietary intake of vitamin C, vitamin E, β-carotene, and Se and antioxidant score and the risk of hip fracture (P for trend ≤ 0·005). The OR of hip fracture for the highest (v. lowest) quartile of intake were 0·39 (95 % CI 0·28, 0·56) for vitamin C, 0·23 (95 % CI 0·16, 0·33) for vitamin E, 0·51 (95 % CI 0·36, 0·73) for β-carotene, 0·43 (95 % CI 0·26, 0·70) for Se and 0·24 (95 % CI 0·17, 0·36) for the antioxidant score. A moderate-to-high dietary intake of retinol equivalents in quartiles 2-4 (v. 1) was found to be associated with a lower risk of hip fracture (OR range: 0·51-0·63, Pvitamin A intake and hip fracture risk (P for trend >0·20). In conclusion, a higher dietary intake of vitamins C and E, β-carotene, and Se and a moderate-to-high dietary intake of retinol equivalents are associated with a lower risk of hip fracture in elderly Chinese.

  10. Validity of a tablet computer version of the Japanese Orthopaedic Association hip disease evaluation questionnaire: a pilot study.

    Science.gov (United States)

    Takegami, Yasuhiko; Seki, Taisuke; Kaneuji, Ayumi; Nakao, Akinobu; Hasegawa, Yukiharu; Ishiguro, Naoki

    2016-08-01

    The Japanese Orthopaedic Association hip disease evaluation questionnaire (JHEQ) was established as a new patient-reported outcome for patients with hip disease. We developed a JHEQ application beta version for tablet computers. The application has a slider system to input visual analogue scale (VAS) measurements. The purposes of this study were 1) to test whether the VAS that was acquired from this slider system was equal to the value recorded on paper and 2) to evaluate the validity and agreement of the JHEQ tablet version. A total of 57 patients were analyzed in the study (mean age, 60.2 years; range, 29-81 years). They received either the paper-and-pencil version (paper version) or the tablet computer version (tablet version). To evaluate the validity of the tablet version, we analyzed differences in the VAS and total scores between the paper version and tablet computer version. In addition, we calculated Cronbach's alpha, the intraclass correlation coefficient (ICC), and the Pearson's correlation coefficient (CC). The VAS scores in the tablet version were significantly lower than those in the paper version (22.3 ± 5.4 vs. 17.0 ± 4.5 and 28.1 ± 6.1 vs. 23.5 ± 5.3, respectively; all P VAS on the tablet version, which used a slider bar system, proved unreliable.

  11. Functional recovery after muscle sparing total hip arthroplasty in comparison to classic lateral approach - A three years follow-up study.

    Science.gov (United States)

    Tudor, Anton; Ruzic, Lana; Vuckovic, Mirela; Prpic, Tomislav; Rakovac, Ivan; Madjarevic, Tomislav; Legovic, Dalen; Santic, Veljko; Mihelic, Radovan; Sestan, Branko

    2016-03-01

    The muscle sparing total hip arthroplasty had generated a distinguishable interest, in both the patients and the surgeons, but its benefits are still often questioned. The main idea of this study was to compare the functional clinical outcome of the patients operated by the anterolateral approach with a muscle-sparing technique (modified Watson-Jones approach), and the patients operated by modified direct lateral approach without the muscle-sparing technique (Bauer/Hardinge approach). The patients (N = 130) were divided into two groups: 68 in a standard method group (STAND) and 62 patients in a muscle sparing surgery group (MSS). The hip flexibility, mobility, the strength of the hip abduction, the pain scale, Harris hip scores, the duration of the hospital stay and the overall satisfaction were measured seven days, three months, one year and three years (in 80 patients) after the surgery. There were no differences in any of the parameters between the groups prior to the procedure. The statistically significant differences in first three follow-ups (up to one year) were determined between the groups in passive and active hip flexion ability but the hip abduction strength, which is a crucial parameter for functional recovery, and 50 m walk test remained better in MSS group even after three years. Patients, who underwent MSS suffered also less pain, stayed in hospital shorter and were more satisfied with the operation outcome. The functional recovery in patients treated with muscle sparing method was faster than in patients operated with conventional lateral approach. Based on the results, we could recommend anterolateral muscle sparing approach for a total hip replacement for its faster and fuller functional recovery. Copyright © 2015 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  12. Wear testing of total hip replacements under severe conditions.

    Science.gov (United States)

    Zietz, Carmen; Fabry, Christian; Reinders, Joern; Dammer, Rebecca; Kretzer, Jan Philippe; Bader, Rainer; Sonntag, Robert

    2015-07-01

    Controlled wear testing of total hip replacements in hip joint simulators is a well-established and powerful method, giving an extensive prediction of the long-term clinical performance. To understand the wear behavior of a bearing and its limits under in vivo conditions, testing scenarios should be designed as physiologically as possible. Currently, the ISO standard protocol 14242 is the most common preclinical testing procedure for total hip replacements, based on a simplified gait cycle for normal walking conditions. However, in recent years, wear patterns have increasingly been observed on retrievals that cannot be replicated by the current standard. The purpose of this study is to review the severe testing conditions that enable the generation of clinically relevant wear rates and phenomena. These conditions include changes in loading and activity, third-body wear, surface topography, edge wear and the role of aging of the bearing materials.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  14. Clinical significance of corrosion of cemented femoral stems in metal-on-metal hips: a retrieval study.

    Science.gov (United States)

    Hothi, Harry S; Berber, Reshid; Panagiotopoulos, Andreas C; Whittaker, Robert K; Rhead, Camilla; Skinner, John A; Hart, Alister J

    2016-11-01

    The clinical significance of corrosion of cemented femoral stems is unclear. The purpose of this retrieval study was to: (1) report on corrosion at the stem-cement interface and (2) correlate these findings with clinical data. We analysed cemented stems (n = 36) composed of cobalt-chromium (CoCr) and stainless steel (SS) in a series of revised metal-on-metal hips. We performed detailed inspection of each stem to assess the severity of corrosion at the stem-cement interface using a scale of 1 (low) to 5 (severe). We assessed the severity of corrosion at each stem trunnion and measured wear rates at the head taper and bearing surfaces. We used non-parametric tests to determine the significance of differences between the CoCr and SS stems in relation to: (1) pre-revision whole blood Co and Cr metal ion levels, (2) trunnion corrosion, (3) bearing surface wear and (4) taper material loss. The corrosion scores of CoCr stems were significantly greater than SS stems (p corrosion. The median pre-revision Co levels of implants with CoCr stems were significantly greater than the SS stems (p corrosion of cemented femoral stems is a common finding at our retrieval centre; surgeons should consider corrosion of CoCr stems as a potential source of metal ions when revising a hip.

  15. Development of an acoustic measurement protocol to monitor acetabular implant fixation in cementless total hip Arthroplasty: A preliminary study.

    Science.gov (United States)

    Goossens, Quentin; Leuridan, Steven; Henyš, Petr; Roosen, Jorg; Pastrav, Leonard; Mulier, Michiel; Desmet, Wim; Denis, Kathleen; Vander Sloten, Jos

    2017-11-01

    In cementless total hip arthroplasty (THA), the initial stability is obtained by press-fitting the implant in the bone to allow osseointegration for a long term secondary stability. However, finding the insertion endpoint that corresponds to a proper initial stability is currently based on the tactile and auditory experiences of the orthopedic surgeon, which can be challenging. This study presents a novel real-time method based on acoustic signals to monitor the acetabular implant fixation in cementless total hip arthroplasty. Twelve acoustic in vitro experiments were performed on three types of bone models; a simple bone block model, an artificial pelvic model and a cadaveric model. A custom made beam was screwed onto the implant which functioned as a sound enhancer and insertor. At each insertion step an acoustic measurement was performed. A significant acoustic resonance frequency shift was observed during the insertion process for the different bone models; 250 Hz (35%, second bending mode) to 180 Hz (13%, fourth bending mode) for the artificial bone block models and 120 Hz (11%, eighth bending mode) for the artificial pelvis model. No significant frequency shift was observed during the cadaveric experiment due to a lack of implant fixation in this model. This novel diagnostic method shows the potential of using acoustic signals to monitor the implant seating during insertion. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

  16. Biomechanical study of plantar pressures during walking in male soccer players with increased vs. normal hip alpha angles.

    Science.gov (United States)

    Hagen, Marco; Abraham, Christoph; Ficklscherer, Andreas; Lahner, Matthias

    2015-01-01

    Femoroacetabular impingement (FAI) is accompanied by increased hip alpha angles, in particular in athletes with high impact sports. The aim of our study was to investigate the dynamic function of the foot during walking in male soccer players with increased versus normal alpha angles. Plantar pressures of 20 injury-free male soccer players were recorded during barefoot walking at 1.6 m/s. Ten subjects had bilaterally increased (>55°) (IA) and ten subjects normal (<50°) hip alpha angles (NA). Both standing and kicking leg were analyzed. Compared to NA, IA showed lower force-time-integrals (-23%; p< 0.01), pressure-time-integrals (-29%; p< 0.001) and relative loads (p< 0.05) under the heel. In IA contact area of the hallux is about 13% (p< 0.05) reduced. In IA relative loads are increased under the lateral midfoot (p< 0.05) and the second toe (p< 0.05). Higher loading of the lateral midfoot is also reflected in the increased force-time integral (+33%; p< 0.001). No differences between legs and no interactions, indicating a specifity in kicking or standing leg, are found. Compared to NA, soccer players with IA show a forward shifting of the center of pressure which indicates a compensatory mechanism of the foot during walking.

  17. The direct anterior minimal invasive approach in total hip replacement: a prospective departmental study on the learning curve.

    Science.gov (United States)

    Brun, Ole-Christian L; Månsson, Lukas; Nordsletten, Lars

    2017-10-16

    Introduction of new surgical techniques is normal, but seldom monitored in real time. The purpose of this study was to monitor the learning curve when introducing a new surgical technique to a department. We did a prospective evaluation of the learning curve when introducing the minimally invasive direct anterior approach in total hip arthroplasty. We wish to investigate whether there is a learning curve for the direct anterior minimal invasive approach in total hip replacement and what are the early complications to this approach. The department changed from the direct lateral approach to the minimally invasive direct anterior approach. We monitored the first 522 patients operated using this approach with regards to patient outcome scores and complications 6 months postoperatively. The last 250 patients operated all had significantly better results with regard to patient outcome scores and cup placement. We investigated 100 patients at a time and compared them with the rest of the patient and found the same pattern. This pattern ends when we reach patients somewhere between 200-300. We established the learning curve on a departmental level with regards to introduction of the minimal invasive direct anterior approach. We see a steady improvement in scores with regards to patient outcome scores and cup positioning until we reach a steady-state. The learning curve here flattens out. Departments must understand that one should expect early complications and somewhat less than optimal results at first when introducing this new surgical technique.

  18. Fear of falling during activities of daily living after total hip arthroplasty in Japanese women: a cross-sectional study.

    Science.gov (United States)

    Nagai, K; Ikutomo, H; Yamada, M; Tsuboyama, T; Masuhara, K

    2014-12-01

    To investigate the prevalence of fear of falling, and identify factors associated with fear of falling during activities of daily living after total hip arthroplasty (THA). Cross-sectional study. Community. Two hundred and fourteen women who had undergone THA. Fear of falling after THA was assessed for 12 activities of daily living using a fear of falling score. The number of falls in the past year, total Oxford Hip Score (OHS), total Penn State Worry Questionnaire (PSWQ) score and walking capacity were recorded as descriptive statistics. Multiple linear regression analysis was performed, with total fear of falling score as the dependent variable and age, body mass index, time since THA, bilateral THA, total OHS, history of falling, walking capacity and total PSWQ score as the independent variables. A number of participants (mean age = 64.2) experienced fear of falling while ascending and descending stairs: 45% (97/214), taking a bath: 26% (56/214), bending to pick something up off the floor: 26% (55/214), and getting up from lying on the floor: 25% (54/214). Fear of falling during activities of daily living after THA was significantly correlated with total OHS, history of falling, walking capacity, total PSWQ score and age (Pactivities of daily living after THA. It is associated with poorer functional outcome, history of falling, lower walking capacity, higher anxiety level and older age. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  19. Hip Labral Tear

    Science.gov (United States)

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

  20. Investigation of Polyhenolic Content of Rose Hip (Rosa canina L. Tea Extracts: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Zeynep İlbay

    2013-02-01

    Full Text Available Three different brands of Rose hip (Rosa canina L. tea were extracted with water, ethanol (EtOH, methanol (MeOH, and aqueous mixtures (50%, v/v by ultrasound-assisted extraction (UAE and Soxhlet methods. Total phenolic content was determined according to the Folin-Ciocalteu method. The results were presented by means of the extract yields and total phenolic contents, expressed in gallic acid equivalent (GAE per g of dried matter (DM. The greatest amount of extract observed in tea samples was obtained by UAE through water with the value of 619.37 ± 0.58 mg/g DM. Regarding the phenolic content, the best result was achieved by the Soxhlet method through 50% MeOH mixture (59.69 ± 0.89 mg GAE/g DM, followed by the UAE method with water (48.59 ± 0.29 mg GAE/g DM.

  1. Investigation of Polyhenolic Content of Rose Hip (Rosa canina L.) Tea Extracts: A Comparative Study

    Science.gov (United States)

    İlbay, Zeynep; Şahin, Selin; Kırbaşlar, Ş. İsmail

    2013-01-01

    Three different brands of Rose hip (Rosa canina L.) tea were extracted with water, ethanol (EtOH), methanol (MeOH), and aqueous mixtures (50%, v/v) by ultrasound-assisted extraction (UAE) and Soxhlet methods. Total phenolic content was determined according to the Folin-Ciocalteu method. The results were presented by means of the extract yields and total phenolic contents, expressed in gallic acid equivalent (GAE) per g of dried matter (DM). The greatest amount of extract observed in tea samples was obtained by UAE through water with the value of 619.37 ± 0.58 mg/g DM. Regarding the phenolic content, the best result was achieved by the Soxhlet method through 50% MeOH mixture (59.69 ± 0.89 mg GAE/g DM), followed by the UAE method with water (48.59 ± 0.29 mg GAE/g DM). PMID:28239095

  2. Pregabalin and dexamethasone for postoperative pain control: a randomized controlled study in hip arthroplasty

    DEFF Research Database (Denmark)

    Mathiesen, O.; Jacobsen, L.S.; Holm, H.E.

    2008-01-01

    Background. Optimal pain treatment with minimal side-effects is essential for early mobility and recovery in patients undergoing total hip arthroplasty. We investigated the analgesic effect of pregabalin and dexamethasone in this surgical procedure. Methods. One hundred and twenty patients were...... randomly allocated to either Group A (placebo), Group B (pregabalin 300 mg), or Group C (pregabalin 300 mg+dexamethasone 8 mg). The medication and acetaminophen 1 g were given before operation. Spinal anaesthesia was performed. Postoperative pain treatment was with acetaminophen 1 g three times daily...... with the other groups. Conclusions. Pregabalin resulted in a 50% reduction in 24 h postoperative morphine requirements. This was not associated with a reduced incidence of nausea or vomiting. Pregabalin resulted in increased levels of sedation. Combining pregabalin and dexamethasone provided no additional...

  3. A randomised, controlled clinical study on total hip arthroplasty using 4 different bearings

    DEFF Research Database (Denmark)

    Borgwardt, Arne; Zerahn, Bo; Fabricius, Sandra D

    2017-01-01

    cumulated prosthesis survival percentages and 95% confidence interval after 10 years were: group A 84.6 (75.8-93.4); group B 95.0 (89.5-100); group C 93.2 (86.7-99.7); group D 66.1 (54.5-77.7). The patients' physical function was significantly improved and remained equally good in all 4 groups, however...... slightly declining with ageing. The luxation rate was initially high, and equal between the groups, but was reduced by improving the surgical procedure introducing capsule repair by reinsertion of the short external hip rotators. CONCLUSIONS: The metal-on-metal or zirconia-on-polyethylene prostheses had...

  4. Hip Hop Stroke: Study Protocol for a Randomized Controlled Trial to Address Stroke Literacy.

    Science.gov (United States)

    Williams, Olajide; Leighton-Herrmann, Ellyn; DeSorbo, Alexandra; Hecht, Mindy; Hedmann, Monique; Huq, Saima; Gerin, William; Chinchilli, Vernon; Ogedegbe, Gbenga; Noble, James

    2015-10-01

    Stroke is the fifth leading cause of death and the leading cause of serious long-term adult disability in the US. Acute stroke treatments with intravenous thrombolysis and endovascular therapy are proven to reduce disability, however a critical limitation on their effectiveness is the narrow time window for administration, which is 4.5 hours and 6 hours respectively from the onset of symptoms. Our overarching goal is to reduce pre-hospital delays to acute stroke treatments in economically disadvantaged minority communities where the greatest delays exist, using Hip Hop Stroke. Hip Hop Stroke (HHS) is a school-based, child-mediated, culturally-tailored stroke communication multimedia intervention developed using validated models of behavior change and designed to improve stroke literacy (knowledge of stroke symptoms, the urgent need to call 911, and prevention measures) of 4(th), 5(th) and 6(th) grade students and their parents residing in poor urban communities. Children in the intervention arm will receive the HHS intervention, while those in the attentional control arm will receive standardized nutrition education based on the USDA's MyPyramid program. Children will be trained and motivated to share stroke information with their parents or other adult caregiver. Both children and parents will complete a stroke knowledge assessment at baseline, immediately following the program, and at 3-months post-program. The primary outcome is the effect of the child mediation on parental stroke literacy. Stroke literate children, a captive audience in school systems, may represent a viable channel for spreading stroke information into households of poor urban communities where mass media stroke campaigns have shown the lowest penetration. These children may also call 911 when witnessing a stroke in their homes or communities. The HHS program may highlight the potential role of children in the chain of stroke recovery as a strategy for reducing prehospital delays to acute

  5. Instability of total hip replacement: A clinical study and determination of its risk factors.

    Science.gov (United States)

    Ezquerra-Herrando, L; Seral-García, B; Quilez, M P; Pérez, M A; Albareda-Albareda, J

    2015-01-01

    To determine the risk factors associated with prosthetic dislocation and simulate a finite element model to determine the safe range of movement of various inclination and anteversion cup positions. Retrospective Case Control study with 46 dislocated patients from 1994 to 2011. 83 randomly selected patients. Dislocation risk factors described in the literature were collected. A prosthetic model was simulated using finite elements with 28, 32, 36 mm heads, and a 52 mm cup. Acetabular position was 25°, 40°, and 60° tilt and with 0°, 15° and 25° anteversion. In extension of 0° and flexion of 90°, internal and external rotation was applied to analyze the range of movement, maximum resisting moment, and stress distribution in the acetabulum to impingement and dislocation. There was greater dislocation in older patients (p=0.002). Higher dislocation in fractures than in osteoarthritis (p=0.001). Less anteversion in dislocated patients (p=0.043). Longer femoral neck in dislocated patients (p=0.002). Finite element model: lower dislocation when there is more anteversion, tilt and bigger femoral heads. Advanced age and fractures are the major risk factors for dislocation. "Safe zone" of movement for dislocation avoidance is 40°-60° tilt and 15°-25° anteversion. Both the defect and excess of soft tissue tension predispose to dislocation. Bigger femoral heads are more stable. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  6. Joined at the hip: linked characters and the problem of missing data in studies of disparity.

    Science.gov (United States)

    Smith, Andrew J; Rosario, Michael V; Eiting, Thomas P; Dumont, Elizabeth R

    2014-08-01

    Paleontological investigations into morphological diversity, or disparity, are often confronted with large amounts of missing data. We illustrate how missing discrete data affect disparity using a novel simulation for removing data based on parameters from published datasets that contain both extinct and extant taxa. We develop an algorithm that assesses the distribution of missing characters in extinct taxa, and simulates data loss by applying that distribution to extant taxa. We term this technique "linkage." We compare differences in disparity metrics and ordination spaces produced by linkage and random character removal. When we incorporated linkage among characters, disparity metrics declined and ordination spaces shrank at a slower rate with increasing missing data, indicating that correlations among characters govern the sensitivity of disparity analysis. We also present and test a new disparity method that uses the linkage algorithm to correct for the bias caused by missing data. We equalized proportions of missing data among time bins before calculating disparity, and found that estimates of disparity changed when missing data were taken into account. By removing the bias of missing data, we can gain new insights into the morphological evolution of organisms and highlight the detrimental effects of missing data on disparity analysis. © 2014 The Author(s). Evolution © 2014 The Society for the Study of Evolution.

  7. Designing a strategy to implement optimal conservative treatments in patients with knee or hip osteoarthritis in orthopedic practice: a study protocol of the BART-OP study.

    Science.gov (United States)

    Hofstede, Stefanie N; Vliet Vlieland, Thea P M; van den Ende, Cornelia H M; Marang-van de Mheen, Perla J; Nelissen, Rob G H H; van Bodegom-Vos, Leti

    2014-02-18

    National and international evidence-based guidelines for hip and knee osteoarthritis recommend to start with (a combination of) conservative treatments, followed by surgical intervention if a patient does not respond sufficiently to conservative treatment options. Despite these recommendations, there are strong indications that conservative treatments are not optimally used in orthopedic practice. Our study aims to quantify the use of conservative treatments in Dutch orthopedic practice and to explore the barriers and facilitators for the use of conservative treatments that should be taken into account in a strategy to improve the embedding of conservative treatments in hip and knee osteoarthritis in orthopedic practice. This study consists of three phases. First, current use of conservative treatments in patients with hip and knee osteoarthritis will be explored using an internet-based survey among at least 100 patients to identify the underused conservative treatments. Second, barriers and facilitators for the use of conservative treatments in orthopedic practice will be identified using semi-structured interviews among 10 orthopedic surgeons and 5 patients. The interviews will be followed by an internet-based survey among approximately 450 orthopedic surgeons and at least 100 patients in which the identified barriers and facilitators will be ranked by importance. Finally, an implementation strategy will be developed based on the results of the previous phases using intervention mapping. The developed strategy is likely to result in an optimal and standardized use of conservative treatment options in hip and knee osteoarthritis in orthopedic practice, because it is focused on identified barriers and facilitators. In addition, the results of this study can be used as an example for optimizing the use of conservative care in other patient groups. In a subsequent study, the developed implementation strategy will be assessed on its effectiveness, feasibility and

  8. Return to Driving After Hip Arthroscopy.

    Science.gov (United States)

    Momaya, Amit M; Stavrinos, Despina; McManus, Benjamin; Wittig, Shannon M; Emblom, Benton; Estes, Reed

    2017-07-11

    The objective of this study was to evaluate patients' braking performance using a modern driving simulator after undergoing a right hip arthroscopy. This prospective study included 5 total driving sessions at which measurements were taken. The study was conducted at an academic medical center. A total of 14 patients scheduled to undergo a right hip arthroscopy were enrolled and compared with a control group of 17 participants to account for a potential learning phenomenon. Patients drove in the simulator preoperatively to establish a baseline, and then drove again at 2, 4, 6, and 8 weeks postoperatively. The control group did not undergo any type of surgical procedure. The main independent variable was time from surgery. A modern driving simulator was used to measure initial reaction time (IRT), throttle release time (TRT), foot movement time (FMT), and brake travel time (BTT). The braking reaction time (BRT) was calculated as the sum of IRT + TRT + FMT, and the total braking time (TBT) was calculated as the sum of BRT + BTT. The experimental group showed no significant changes in BTT (P = 0.11, ηG = 0.04) nor TBT (P = 0.20, ηG = 0.03) over the duration of 8 weeks. Although the experimental group did exhibit significant improvements in IRT (P = 0.002), TRT (P < 0.0001), FMT (P < 0.0001), and BRT (P = 0.0002) between preoperative and 2 weeks postoperative driving sessions, there were no significant changes thereafter. The mean preoperative TBT and 2 weeks postoperative TBT for the experimental group were 3.07 seconds (SD = 0.50) and 2.97 seconds (SD = 0.57), respectively. No learning phenomenon was observed in the control group. This study's findings suggest that patients may return to driving 2 weeks postoperatively from a right-sided hip arthroscopy procedure.

  9. Simulations & Case Studies. [SITE 2002 Section].

    Science.gov (United States)

    Seymour, Cathy R., Ed.

    This document contains the following papers on simulations and case studies from the SITE (Society for Information Technology & Teacher Education) 2002 conference: "3-D Virtual Classroom Technology" (Kimberly Arseneau Miller, Angela Glod); "Simulated Lesson Design Studios" (Willis Copeland); "Lights, Camera, Integration: Presentation Programs and…

  10. Larger femoral periprosthetic bone mineral density decrease following total hip arthroplasty for femoral neck fracture than for osteoarthritis: a prospective, observational cohort study.

    Science.gov (United States)

    Mann, Tobias; Eisler, Thomas; Bodén, Henrik; Muren, Olle; Stark, André; Salemyr, Mats; Sköldenberg, Olof

    2015-04-01

    Studies on patients with degenerative joint disease of the hip show that femoral periprosthetic bone mineral decreases following total hip arthroplasty. Scarcely any osteodensitometric data exist on femoral neck fracture (FNF) patients and periprosthetic bone remodelling. In two parallel cohorts we enrolled 87 patients (mean age, 72 ± 12 years; male:female ratio, 30:57) undergoing total hip arthroplasty for either primary osteoarthritis (OA) of the hip (n = 37) or for an acute FNF (n = 50) and followed them for a mean of 5.4 years. Outcomes were bone mineral density (BMD) changes in the periprosthetic Gruen zones 1-7, the incidence of periprosthetic fractures and clinical outcome. The bone mineral loss in the fracture group was more than twice that of the osteoarthritis group, -16.9% versus -6.8% (p = 0.004). The incidence of periprosthetic fractures was 12% (6/50) in the fracture cohort compared with none (0%) in the OA cohort (p = 0.03). Periprosthetic bone mineral loss following total hip arthroplasty is significantly greater in patients who are treated for acute FNF than in OA patients. This decrease of BMD follows a different pattern with the FNF patients losing larger proportions of bone in Gruen zones 1, 2, 6, and 7 while the OA patients tend to have larger losses only in zones 1 and 7. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  11. Tantalum acetabular augments in one-stage exchange of infected total hip arthroplasty: a case-control study.

    Science.gov (United States)

    Klatte, Till Orla; Kendoff, Daniel; Sabihi, Reza; Kamath, Atul F; Rueger, Johannes M; Gehrke, Thorsten

    2014-07-01

    During the one-stage exchange procedure for periprosthetic joint infection (PJI) after total hip arthroplasty (THA), acetabular defects challenge reconstructive options. Porous tantalum augments are an established tool for addressing acetabular destruction in aseptic cases, but their utility in septic exchange is unknown. This retrospective case-control study presents the initial results of tantalum augmentation during one-stage exchange for PJI. Primary endpoints were rates of re-infection and short-term complications associated with this technique. Study patients had no higher risk of re-infection with equivalent durability at early follow-up with a re-infection rate in both groups of 4%. In conclusion, tantalum augments are a viable option for addressing acetabular defects in one-stage exchange for septic THA. Further study is necessary to assess long-term durability when compared to traditional techniques for acetabular reconstruction. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: a cost analysis of a multicenter prospective study

    OpenAIRE

    Burgers, Paul; Hoogendoorn, Martine; Van Woensel, E.A.C.; Poolman, Rudolf; Bhandari, Mohit; Patka, Peter; Lieshout, Esther

    2016-01-01

    Summary The aim of this study was to determine the total medical costs for treating displaced femoral neck fractures with hemi- or total hip arthroplasty in fit elderly patients. The mean total costs per patient at 2?years of follow-up were ?26,399. These results contribute to cost awareness. Introduction The absolute number of hip fractures is rising and increases the already significant burden on society. The aim of this study was to determine the mean total medical costs per patient for tr...

  13. Can lifestyle factors explain why body mass index and waist-to-hip ratio increase with increasing tobacco consumption? The Inter99 study

    DEFF Research Database (Denmark)

    Pisinger, C; Toft, U; Jørgensen, Torben

    2009-01-01

    BACKGROUND: The relationship between smoking, lifestyle, and weight, body mass index (BMI) and waist-to-hip ratio (WH ratio) is complex, and not fully understood. METHODS: In total, 6784 subjects (2408 daily smokers) were included in a population-based study (the Inter99 study) in Denmark. Weight......, height, and waist and hip circumference were measured. Self-reported tobacco consumption and lifestyle variables (dietary quality, energy intake, physical activity in leisure time and alcohol consumption) were registered. RESULTS: Daily smokers had a significantly lower BMI and significantly higher WH...... ratio than never smokers (Pconsumption (Pconsumption. The association between increasing WH ratio and increasing tobacco consumption was largely explained...

  14. Canine Hip Dysplasia: Breed Effects

    OpenAIRE

    Martin, S W; Kirby, K.; Pennock, P. W.

    1980-01-01

    This paper is a refinement of previous studies in that only suitably radiographed dogs were included in the data base. The rate of hip dysplasia varied widely by breed from five percent in siberian huskies to eighty-three percent in english bulldogs. There was a significant difference in the prevalence of dysplasia within at least two breeds; golden retrievers and old english sheepdogs. Physical size per se did not appear to be an important determinant of hip dysplasia.

  15. Potential cost saving of Epoetin alfa in elective hip or knee surgery due to reduction in blood transfusions and their side effects: a discrete-event simulation model.

    Directory of Open Access Journals (Sweden)

    Jörg Tomeczkowski

    Full Text Available OBJECTIVES: Transfusion of allogeneic blood is still common in orthopedic surgery. This analysis evaluates from the perspective of a German hospital the potential cost savings of Epoetin alfa (EPO compared to predonated autologous blood transfusions or to a nobloodconservationstrategy (allogeneic blood transfusion strategyduring elective hip and knee replacement surgery. METHODS: Individual patients (N = 50,000 were simulated based on data from controlled trials, the German DRG institute (InEK and various publications and entered into a stochastic model (Monte-Carlo of three treatment arms: EPO, preoperative autologous donation and nobloodconservationstrategy. All three strategies lead to a different risk for an allogeneic blood transfusion. The model focused on the costs and events of the three different procedures. The costs were obtained from clinical trial databases, the German DRG system, patient records and medical publications: transfusion (allogeneic red blood cells: €320/unit and autologous red blood cells: €250/unit, pneumonia treatment (€5,000, and length of stay (€300/day. Probabilistic sensitivity analyses were performed to determine which factors had an influence on the model's clinical and cost outcomes. RESULTS: At acquisition costs of €200/40,000 IU EPO is cost saving compared to autologous blood donation, and cost-effective compared to a nobloodconservationstrategy. The results were most sensitive to the cost of EPO, blood units and hospital days. CONCLUSIONS: EPO might become an attractive blood conservation strategy for anemic patients at reasonable costs due to the reduction in allogeneic blood transfusions, in the modeled incidence of transfusion-associated pneumonia andthe prolongedlength of stay.

  16. Usability Test of Exercise Games Designed for Rehabilitation of Elderly Patients After Hip Replacement Surgery: Pilot Study.

    Science.gov (United States)

    Ling, Yun; Ter Meer, Louis P; Yumak, Zerrin; Veltkamp, Remco C

    2017-10-12

    Patients who receive rehabilitation after hip replacement surgery are shown to have increased muscle strength and better functional performance. However, traditional physiotherapy is often tedious and leads to poor adherence. Exercise games, provide ways for increasing the engagement of elderly patients and increase the uptake of rehabilitation exercises. The objective of this study was to evaluate Fietsgame (Dutch for cycling game), which translates existing rehabilitation exercises into fun exercise games. The system connects exercise games with a patient's personal record and a therapist interface by an Internet of Things server. Thus, both the patient and physiotherapist can monitor the patient's medical status. This paper describes a pilot study that evaluates the usability of the Fietsgame. The study was conducted in a rehabilitation center with 9 participants, including 2 physiotherapists and 7 patients. The patients were asked to play 6 exercise games, each lasting about 5 min, under the guidance of a physiotherapist. The mean age of the patients was 74.57 years (standard deviation [SD] 8.28); all the patients were in the recovery process after hip surgery. Surveys were developed to quantitatively measure the usability factors, including presence, enjoyment, pain, exertion, and technology acceptance. Comments on advantages and suggested improvements of our game system provided by the physiotherapists and patients were summarized and their implications were discussed. The results showed that after successfully playing the games, 75% to 100% of the patients experienced high levels of enjoyment in all the games except the squats game. Patients reported the highest level of exertion in squats when compared with other exercise games. Lunges resulted in the highest dropout rate (43%) due to interference with the Kinect v2 from support chairs. All the patients (100%) found the game system useful and easy to use, felt that it would be a useful tool in their further

  17. Designing a strategy to implement cost-effective blood transfusion management in elective hip and knee arthroplasties: A study protocol

    Directory of Open Access Journals (Sweden)

    Voorn Veronique MA

    2012-06-01

    Full Text Available Abstract Background Total hip and knee arthroplasties are two of the most commonly performed procedures in orthopedic surgery. Different blood-saving measures (BSMs are used to reduce the often-needed allogenic blood transfusions in these procedures. A recent large randomized controlled trial showed it is not cost effective to use the BSMs of erythropoietin and perioperative autologous blood salvage in elective primary hip and knee arthroplasties. Despite dissemination of these study results, medical professionals keep using these BSMs. To actually change practice, an implementation strategy is needed that is based on a good understanding of target groups and settings and the psychological constructs that predict behavior of medical professionals. However, detailed insight into these issuses is lacking. Therefore, this study aims to explore which groups of professionals should be targeted at which settings, as well as relevant barriers and facilitators that should be taken into acount in the strategy to implement evidence-based, cost-effective blood transfusion management and to de-implement BSMs. Methods The study consists of three phases. First, a questionnaire survey among all Dutch orthopedic hospital departments and independent treatment centers (n = 99 will be conducted to analyze current blood management practice. Second, semistructured interviews will be held among 10 orthopedic surgeons and 10 anesthesiologists to identify barriers and facilitators that are relevant for the uptake of cost-effective blood transfusion management. Interview questions will be based on the Theoretical Domains Interview framework. The interviews will be followed by a questionnaire survey among 800 medical professionals in orthopedics and anesthesiology (400 professionals per discipline in which the identified barriers and facilitators will be ranked by frequency and importance. Finally, an implementation strategy will be developed based on the results

  18. Geriatric Patients With Fractures Below the Hip are Medically Similar to Geriatric Patients With Hip Fracture.

    Science.gov (United States)

    Della Rocca, Gregory J; Uppal, Harmeeth S; Copeland, Marilyn E; Crist, Brett D; Volgas, David A

    2015-03-01

    The objective of this study was to compare a cohort of geriatric patients with operatively managed isolated fractures below the hip to a cohort of geriatric patients with operatively managed isolated hip fractures. All patients greater than 59 years of age admitted to our institution for surgical care of an isolated lower extremity fracture during a 3-year period were included. Patients were divided into 2 cohorts: BTH (fracture below the subtrochanteric region of the femur) and HIP (proximal femoral fracture at subtrochanteric region or proximal). We identified 141 patients included in cohort BTH and 205 patients included in cohort HIP. HIP patients were older (P patients and of peripheral neuropathy (P = .014) in BTH patients. HIP patients were more likely to be under active antiosteoporotic medication management and were more likely to be receiving pharmacological anticoagulation at the time of admission. HIP patients and BTH patients were similar with regard to necessity of assistance with ambulation preinjury, but HIP patients were less likely to reside independently at home than were BTH patients (P patients were also less likely to be discharged directly home from the hospital (P Geriatric patients with fractures below the hip are medically similar to geriatric patients with hip fracture. Medical comanagement protocols have been extensively published that improve care of geriatric patients with hip fracture; consideration should be given to similar protocol-driven medical comanagement programs for geriatric patients with fractures below the hip.

  19. 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 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 replacement.

  20. 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

  1. Culturally Relevant Teaching: Hip-Hop Pedagogy in Urban Schools. Counterpoints: Studies in the Postmodern Theory of Education. Volume 396

    Science.gov (United States)

    Prier, Darius D.

    2012-01-01

    "Culturally Relevant Teaching" centers hip-hop culture as a culturally relevant form of critical pedagogy in urban pre-service teacher education programs. In this important book, Darius D. Prier explores how hip-hop artists construct a sense of democratic education and pedagogy with transformative possibilities in their schools and communities. In…

  2. A Cadaveric Study of Ultrasound-Guided Subpectineal Injectate Spread Around the Obturator Nerve and Its Hip Articular Branches

    DEFF Research Database (Denmark)

    Nielsen, Thomas D.; Moriggl, Bernhard; Soballe, Kjeld

    2017-01-01

    Background and Objectives: The femoral and obturator nerves are assumed to account for the primary nociceptive innervation of the hip joint capsule. The fascia iliaca compartment block and the so-called 3-in-1-block have been used in patients with hip fracture based on a presumption that local...

  3. Relatives in older patients' fast-track treatment programme during total hip or knee replacement. A grounded theory study

    DEFF Research Database (Denmark)

    Berthelsen, Connie Bøttcher

    The aim of this Ph.D.-dissertation was to generate grounded theories of relatives, patients, and health professionals’ pattern of behaviour, respectively, in relation to the relatives of older patients’ fast-track treatment programmes during total hip or knee replacement. The dissertation includes...... three classic grounded theory studies discovered through Glaser’s theoretical and methodological framework. The constant comparative method was the guiding principle of simultaneous data collection, data analysis, and substantive and theoretical coding, while theoretical sampling and writing memos. Data...... was collected between 2010 and 2011 in the orthopaedic wards of two Copenhagen university hospitals, and guided by theoretical sampling. Study I: Seven relatives of patients over 70 years of age participated. Data consisted of 14 non-participant observations, 14 post-observational interviews, and five formal...

  4. 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 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...

  5. Inflammatory Cytokine Levels and Depressive Symptoms in Older Women in the Year after Hip Fracture: Findings from the Baltimore Hip Studies

    Science.gov (United States)

    Matheny, Maya E.; Miller, Ram R.; Shardell, Michelle D.; Hawkes, William G.; Lenze, Eric J.; Magaziner, Jay; Orwig, Denise L.

    2011-01-01

    OBJECTIVES Determine whether interleukin 6 (IL-6) or soluble tumor necrosis factor α receptor 1 (sTNF-αR1) are associated with depressive symptoms in the year after hip fracture DESIGN Prospective cohort SETTING Three Baltimore-area hospitals PARTICIPANTS Community-dwelling women aged ≥65 years, admitted with a new, non-pathological fracture of the proximal femur (n=133). MEASUREMENTS At 2, 6 and 12 months postfracture, serum was analyzed for IL-6 and sTNF-αR1, and depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS). Generalized estimating equations were used to model the longitudinal relationship between IL-6 and sTNF-αR1 and GDS score. We also examined whether lower extremity function, as measured by Lower Extremity Gain Scale (LEGS), explained the relationship between IL-6, sTNF-αR1 and GDS score. RESULTS Patients in the highest categories of IL-6 (≥5.14 pg/ml) and sTNF-αR1 (≥2421 pg/ml) had the highest GDS scores in the year postfracture (p=0.09 for both). At 12 months postfracture, those in the highest IL-6 and sTNF-αR1 categories had GDS scores that were on average 1.9 (95% confidence interval [CI]: 0.4, 3.4; p=0.01) and 1.4 (95% CI: −0.1, 3.0; p=0.07) points higher than those in the lowest category, respectively. Adjusting for LEGS score, the mean difference in GDS scores for highest versus lowest IL-6 categories was 1.6 (95% CI: 0.2, 3.0; p=0.02) points at 12 months. CONCLUSION Results from these exploratory analyses support a role for inflammation in the pathophysiology of depressive symptoms after hip fracture. Depressive symptoms in the context of elevated cytokines may represent a sickness syndrome that is chronic in some individuals. Further research should establish the cause and effect of this relationship as well as long-term correlates. PMID:22188073

  6. Adductor longus activation during common hip exercises.

    Science.gov (United States)

    Delmore, Robert J; Laudner, Kevin G; Torry, Michael R

    2014-05-01

    Hip-adductor strains are among the most common lower-extremity injuries sustained in athletics. Treatment of these injuries involves a variety of exercises used to target the hip adductors. To identify the varying activation levels of the adductor longus during common hip-adductor exercises. Descriptive study. Laboratory. 24 physically active, college-age students. None. Peak and average electromyographic (EMG) activity of the adductor longus muscle during the following 6 hip-adductor rehabilitation exercises: side-lying hip adduction, ball squeezes, rotational squats, sumo squats, standing hip adduction on a Swiss ball, and side lunges. The side-lying hip-adduction exercise produced more peak and average activation than any other exercise (P Ball squeezes produced more peak and average activation than rotational squats, sumo squats, and standing adduction on a Swiss ball (P Ball squeezes had more average activation than side lunges (P = .001). All other variables for peak activation during the exercises were not statistically significant (P > .08). These results allowed the authors to provide an overall ranking system (highest to lowest muscle activation): side-lying hip adduction, ball squeezes, side lunges, standing adduction on a Swiss ball, rotational squats, and sumo squats. The study provides a ranking system on the activation levels of the adductor longus muscle for 6 common hip-adductor rehabilitation exercises, with the side-lying hip-adduction and ball-squeeze exercises displaying the highest overall activation.

  7. Effectiveness of multidisciplinary nutritional care on nutritional intake, nutritional status and quality of life in patients with hip fractures: a controlled prospective cohort study

    NARCIS (Netherlands)

    Hoekstra, Jellie C.; Goosen, Jon H. M.; de Wolf, G. Sander; Verheyen, Cees C. P. M.

    2011-01-01

    The purpose of this study was to determine the effectiveness of a multidisciplinary intervention program on nutritional intake and of nutritional intake on nutritional status and quality of life in older patients treated for a hip fracture. A controlled prospective cohort study included 66 patients

  8. Crop micrometeorology : a simulation study

    NARCIS (Netherlands)

    Goudriaan, J.

    1977-01-01

    This monograph presents the results of a detailed study in micrometeorology; one of the sciences that play an important role in production ecology. The purpose is to explain the microweather as a function of the properties of plant and soil, and of the weather conditions prevalent at some

  9. Editorial Commentary: Anatomical Vandalism of the Hip? Hip Capsular Repair Seems a Sound Adjunct to Hip Arthroscopic Surgery.

    Science.gov (United States)

    van Arkel, Richard J; Jeffers, Jonathan R T; Amis, Andrew A

    2017-02-01

    The study "Contribution of the Pubofemoral Ligament to Hip Stability: A Biomechanical Study" by Martin, Khoury, Schröder, Johnson, Gómez-Hoyos, Campos, and Palmer found that cutting the hip capsular ligament allowed a large increase in femoral internal rotation, particularly in the flexed hip, causing subluxation to occur. In addition to providing new data on the role of the pubofemoral ligament, it raises the question of whether hip joint surgeons should repair the capsule-what are the likely consequences?-and whether any beneficial effects persist in long-term clinical follow-ups. For now, hip capsular repair seems a sound adjunct to hip arthroscopic surgery. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  10. 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

  11. Palpation and dorsal acetabular rim radiographic projection for early detection of canine hip dysplasia: a prospective study.

    Science.gov (United States)

    Gatineau, Matthieu; Dupuis, Jacques; Beauregard, Guy; Charette, Benoît; Breton, Luc; Beauchamp, Guy; d'Anjou, Marc-André

    2012-01-01

    To determine the value of 2 diagnostic methods: (1) the reduction angle (RA) using the Ortolani maneuver and (2) the dorsal acetabular slope (DAS) from the dorsal acetabular rim (DAR) radiographic projection, to predict osteoarthritis (OA) in dogs with hip dysplasia. Prospective study. Dogs (n = 73). Hip-extended ventrodorsal (VD) radiographic projections, RA, and DAS were evaluated when dogs were 6, 12, and 24 months of age. VD projections were qualitatively scored for OA. RA was determined using the Ortolani maneuver in dorsal recumbency and DAS using the DAR projection. Distraction index (DI) measurements from the compression-distraction radiographic projections (PennHIP method) were also performed at 6 months of age. Statistical analyses were used to establish the range of values of normal and abnormal RA and DAS, to document the temporal variation in RA and DAS, to compare the ability of the different methods to predict coxofemoral OA, to determine the influence of pure passive laxity and of the DAS on the occurrence of an Ortolani sign and on the magnitude of the RA, to establish the relationship between the DAS and subsequent development of passive laxity and coxofemoral OA, and to evaluate the influence of the DAS and RA on the occurrence of coxofemoral OA with severe, moderate, and minimal coxofemoral passive joint laxity, respectively. VD, RA, DAS, and DI methods of coxofemoral joint evaluation correlated significantly with the status of the coxofemoral joints at 2 years of age. The risk of occurrence of coxofemoral OA increased, as the RA, DAS, or DI increased. There was a significant positive linear relationship between RA and DI (P = .015, r(2) = 0.32), RA and DAS (P = .0078, r(2) = 0.38), and DAS and DI (P = .015, r(2) = 0.33). A negative Ortolani sign was at all times significantly predictive of absence of coxofemoral OA at 2 years of age. DAS best predicted coxofemoral OA for DI ≥ 0.7, whereas RA best predicted coxofemoral OA for 0.3 < DI < 0

  12. Odds ratios for hip- and lower forearm fracture using peripheral bone densitometry; a case-control study of postmenopausal women

    DEFF Research Database (Denmark)

    Saleh, M M A; Jørgensen, H L; Lauritzen, J B

    2002-01-01

    concern when using peripheral densitometry is the poor correlation with the central measurements. The main aim of this study is, therefore, to assess the possibility of expressing ultrasound measurements at the heel and bone mineral density (BMD) measured at the distal forearm as fracture odds ratios...... rather than an absolute measure of bone mass. METHODS: A total of 76 women with lower forearm fracture, 47 women with hip fracture and 231 age-matched women (controls) were included. All had broadband ultrasound attenuation (BUA) and speed of sound (SOS) measured at the heel using the DTU-one ultrasound...... scanner as well as BMD measured by dual X-ray absorptiometry on the DTX-200 at the distal forearm. RESULTS: BUA, SOS and BMD at the distal forearm were all significantly lower in fracture patients compared with their respective control groups. The odds ratio for lower forearm fracture was 3.1 (95% CI: 1...

  13. 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.)

  14. [Virtual simulation for optimizing the range of motion in hip alloarthroplasty using an adapted thrust-plate prosthesis model].

    Science.gov (United States)

    Jerosch, J; Wetzel, R; Aldinger, G; Weipert, A; Hanusek, S; Filler, T J; Peuker, E T

    2000-07-01

    The purpose of the present study was to increase the free range of motion in conventional trust-plate prosthesis design and to optimize the trust-plate contact as well as the osteointegration area below the trust-plate. For the first part of the study, the two-dimensional geometry of the osteotomy plane was demonstrated in 25 CT-reconstructed femora after performing a virtual cut at a CCD angle of 135 degrees. In the second part, we constructed a prototype of an anatomic adapted trust-plate prosthesis (A-TPP) with an optimized trust-plate and corpus geometry based on the three-dimensional data of three human cadaveric femurs (age 67-75 years). In the final step, we documented the range of motion with computer-aided movement-mapping and compared the conventional TPP with the A-TPP. The results showed a wide variance in osteotomy geometry in the 12 femurs. With the A-TPP, we were able to obtain a much better fit in the trust plate surface. The movement-mapping showed a much higher range of motion in the A-TPP implant. With the A-TPP, the implant surface area for osteointegration could also be significantly increased.

  15. Rethinking Pedagogy in Urban Spaces: Implementing Hip-Hop Pedagogy in the Urban Science Classroom

    Science.gov (United States)

    Adjapong, Edmund S.; Emdin, Christopher

    2015-01-01

    A significant amount of research regarding Hip-Hop Based Education (HHBE) fails to provide insight on how to incorporate elements of Hip-Hop into daily teaching practices; rather Hip-Hop based educators focus mainly on incorporating Hip-Hop culture into curricula. This study explores the benefits of using two specific Hip-Hop pedagogical practices…

  16. A pilot study examining the impact of exercise training on skeletal muscle genes related to the TLR signaling pathway in older adults following hip fracture recovery.

    Science.gov (United States)

    McKenzie, Alec I; Briggs, Robert A; Barrows, Katherine M; Nelson, Daniel S; Kwon, Oh Sung; Hopkins, Paul N; Higgins, Thomas F; Marcus, Robin L; Drummond, Micah J

    2017-01-01

    Older adults after hip fracture surgery experience progressive muscle atrophy and weakness, limiting full recovery. Further understanding of the molecular mechanisms in muscle with adaptation to exercise training in this vulnerable population is necessary. Therefore, we conducted a pilot study to investigate the skeletal muscle inflammatory and ceramide biosynthesis gene expression levels associated with the toll-like receptor (TLR) pathway before (Pre) and following a 3-mo multicomponent exercise training program in older adults (3M, 4F; 78.4 ± 13.3 yr; 25.5 ± 2.3 kg/m2) ~4 mo after repair from hip fracture (HipFx). Vastus lateralis biopsies from the surgical limb were obtained before (Pre) and after training. Molecular end points and muscle function data were also compared with matched nonexercise healthy controls (CON). As a follow-up analysis, we evaluated specific sphingolipid pools in HipFx and CON muscle. Following training, quadriceps cross-sectional area, strength, and 6-min walk (6MW) increased in the surgical limb (P exercise training alters skeletal muscle inflammation and ceramide metabolism associated with TLR signaling in older adults recovering from hip fracture surgery and may be related to improvements in muscle function recovery. These pilot data demonstrate that 3 mo of exercise training in older adults recovering from hip fracture surgery was able to mitigate skeletal muscle gene expression related to inflammation and ceramide metabolism while also improving surgical limb lean tissue, strength, and physical function. Copyright © 2017 the American Physiological Society.

  17. [Locomotor development in infants with developmental dysplasia of the hip or idiopathic clubfoot undergoing orthopedic treatment. Prospective comparative study].

    Science.gov (United States)

    Masquijo, J J; Campos, L; Torres-Gómez, A; Allende, V

    2013-10-01

    Several disorders of early childhood, such as developmental dysplasia of the hip (DDH) and clubfoot, requires orthopedic treatment that limits active mobility of the lower extremities for a period of time. The aim of our study was to evaluate the impact on locomotor development of the orthopedic treatment in infants less than one year-old. The study included a prospective cohort of consecutive patients diagnosed with developmental dysplasia of the hip (Group A, 24 patients), and clubfoot (Group B, 32 patients) treated from January 2007 to June 2009. A third group (Group C) of 50 healthy children was used as control. The variables evaluated were: months with a brace, age to sit without support, age at the start of crawling, and age at the beginning of walking. The results obtained were analyzed. Comparisons between the three groups were performed using the Kruskal-Wallis test and Mann-Whitney test. We chose a value of P<.05 as level of statistical significance. The analysis of independent samples showed that the mean age at which the patients began to sit were similar: 6.12, 6.42 and 6.19 months, respectively (P=.249). The mean age for crawling was similar, although with a slight trend toward statistical significance: 8.84, 9.38 and 9.17 months, respectively (P=.08). The age at which they started walking was different between the three groups: 12.14, 13.21 and 12.41 months, respectively (P<.001). Orthopedic treatment of DDH and clubfoot in children less than one year-old slightly slows down the course of normal locomotor development. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  18. Differences in the Association of Hip Cartilage Lesions and Cam-type Femoroacetabular Impingement with Movement Patterns: A Preliminary Study

    Science.gov (United States)

    Deepak, Kumar; Alexander, Dillon; Nardo, Lorenzo; Link, Thomas M; Majumdar, Sharmila; Souza, Richard B

    2014-01-01

    Objective Preliminary study to investigate the differences in hip movement patterns during different daily and athletic activities in individuals with cam-type femoroacetabular impingement (FAI) with and without cartilage lesions compared with controls. Design Controlled laboratory study using a Cross-sectional design. Setting Research Institution with Tertiary Care Medical Center. Participants Fifteen subjects [M:F – 13:2, Age- 31.6±9.7 years (22-52), BMI- 24.9±4.6 (18.8-38.4), FAI: Control = 7:8]. Methods All subjects had 3-Tesla MR imaging of the hip and also underwent 3-D motion capture during walking, deep-squat and drop landing tasks. Experienced radiologists graded cartilage lesions on clinical MR images. Outcomes Peak kinematic and kinetic variables were compared between those with and without FAI, and those with FAI and cartilage lesions compared to subjects without cartilage lesions. Results Subjects with FAI demonstrated no significant differences for walking or drop-landing compared to controls. However, during deep-squat, subjects with FAI adducted more and had greater internal rotation moment. Subjects with cartilage lesions in the presence of a cam-lesion demonstrated - no difference for walking; greater adduction, greater internal rotation moment and lower transverse plane range of motion during deep-squat; and greater adduction and lower internal rotation during drop-landing, compared to those without cartilage lesions. Conclusions We observed differences in movement patterns between subjects with FAI compared to controls. However, the differences were more pronounced between subjects with FAI who had cartilage lesions compared to subjects who did not have cartilage lesions. These findings highlight the importance of understanding the complex interplay between bony morphology, cartilage lesions, and movement patterns in individuals with cam-type FAI. PMID:24534097

  19. Effectiveness of sensor monitoring in an occupational therapy rehabilitation program for older individuals after hip fracture, the SO-HIP trial: study protocol of a three-arm stepped wedge cluster randomized trial.

    Science.gov (United States)

    Pol, Margriet C; Ter Riet, Gerben; van Hartingsveldt, Margo; Kröse, Ben; de Rooij, Sophia E; Buurman, Bianca M

    2017-01-03

    The performance of activities of daily living (ADL) at home is important for the recovery of older individuals after hip fracture. However, 20-90% of these individuals lose ADL function and never fully recover. It is currently unknown to what extent occupational therapy (OT) with coaching based on cognitive behavioral treatment (CBT) improves recovery. The same holds for sensor monitoring-based coaching in addition to OT. Here, we describe the design of a study investigating the effect of sensor monitoring embedded in an OT rehabilitation program on the recovery of ADL among older individuals after hip fracture. Six nursing homes will be randomized in a three-arm stepped wedge cluster randomized trial. All nursing homes will initially provide standard care. At designated time points, nursing homes, successively and in random order, will cross over to the provision of OT and at the next time point, to sensor monitoring-enhanced OT. A total of 288 older individuals, previously living alone in the community, who after a hip fracture were admitted to a geriatric rehabilitation ward for a short-term rehabilitation, will be enrolled. Individuals in the first intervention group (OTc) will participate in an OT rehabilitation program with coaching based on cognitive behavioral therapy (CBT) principles. In the sensor monitoring group, sensor monitoring is added to the OT intervention (OTcsm). Participants will receive a sensor monitoring system consisting of (i) an activity monitor during nursing home stay, (ii) a sensor monitoring system at home and a (iii) a web-based feedback application. These components will be embedded in the OT. The OT consists of a weekly session with an occupational therapist during the nursing home stay followed by four home visits and four telephone consultations. The primary outcome is patient-perceived daily functioning at 6 months, assessed using the Canadian Occupational Performance Measure (COPM). As far as we know, this study is the first

  20. Hip muscle strength and muscle cross sectional area in men with and without hip osteoarthritis.

    Science.gov (United States)

    Arokoski, Merja H; Arokoski, Jari P A; Haara, Mikko; Kankaanpää, Markku; Vesterinen, Minna; Niemitukia, Lea H; Helminen, Heikki J

    2002-10-01

    To study the hip muscle strength and cross sectional area (CSA) in men with hip osteoarthritis (OA) compared to age and sex matched healthy controls. Based on the American College of Rheumatology criteria regarding classification of hip OA, 27 men (aged 47-64 yrs) with unilateral or bilateral hip OA and 30 age matched randomly selected healthy male controls were studied. The maximal isometric hip abductor, adductor, flexor, and extensor strength (Nm) at 0 degree of hip flexion in the supine position was determined with a dynamometer. The isokinetic hip flexion and extension strength (peak torque, Nm) was determined using angular velocities of 60 degrees /s and 120 degrees /s. The subjective severity of hip pain was rated by visual analog scale prior to the muscle strength test. CSA of the pelvic and thigh muscles was measured from magnetic resonance images. The reliability of intraclass correlation coefficients for repeated measures of muscle strength varied from 0.70 to 0.94 in controls and from 0.84 to 0.98 in subjects with OA. Hip isometric adductor and abductor strength was 25% and 31% lower (p muscles did not differ between the groups. However, in OA subjects, the CSA of the pelvic and thigh muscles was 6-13% less (p muscle strength than controls. The decrease of muscle size and hip pain may contribute to the decrease of muscle strength in hip OA. Other possible underlying causes of the muscle weakness need to be studied.

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

    Science.gov (United States)

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

    2017-04-01

    Developmental dysplasia of the hip (DDH) is a common condition predisposing to osteoarthritis (OA). Especially since DDH is best identified and treated in infancy before bones ossify, there is surprisingly a near-complete absence of literature examining mechanical behavior of infant dysplastic hips. We sought to identify current practice in finite element modeling (FEM) of DDH, to inform future modeling of infant dysplastic hips. We performed multi-database systematic review using PRISMA criteria. Abstracts (n = 126) fulfilling inclusion criteria were screened for methodological quality, and results were analyzed and summarized for eligible articles (n = 12). The majority of the studies modeled human adult dysplastic hips. Two studies focused on etiology of DDH through simulating mechanobiological growth of prenatal hips; we found no FEM-based studies in infants or children. Finite element models used either patient-specific geometry or idealized average geometry. Diversities in choice of material properties, boundary conditions, and loading scenarios were found in the finite-element models. FEM of adult dysplastic hips demonstrated generally smaller cartilage contact area in dysplastic hips than in normal joints. Contact pressure (CP) may be higher or lower in dysplastic hips depending on joint geometry and mechanical contribution of labrum (Lb). FEM of mechanobiological growth of prenatal hip joints revealed evidence for effects of the joint mechanical environment on formation of coxa valga, asymmetrically shallow acetabulum and malformed femoral head associated with DDH. Future modeling informed by the results of this review may yield valuable insights into optimal treatment of DDH, and into how and why OA develops early in DDH. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  2. Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers.

    Science.gov (United States)

    Johansson, H; Hongslo Vala, C; Odén, A; Lorentzon, M; McCloskey, E; Kanis, J A; Harvey, N C; Ohlsson, C; Stefan Lohmander, L; Kärrholm, J; Mellström, D

    2018-01-12

    We aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty. The risks of hip fracture and hip arthroplasty are influenced by factors including socioeconomic status, education, urbanization, latitude of residence, and physical activity. Farming is an occupation encompassing rural living and high level of physical activity. Therefore, we aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. We studied the risk of hip fracture, and hip arthroplasty due to primary osteoarthritis, in all men and women aged 35 years or more in Sweden between 1987 and 2002. Documented occupations were available in 3.5 million individuals, of whom 97,136 were farmers. The effects of age, sex, income, education, location of residence, and occupation on risk of hip fracture or hip arthroplasty were examined using a modification of Poisson regression. A total of 4027 farmers and 93,109 individuals with other occupations sustained a hip fracture, while 5349 farmers and 63,473 others underwent a hip arthroplasty. Risk of hip fracture was higher with greater age, lower income, lower education, higher latitude, and urban area for all men and women. Compared to all other occupations, male farmers had a 20% lower age-adjusted risk of hip fracture (hazard ratio (HR) 0.80, 95%CI 0.77-0.84), an effect that was not seen in female farmers (HR 0.96, 95% CI 0.91-1.01). Both male and female farmers had a higher age-adjusted risk for hip arthroplasty. Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.

  3. Fixation of total hip components in rheumatoid arthritis and arthrosis. A radiographic, roentgen stereophotogrammetric, densitometric and histomorphometric study

    Energy Technology Data Exchange (ETDEWEB)

    Oensten, I.

    1994-10-14

    The radiographic survival of the Charnley prosthesis was studied in two retrospective, matched-pair cohorts of rheumatoid arthritis (RA) and arthrosis (OA) patients. In RA, the 7-year radiographic socket survival improved from 87% to 96% after the introduction of flanged sockets, bone transplants in cases of acetabular protrusion and the rejection of the pilot hole technique. In OA the 10-year radiographic socket survival was 95%. In both groups the 7-year radiographic stem survival improved from 80% to 96% following the introduction of the new cementing technique. Migration of the Charnley prosthesis in the first two years was evaluated by roentgen stereophotogrammetric analysis (RSA) in RA and OA patients, and related to the histomorphometric characteristics of trabecular bone in the acetabulum and the femur. In RA, sockets migrated six times more in the proximal direction as compared with OA; there was no difference in migration in other directions. Stem fixation was equally secure in RA and OA. RA cases had more osteoid in both the femur and the acetabulum, but the amount of osteoid was not correlated with the degree of migration. The bone mineral content (BMC) of RA and OA hips was assessed by dual photone roentgen absorptiometry prior to hip replacement. Patients with RA had 20% less BMC than those with OA but there were no signs of a relative peri-acetabular deficit. In two randomized trials of 81 OA patients, migration of the uncemented, Harris-Galante type I socket was evaluated by RSA and compared with Charnley sockets. After a minimum follow-up of 2 years, no difference in migration between the two socket designs was found. 98 refs, 18 figs, 2 tabs.

  4. Use of inhaled and oral glucocorticoids, severity of inflammatory disease and risk of hip/femur fracture : a population-based case-control study

    NARCIS (Netherlands)

    de Vries, F.|info:eu-repo/dai/nl/303546670; Pouwels, S.|info:eu-repo/dai/nl/34158990X; Lammers, J.W.J.; Leufkens, H.G.M.|info:eu-repo/dai/nl/075255049; Bracke, M.|info:eu-repo/dai/nl/185443354; Cooper, C.; van Staa, T.P.|info:eu-repo/dai/nl/304827762

    BACKGROUND: Patients using higher dosages of inhaled or oral glucocorticoids (GCs) have an increased risk of hip/femur fractures. The role of the underlying disease in the aetiology of this increased risk has not been widely studied. OBJECTIVE: To evaluate the contribution of the underlying disease

  5. The distribution and inter-relationships of radiologic features of osteoarthrosis of the hip. A survey of 4151 subjects of the Copenhagen City Heart Study: the Osteoarthrosis Substudy

    DEFF Research Database (Denmark)

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

    2004-01-01

    of reduced joint space width (JSW), and secondary radiographic OA features. METHOD: The study was a cross-sectional survey. Radiologic features of hip OA were recorded from standardized, standing pelvic radiographs of 3686 subjects (1397M/2289F). OA features were investigated for inter...

  6. Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: a cost analysis of a multicenter prospective study

    NARCIS (Netherlands)

    P.T.P.W. Burgers (Paul); M. Hoogendoorn (Martine); E.A.C. Van Woensel; R.W. Poolman (Rudolf); M. Bhandari (Mohit); P. Patka (Peter); E.M.M. van Lieshout (Esther)

    2016-01-01

    textabstractSummary: The aim of this study was to determine the total medical costs for treating displaced femoral neck fractures with hemi- or total hip arthroplasty in fit elderly patients. The mean total costs per patient at 2 years of follow-up were €26,399. These results contribute to cost

  7. Pelvic and hip kinematics during single-leg drop-landing are altered in sports participants with long-standing groin pain: A cross-sectional study.

    Science.gov (United States)

    Janse van Rensburg, L; Dare, M; Louw, Q; Crous, L; Cockroft, J; Williams, L; Olivier, B

    2017-07-01

    The aim of this study was to determine the differences in three-dimensional pelvic and hip kinematics during a single-leg drop-landing task in active sports participants with long-standing groin pain compared to healthy matched controls. This was a descriptive study incorporating a cross-sectional design. The study was conducted at the Unit for Human Movement Analysis, Stellenbosch University, South Africa. The study sample was comprised of 20 male club level soccer, rugby, running and cycling participants between the ages of 18 and 55 years. Ten cases with long-standing groin pain and ten asymptomatic matched controls participated. Three-dimensional pelvic and hip kinematics were captured with an optical motion capture system during a single-leg drop-landing task. Participants with groin pain landed with more downward lateral pelvic tilt (0.77°, p = 0.01, r = 0.35), hip abduction (2.05°, p Sports participants with long-standing groin pain have altered pelvic and hip kinematics during single-leg drop-landing compared to healthy controls. The kinematic differences may contribute towards the persistent nature of groin pain, although these strategies may also be present as a result of the presence or the expectation of pain. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Hip muscle strength is decreased in middle-aged recreational male athletes with midportion Achilles tendinopathy: A cross-sectional study

    NARCIS (Netherlands)

    Habets, B.; Smits, H.W.; Backx, F.J.; Cingel, R.E. van; Huisstede, B.M.A.

    2017-01-01

    OBJECTIVE: Investigating differences in hip muscle strength between athletes with Achilles tendinopathy (AT) and asymptomatic controls. DESIGN: Cross-sectional case-control study. SETTING: Sports medical center. PARTICIPANTS: Twelve recreational male athletes with mid-portion AT and twelve matched

  9. Clinical and radiographical results of 179 thrust plate hip prostheses: 5-14 years follow-up study.

    Science.gov (United States)

    Yasunaga, Yuji; Yamasaki, Takuma; Matsuo, Toshihiko; Yoshida, Tomokazu; Oshima, Seigo; Hori, Junji; Yamasaki, Keiichiro; Ochi, Mitsuo

    2012-04-01

    The thrust plate hip prosthesis (TPP) is a bone-reserving prosthesis for cementless fixation at the metaphysis of the proximal femur. We retrospectively evaluated the results of 162 patients (179 hips) who underwent hip arthroplasty using TPP. Eighty-three patients (87 hips) suffered from osteoarthritis of the hip joint (OA group), 79 patients (92 hips) from osteonecrosis of the femoral head (ON group). The mean age at surgery was 55 years in the OA group and 47.4 years in the ON group. The mean follow-up period was 97 months in the OA group and 104 months in the ON group. For these patients, we evaluated the results clinically and radiographically. The mean Merle d'Aubigne's score improved from 8.2 to 16.9 in the OA group and from 9.1 to 16.6 in the ON group at the final follow-up. Early mechanical loosening of TPP was observed in two hips of OA and one hip of ON. In one patient of ON, bilateral TPPs had to be removed 5 years postoperatively because of infection. Two female patients with ON suffered from a spontaneous femoral fracture below the tip of the lateral plate. Kaplan-Meier survivorship using TPP removed for any reason as the end point was 97.7% in the OA group and 90.3% in the ON group after 13 years. The middle-term results of the TPP were satisfactory if the indication for the TPP and the operative procedure were appropriate. The TPP is a useful and safe prosthesis for relatively young patients with not only osteoarthritis of the hip but also osteonecrosis of the femoral head.

  10. Nationwide data on municipal drinking water and hip fracture: could calcium and magnesium be protective? A NOREPOS study.

    Science.gov (United States)

    Dahl, Cecilie; Søgaard, Anne Johanne; Tell, Grethe S; Flaten, Trond Peder; Hongve, Dag; Omsland, Tone Kristin; Holvik, Kristin; Meyer, Haakon E; Aamodt, Geir

    2013-11-01

    Norway has a high incidence of hip fractures, and the incidence varies by degree of urbanization. This variation may reflect a difference in underlying environmental factors, perhaps variations in the concentration of calcium and magnesium in municipal drinking water. A trace metal survey (1986-1991) in 556 waterworks (supplying 64% of the Norwegian population) was linked geographically to hip fractures from hospitals throughout the country (1994-2000). In all, 5472 men and 13,604 women aged 50-85years suffered a hip fracture. Poisson regression models were fitted, adjusting for age, urbanization degree, region of residence, type of water source, and pH. The concentrations of calcium and magnesium in drinking water were generally low. An inverse association was found between concentration of magnesium and risk of hip fracture in both genders (IRR men highest vs. lowest tertile=0.80, 95% CI: 0.74, 0.87; IRR women highest vs. lowest tertile=0.90, 95% CI: 0.85, 0.95), but no consistent association between calcium and hip fracture risk was observed. The highest tertile of urbanization degree (city), compared to the lowest (rural), was related to a 23 and 24% increase in hip fracture risk in men and women, respectively. The association between magnesium and hip fracture did not explain the variation in hip fracture risk between city and rural areas. Magnesium in drinking water may have a protective role against hip fractures; however this association should be further investigated. © 2013 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Moreside, Janice M; McGill, Stuart M

    2012-05-01

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

  12. Acetabular Global Insufficiency in Patients with Down Syndrome and Hip-Related Symptoms: A Matched-Cohort Study.

    Science.gov (United States)

    Bulat, Evgeny; Maranho, Daniel A; Kalish, Leslie A; Millis, Michael B; Kim, Young-Jo; Novais, Eduardo N

    2017-10-18

    The etiology of hip instability in Down syndrome is not completely understood. We investigated the morphology of the acetabulum and femur in patients with Down syndrome and compared measurements of the hips with those of matched controls. Computed tomography (CT) images of the pelvis of 42 patients with Down syndrome and hip symptoms were compared with those of 42 age and sex-matched subjects without Down syndrome or history of hip disease who had undergone CT for abdominal pain. Each of the cohorts had 23 male and 19 female subjects. The mean age (and standard deviation) in each cohort was 11.3 ± 5.3 years. The lateral center-edge angle (LCEA), acetabular inclination angle (IA), acetabular depth-width ratio (ADR), acetabular version, and anterior and posterior acetabular sector angles (AASA and PASA) were compared. The neck-shaft angle and femoral version were measured in the patients with Down syndrome only. The hips of the patients with Down syndrome were further categorized as stable (n = 21) or unstable (n = 63) for secondary analysis. The hips in the Down syndrome group had a smaller LCEA (mean, 10.8° ± 12.6° compared with 25.6° ± 4.6°; p Down syndrome cohort, the unstable hips showed greater femoral anteversion (mean, 32.7° ± 14.6° compared with 23.6° ± 10.6°; p = 0.002) and worse global acetabular insufficiency compared with the stable hips. No differences between the unstable and stable hips were found with respect to acetabular version (mean AVC, 7.8° ± 5.5° compared with 7.6° ± 3.8°; p = 0.93) and the neck-shaft angle (mean, 133.7° ± 6.7° compared with 133.2° ± 6.4°; p = 0.81). Patients with Down syndrome and hip-related symptoms had more retroverted and shallower acetabula with globally reduced coverage of the femoral head compared with age and sex-matched subjects. Hip instability among those with Down syndrome was associated with worse global acetabular insufficiency and increased femoral anteversion, but not with more severe

  13. Physiopathology and biomechanics of hip osteoarthritis

    Directory of Open Access Journals (Sweden)

    M. Cutolo

    2011-09-01

    Full Text Available Several factors seem to play a relevant role in the pathogenesis of hip osteoarthritis. Among these, an altered biomechanic and neuromuscular integrity of the hip joint should be considered. This is a review of the recent international literature concerning the role of loads and strengths acting on the hip joint, in order to better understand the pathogenesis and the physiopathology of the hip osteoarthritis. The study of these factors might be important to prevent the development of the osteoarthritis and might suggest the conservative treatment. In particular, the role of the balance among the muscles working in maintaining the equilibrium of the acting strengths is matter of discussion. The articular and neuromuscular dysfunction might induce an altered load distribution in the hip, particularly on the articular cartilage surface, and seems to favour the development of hip osteoarthritis...

  14. Hip Injuries and Disorders

    Science.gov (United States)

    ... or falling can all sometimes lead to hip injuries. These include Strains Bursitis Dislocations Fractures Certain diseases also lead to hip injuries or problems. Osteoarthritis can cause pain and limited ...

  15. 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 ...

  16. Total Hip Replacement

    Science.gov (United States)

    ... can occur after surgery. Avoiding Problems After Surgery Hip implant dislocation. Recognizing the Signs of a Blood Clot Follow ... Other Precautions To assure proper recovery and prevent dislocation of the ... your hip replacement. Prior to discharge from the hospital, your ...

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

    DEFF Research Database (Denmark)

    Lauritzen, J B

    1997-01-01

    with aging, but the time-trend in increasing age-specific incidence may not be a universal phenomenon. Postmenopausal women suffering earlier non-hip fractures have an increased risk of later hip fracture. The relative risk being highest within the first years following the fracture. Nursing home residents...... have a high risk of hip fracture (annual rate of 5-6%), and the incidence of falls is about 1,500 falls/1,000 persons/year. Most hip fractures are a result of a direct trauma against the hip. The incidence of falls on the hip among nursing home residents is about 290 falls/1,000 persons/year and about...... the hip may influence the risk of hip fracture, and being an important determinant for the development of hip fracture, maybe more important than bone strength. External hip protectors were developed and tested in an open randomised nursing home study. The rate of hip fractures was reduced by 50...

  18. Avoidance of activity and limitations in activities in patients with osteoarthritis of the hip or knee: a 5 year follow-up study on the mediating role of reduced muscle strength.

    NARCIS (Netherlands)

    Pisters, M.F.; Veenhof, C.; Dijk, G.M. van; Dekker, J.

    2014-01-01

    Objective: To evaluate the mediating role of reduced muscle strength in the relationship between avoidance of activity and limitations in activities in patients with knee or hip osteoarthritis (OA). Methods: A longitudinal cohort study with 5 years follow-up was conducted. Patients with knee or hip

  19. Unchanging Incidence of Hip Fracture in Southeastern Norway

    National Research Council Canada - National Science Library

    Polesie, Sam; Sigurdsen, Ulf; Bjørgul, Kristian

    2013-01-01

    Purpose: The aim of this study was to ascertain trends in the incidence of hip fracture in southeastern Norway by comparing the hip fracture incidence for the years 2008 to 2010 to that of a study from 1998...

  20. Walking Recovery after a Hip Fracture: A Prospective Follow-Up Study among Community-Dwelling over 60-Year Old Men and Women

    Directory of Open Access Journals (Sweden)

    Anu Salpakoski

    2014-01-01

    Full Text Available Purpose. Recovery of walking outdoors after hip fracture is important for equal participation in the community. The causes of poor recovery are not fully understood. This study investigates recovery of walking outdoors and associated determinants after hip fracture. Methods. A prospective follow-up study, among clinical sample of 81 community-dwelling hip fracture patients over 60 years. Perceived difficulty in walking outdoors and 500 meters was assessed before fracture, at discharge to home (3.2 ± 2.2 weeks after surgery, and on average 6.0 ± 3.3 weeks after discharge. Potential determinants for walking recovery were assessed. Linear latent trajectory model was used to analyse changes during follow-up. Association between walking trajectories and potential determinants was analysed with a logistic regression model. Results. Two trajectories, No-to-minor-difficulty and Catastrophic, were found. Thirty-eight percent of the participants ended up in the Catastrophic trajectory for walking outdoors and 67% for 500 meters. Multivariate logistic regression analysis revealed that use of walking aid and indoor falls before fracture and prolonged pain were independently associated with catastrophic decline in both primary outcomes: difficulty in walking outdoors and 500 meters. Conclusions. A large proportion of community-dwelling older people recovering from hip fracture experienced catastrophic decline in outdoor walking. Acknowledging recovery prognoses at early stage enables individualized rehabilitation.

  1. Usability Test of Exercise Games Designed for Rehabilitation of Elderly Patients After Hip Replacement Surgery: Pilot Study

    NARCIS (Netherlands)

    Y. Ling (Yun); L.P.D.M. ter Meer (Louis); Z. Yumak (Zerrin); R.C. Veltkamp (Remco)

    2017-01-01

    markdownabstractBACKGROUND: Patients who receive rehabilitation after hip replacement surgery are shown to have increased muscle strength and better functional performance. However, traditional physiotherapy is often tedious and leads to poor adherence. Exercise games, provide ways for increasing

  2. Association of Hip Bone Mineral Density and Body Composition in a Rural Indian Population: The Andhra Pradesh Children and Parents Study (APCAPS).

    Science.gov (United States)

    Matsuzaki, Mika; Kulkarni, Bharati; Kuper, Hannah; Wells, Jonathan C; Ploubidis, George B; Prabhakaran, Poornima; Gupta, Vipin; Walia, Gagandeep Kaur; Aggarwal, Aastha; Prabhakaran, Dorairaj; Davey Smith, George; Radhakrishna, Kankipati Vijaya; Ben-Shlomo, Yoav; Kinra, Sanjay

    2017-01-01

    Fat mass is variably associated with bone mass, possibly due to differential mechanical and biological effects of fat mass. We examined the association of fat mass with bone mass in a lean population. To investigate association between hip bone mineral density and fat and lean mass in a cross-sectional study from southern India. The Andhra Pradesh Children and Parents Study is a prospective cohort study in Hyderabad, India. In 2009-2012, the study collected data on anthropometric measures, bone mineral density (BMD), fat mass, and lean mass measured by dual-energy x-ray absorptiometry, and socioeconomic data of the adult participants (n = 1760; mean age = 34.9 years old for women; 2130 and 32.3 for men). The median BMI (kg/m2) was 20.1 kg/m2. Women had relatively higher fat mass as compared to men. In models adjusted for lean mass, there was an association between hip bone mineral density and fat mass in women (β (95% confidence interval): premenopausal 0.025 (0.006 to 0.045); postmenopausal 0.045 (0.014 to 0.076)) but not in men (0.001 (-0.012 to 0.0014)). The association between hip BMD and fat mass was stronger in postmenopausal than premenopausal women. Hip BMD was consistently associated with lean mass, in both men and women. In this relatively lean population, lean mass was more consistently associated with hip BMD than fat mass. Weight gain through lean mass improvement may be a more reliable public health strategy for strengthening bone health in transitional settings.

  3. Effect of exercise and weight loss in people who have hip osteoarthritis and are overweight or obese: a prospective cohort study.

    Science.gov (United States)

    Paans, Nienke; van den Akker-Scheek, Inge; Dilling, Roelien G; Bos, Martine; van der Meer, Klaas; Bulstra, Sjoerd K; Stevens, Martin

    2013-02-01

    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 with hip OA. The aim of this study was to obtain preliminary evidence of the effect of a program of exercise in combination with weight loss on physical function in people who have hip OA and are overweight or obese. This investigation was a prospective cohort study. Thirty-five people who were 25 years or older, had clinical and radiological evidence of hip OA, and were overweight or obese (body mass index of >25 kg/m(2)) were included. They participated in an 8-month program of exercise in combination with weight loss. A body mass index of 40 kg/m(2) was used as the upper limit. The primary outcome was self-reported physical function, as measured with a subscale of the Western Ontario and McMaster Universities Osteoarthritis Index. Secondary outcome measures included pain and walking tests as quantitative measures of function. Participation in the combination program resulted in a 32.6% improvement in self-reported physical function after 8 months, a finding that could be considered clinically relevant. Significant improvements also were seen in pain and on walking tests. The lack of a control group was a limitation of this study. This appears to be the first study investigating the effect of exercise and weight loss as a combination treatment in people with hip OA. The results provide preliminary evidence that this combination treatment is effective in people with hip OA.

  4. Anatomical Variance in Acetabular Anteversion Does Not Predict Hip Fracture Patterns in the Elderly: A Retrospective Study in 135 Patients

    OpenAIRE

    Kamath, Megan Y.; Coleman, Nathan W.; Belkoff, Stephen M.; Mears, Simon C.

    2011-01-01

    It has been suggested that variances in the anatomy of the acetabulum determine the type of hip fracture in elderly patients. Based on this concept, an overly anteverted acetabulum would lead to impingement of the femoral neck against the posterior rim of the acetabulum, causing a femoral neck fracture, whereas with a retroverted acetabulum, external rotation of the hip would be limited by the capsular tissues attached to the trochanteric region, causing a trochanteric fracture. To test the h...

  5. Bursitis of the Hip

    Science.gov (United States)

    ... t Want to Eat Home Diseases and Conditions Bursitis of the Hip Condition Bursitis of the Hip Share Print Table of Contents1. ... Prevention5. Treatment6. Everyday Life7. Questions8. Resources What is bursitis of the hip? Bursitis is the painful swelling ...

  6. Hip Problems in Infants

    Science.gov (United States)

    ... babies have hip problems that can lead to dislocation of the hip bones. This is also called dysplasia (say: “diss- ... March 2014 Categories: Family Health, Infants and ToddlersTags: dislocation, dysplasia, external, femoral, hip, infants, internal, problems, socket, torsion Family Health, Infants ...

  7. Ultrasound: Infant Hip

    Science.gov (United States)

    ... Habits for TV, Video Games, and the Internet Ultrasound: Infant Hip KidsHealth > For Parents > Ultrasound: Infant Hip Print A A A What's in ... en los lactantes What It Is A hip ultrasound is a safe and painless test that uses ...

  8. Hip supporting device

    DEFF Research Database (Denmark)

    2011-01-01

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

  9. Hip mechanics underlie lower extremity power training-induced increase in old adults' fast gait velocity: The Potsdam Gait Study (POGS).

    Science.gov (United States)

    Beijersbergen, Chantal M I; Granacher, Urs; Gäbler, Martijn; DeVita, Paul; Hortobágyi, Tibor

    2017-02-01

    Aging is associated with slowed gait and old compared with young adults generally walk with greater positive hip work (H1) and reduced positive ankle work (A2). The role of exercise interventions on old adults' gait mechanics that underlie training-induced improvements in gait velocity is unclear. We examined the effects of lower extremity power training and detraining on old adults' gait kinetics. As part of the Potsdam Gait Study (POGS), healthy old adults completed a no-intervention control period (69.1±4.4yrs, n=14) or a power training program followed by detraining (72.9±5.4yrs, n=15). We measured isokinetic knee extensor and plantarflexor power and measured hip, knee and ankle kinetics at habitual, fast and standardized walking speeds. Power training significantly increased isokinetic knee extensor power (25%), plantarflexor power (43%), and fast gait velocity (5.9%). Gait mechanics underlying the improved fast gait velocity included increases in hip angular impulse (29%) and H1 work (37%) and no changes in positive knee (K2) and A2 work. Detraining further improved fast gait velocity (4.7%) with reductions in H1 (-35%), and increases in K2 (36%) and A2 (7%). Power training increased fast gait velocity in healthy old adults by increasing the reliance on hip muscle function and thus further strengthened the age-related distal-to-proximal shift in muscle function. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Handgrip strength but not appendicular lean mass is an independent predictor of functional outcome in hip-fracture women: a short-term prospective study.

    Science.gov (United States)

    Di Monaco, Marco; Castiglioni, Carlotta; De Toma, Elena; Gardin, Luisa; Giordano, Silvia; Di Monaco, Roberto; Tappero, Rosa

    2014-09-01

    To investigate the contribution of muscle mass and handgrip strength in predicting the functional outcome after hip fracture in women. Observational study. Rehabilitation hospital. White women (N=123 of 149) who were consecutively admitted to a rehabilitation hospital because of their first fracture of the hip. Not applicable. We measured appendicular lean mass (aLM) by dual-energy x-ray absorptiometry (DXA) 21.1 ± 8.7 (mean ± SD) days after hip fracture occurrence in the 123 women. On the same day, we assessed grip strength at the nondominant arm with a dynamometer. At the end of acute inpatient rehabilitation we measured the ability to function in activities of daily living by using the Barthel Index, and lower limb performance by using the Timed Up and Go (TUG) test. We found significant correlations between handgrip strength measured before rehabilitation and Barthel Index scores after rehabilitation (ρ=.50; Pwomen after a hip fracture. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. Impact of board-certificated physiatrists on rehabilitation outcomes in elderly patients after hip fracture: An observational study using the Japan Rehabilitation Database.

    Science.gov (United States)

    Momosaki, Ryo; Kakuda, Wataru; Yamada, Naoki; Abo, Masahiro

    2016-08-01

    To clarify the impact on rehabilitation outcomes of board-certificated physiatrists (BCP) as the physicians with primary responsibility for elderly patients in convalescent rehabilitation wards after hip fracture. The present retrospective observational study used 2005-2013 data from the Japan Rehabilitation Database. We identified in-hospital patients with hip fracture admitted to rehabilitation wards. After applying exclusion criteria, 824 patients were eligible. The primary outcome was functional independence measure instrument efficiency. BCP were responsible for the care of 46% of patients with hip fracture. Patients who were managed by a BCP had significantly higher mean functional independence measure efficiency than patients who were not, both before and after adjustment by inverse propensity-score weighting (0.37 vs 0.26; P = 0.04 and 0.39 vs 0.26; P rehabilitation outcomes in patients with hip fracture at convalescent rehabilitation wards. Geriatr Gerontol Int 2016; 16: 963-968. © 2015 Japan Geriatrics Society.

  12. Population data on calcium in drinking water and hip fracture: An association may depend on other minerals in water. A NOREPOS study.

    Science.gov (United States)

    Dahl, Cecilie; Søgaard, Anne Johanne; Tell, Grethe S; Forsén, Lisa; Flaten, Trond Peder; Hongve, Dag; Omsland, Tone Kristin; Holvik, Kristin; Meyer, Haakon E; Aamodt, Geir

    2015-12-01

    The Norwegian population has among the highest hip fracture rates in the world. The incidence varies geographically, also within Norway. Calcium in drinking water has been found to be beneficially associated with bone health in some studies, but not in all. In most previous studies, other minerals in water have not been taken into account. Trace minerals, for which drinking water can be an important source and even fulfill the daily nutritional requirement, could act as effect-modifiers in the association between calcium and hip fracture risk. The aim of the present study was to investigate the association between calcium in drinking water and hip fracture, and whether other water minerals modified this association. A survey of trace metals in 429 waterworks, supplying 64% of the population in Norway, was linked geographically to the home addresses of patients with incident hip fractures (1994-2000). Drinking water mineral concentrations were divided into "low" (below and equal waterworks average) and "high" (above waterworks average). Poisson regression models were fitted, and all incidence rate ratios (IRRs) were adjusted for age, geographic region, urbanization degree, type of water source, and pH of the water. Effect modifications were examined by stratification, and interactions between calcium and magnesium, copper, zinc, iron and manganese were tested both on the multiplicative and the additive scale. Analyses were stratified on gender. Among those supplied from the 429 waterworks (2,110,916 person-years in men and 2,397,217 person-years in women), 5433 men and 13,493 women aged 50-85 years suffered a hip fracture during 1994-2000. Compared to low calcium in drinking water, a high level was associated with a 15% lower hip fracture risk in men (IRR=0.85, 95% CI: 0.78, 0.91) but no significant difference was found in women (IRR=0.98, 95%CI: 0.93-1.02). There was interaction between calcium and copper on hip fracture risk in men (p=0.051); the association

  13. Predicting Hip Fracture Type With Cortical Bone Mapping (CBM) in the Osteoporotic Fractures in Men (MrOS) Study.

    Science.gov (United States)

    Treece, Graham M; Gee, Andrew H; Tonkin, Carol; Ewing, Susan K; Cawthon, Peggy M; Black, Dennis M; Poole, Kenneth E S

    2015-11-01

    Hip fracture risk is known to be related to material properties of the proximal femur, but fracture prediction studies adding richer quantitative computed tomography (QCT) measures to dual-energy X-ray (DXA)-based methods have shown limited improvement. Fracture types have distinct relationships to predictors, but few studies have subdivided fracture into types, because this necessitates regional measurements and more fracture cases. This work makes use of cortical bone mapping (CBM) to accurately assess, with no prior anatomical presumptions, the distribution of properties related to fracture type. CBM uses QCT data to measure the cortical and trabecular properties, accurate even for thin cortices below the imaging resolution. The Osteoporotic Fractures in Men (MrOS) study is a predictive case-cohort study of men over 65 years old: we analyze 99 fracture cases (44 trochanteric and 55 femoral neck) compared to a cohort of 308, randomly selected from 5994. To our knowledge, this is the largest QCT-based predictive hip fracture study to date, and the first to incorporate CBM analysis into fracture prediction. We show that both cortical mass surface density and endocortical trabecular BMD are significantly different in fracture cases versus cohort, in regions appropriate to fracture type. We incorporate these regions into predictive models using Cox proportional hazards regression to estimate hazard ratios, and logistic regression to estimate area under the receiver operating characteristic curve (AUC). Adding CBM to DXA-based BMD leads to a small but significant (p fracture, with AUC increasing from 0.78 to 0.79, assessed using leave-one-out cross-validation. For specific fracture types, the improvement is more significant (p fractures and 0.76 to 0.82 for femoral neck fractures. In contrast, adding DXA-based BMD to a CBM-based predictive model does not result in any significant improvement. © 2015 The Authors. Journal of Bone and Mineral Research published by

  14. Health improvement and prevention study (HIPS - evaluation of an intervention to prevent vascular disease in general practice

    Directory of Open Access Journals (Sweden)

    Davies Gawaine

    2010-08-01

    Full Text Available Abstract Background The Health Improvement and Prevention Study (HIPS study aims to evaluate the capacity of general practice to identify patients at high risk for developing vascular disease and to reduce their risk of vascular disease and diabetes through behavioural interventions delivered in general practice and by the local primary care organization. Methods/Design HIPS is a stratified randomized controlled trial involving 30 general practices in NSW, Australia. Practices are randomly allocated to an 'intervention' or 'control' group. General practitioners (GPs and practice nurses (PNs are offered training in lifestyle counselling and motivational interviewing as well as practice visits and patient educational resources. Patients enrolled in the trial present for a health check in which the GP and PN provide brief lifestyle counselling based on the 5As model (ask, assess, advise, assist, and arrange and refer high risk patients to a diet education and physical activity program. The program consists of two individual visits with a dietician or exercise physiologist and four group sessions, after which patients are followed up by the GP or PN. In each practice 160 eligible patients aged between 40 and 64 years are invited to participate in the study, with the expectation that 40 will be eligible and willing to participate. Evaluation data collection consists of (1 a practice questionnaire, (2 GP and PN questionnaires to assess preventive care attitudes and practices, (3 patient questionnaire to assess self-reported lifestyle behaviours and readiness to change, (4 physical assessment including weight, height, body mass index (BMI, waist circumference and blood pressure, (5 a fasting blood test for glucose and lipids, (6 a clinical record audit, and (7 qualitative data collection. All measures are collected at baseline and 12 months except the patient questionnaire which is also collected at 6 months. Study outcomes before and after the

  15. 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

  16. 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

    Science.gov (United States)

    Jameson, Simon S.; Mason, James; Baker, Paul N.; Gregg, Paul J.; Deehan, David J.; Reed, Mike R.

    2015-01-01

    Background 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. Methods and Findings 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. Results 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

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