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Sample records for hip strengthening reduces

  1. Burnishing Techniques Strengthen Hip Implants

    Science.gov (United States)

    2010-01-01

    In the late 1990s, Lambda Research Inc., of Cincinnati, Ohio, received Small Business Innovation Research (SBIR) awards from Glenn Research Center to demonstrate low plasticity burnishing (LPB) on metal engine components. By producing a thermally stable deep layer of compressive residual stress, LPB significantly strengthened turbine alloys. After Lambda patented the process, the Federal Aviation Administration accepted LPB for repair and alteration of commercial aircraft components, the U.S. Department of Energy found LPB suitable for treating nuclear waste containers at Yucca Mountain. Data from the U.S. Food and Drug Administration confirmed LPB to completely eliminate the occurrence of fretting fatigue failures in modular hip implants.

  2. EFFECTIVENESS OF DRY NEEDLING, STRETCHING, AND STRENGTHENING TO REDUCE PAIN AND IMPROVE FUNCTION IN SUBJECTS WITH CHRONIC LATERAL HIP AND THIGH PAIN: A RETROSPECTIVE CASE SERIES.

    Science.gov (United States)

    Pavkovich, Ron

    2015-08-01

    Chronic lateral hip and thigh pain is regularly treated by the physical therapist. Many issues can cause pain in this region, and trigger points may contribute to pain. Dry Needling (DN) is an intervention used by physical therapists where a monofilament needle is inserted into soft tissue to reduce pain thereby facilitating return to prior level of function. The purpose of this case series is to report the outcomes of DN and conventional physical therapy as a treatment intervention for subjects with chronic lateral hip and thigh pain. Four subjects with chronic lateral hip and thigh pain attended between four and eight sixty-minute sessions of dry needling and stretching/ strengthening activities over a four to eight week intervention course. Outcomes were tested at baseline and upon completion of therapy. A long-term follow up averaging 12.25 months (range 3 to 20 months) was also performed. The outcome measures included the Visual Analog Scale (VAS) and the Lower Extremity Functional Scale (LEFS). The LEFS and VAS indicated clinically meaningful improvements in disability and pain in the short term and upon long term follow up for each subject. The LEFS(mean) for the four subjects improved from 50.75 at baseline to 66.75 at the completion of treatment. At long-term follow-up, the LEFS(mean) was 65.50. Each subject met the minimal clinically important difference (MCID) and minimal detectable change (MDC) for the LEFS and the VAS. The VAS was broken down into best (VAS(B)), current (VAS(C)), and worst (VAS(W)) rated pain levels and averaged between the four subjects. The VAS(B) improved from 20 mm at the initial assessment to 0 mm upon completion of the intervention duration. The VAS(C) improved from 25.75 mm to 11.75 mm, and the VAS(W) improved from 85 mm to 32.5 mm. At the long-term follow up (average 12.25 months), the VAS(B), VAS(C), and VAS(W) scores were 0 mm, 14.58 mm, and 43.75 mm respectively. Clinically meaningful improvements in pain and disability were

  3. Effectiveness of hip muscle strengthening in patellofemoral pain syndrome patients: a systematic review

    Science.gov (United States)

    Santos, Thiago R. T.; Oliveira, Bárbara A.; Ocarino, Juliana M.; Holt, Kenneth G.; Fonseca, Sérgio T.

    2015-01-01

    Introduction: Patellofemoral pain syndrome (PFPS) is characterized by anterior knee pain, which may limit the performance of functional activities. The influence of hip joint motion on the development of this syndrome has already been documented in the literature. In this regard, studies have investigated the effectiveness of hip muscle strengthening in patients with PFPS. Objectives: The aims of this systematic review were (1) to summarize the literature related to the effects of hip muscle strengthening on pain intensity, muscle strength, and function in individuals with PFPS and (2) to evaluate the methodological quality of the selected studies. Method: A search for randomized controlled clinical trials was conducted using the following databases: Google Scholar, MEDLINE, PEDro, LILACS, and SciELO. The selected studies had to distinguish the effects of hip muscle strengthening in a group of patients with PFPS, as compared to non-intervention or other kinds of intervention, and had to investigate the following outcomes: pain, muscle strength, and function. The methodological quality of the selected studies was analyzed by means of the PEDro scale. Results: Seven studies were selected. These studies demonstrated that hip muscle strengthening was effective in reducing pain. However, the studies disagreed regarding the treatments' ability to improve muscle strength. Improvement in functional capabilities after hip muscle strengthening was found in five studies. Conclusion: Hip muscle strengthening is effective in reducing the intensity of pain and improving functional capabilities in patients with PFPS, despite the lack of evidence for its ability to increase muscle strength. PMID:26039034

  4. Effectiveness of hip muscle strengthening in patellofemoral pain syndrome patients: a systematic review

    Directory of Open Access Journals (Sweden)

    Thiago R. T. Santos

    2015-06-01

    Full Text Available Introduction: Patellofemoral pain syndrome (PFPS is characterized by anterior knee pain, which may limit the performance of functional activities. The influence of hip joint motion on the development of this syndrome has already been documented in the literature. In this regard, studies have investigated the effectiveness of hip muscle strengthening in patients with PFPS. Objectives: The aims of this systematic review were (1 to summarize the literature related to the effects of hip muscle strengthening on pain intensity, muscle strength, and function in individuals with PFPS and (2 to evaluate the methodological quality of the selected studies. Method: A search for randomized controlled clinical trials was conducted using the following databases: Google Scholar, MEDLINE, PEDro, LILACS, and SciELO. The selected studies had to distinguish the effects of hip muscle strengthening in a group of patients with PFPS, as compared to non-intervention or other kinds of intervention, and had to investigate the following outcomes: pain, muscle strength, and function. The methodological quality of the selected studies was analyzed by means of the PEDro scale. Results: Seven studies were selected. These studies demonstrated that hip muscle strengthening was effective in reducing pain. However, the studies disagreed regarding the treatments' ability to improve muscle strength. Improvement in functional capabilities after hip muscle strengthening was found in five studies. Conclusion: Hip muscle strengthening is effective in reducing the intensity of pain and improving functional capabilities in patients with PFPS, despite the lack of evidence for its ability to increase muscle strength.

  5. 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 cate...

  6. Large strengthening effect of a hip-flexor training programme

    DEFF Research Database (Denmark)

    Thorborg, Kristian; Bandholm, Thomas Quaade; Zebis, Mette;

    2016-01-01

    PURPOSE: To investigate the effect on hip-flexion strength of a 6-week hip-flexor training programme using elastic bands as resistance. We hypothesized that the training group, compared to a control group, would increase their hip-flexion strength more. METHODS: Thirty-three healthy subjects (45 ...

  7. Changes in knee biomechanics after a hip-abductor strengthening protocol for runners with patellofemoral pain syndrome.

    Science.gov (United States)

    Ferber, Reed; Kendall, Karen D; Farr, Lindsay

    2011-01-01

    Very few authors have investigated the relationship between hip-abductor muscle strength and frontal-plane knee mechanics during running. To investigate this relationship using a 3-week hip-abductor muscle-strengthening program to identify changes in strength, pain, and biomechanics in runners with patellofemoral pain syndrome (PFPS). Cohort study. University-based clinical research laboratory. Fifteen individuals (5 men, 10 women) with PFPS and 10 individuals without PFPS (4 men, 6 women) participated. The patients with PFPS completed a 3-week hip-abductor strengthening protocol; control participants did not. The dependent variables of interest were maximal isometric hip-abductor muscle strength, 2-dimensional peak knee genu valgum angle, and stride-to-stride knee-joint variability. All measures were recorded at baseline and 3 weeks later. Between-groups differences were compared using repeated-measures analyses of variance. At baseline, the PFPS group exhibited reduced strength, no difference in peak genu valgum angle, and increased stride-to-stride knee-joint variability compared with the control group. After the 3-week protocol, the PFPS group demonstrated increased strength, less pain, no change in peak genu valgum angle, and reduced stride-to-stride knee-joint variability compared with baseline. A 3-week hip-abductor muscle-strengthening protocol was effective in increasing muscle strength and decreasing pain and stride-to-stride knee-joint variability in individuals with PFPS. However, concomitant changes in peak knee genu valgum angle were not observed.

  8. THE EFFECT OF ADDING SPECIFIC HIP STRENGTHENING EXERCISES TO CONVENTIONAL KNEE EXERCISES IN PATIENTS WITH PATELLO FEMORAL PAIN SYNDROME

    Directory of Open Access Journals (Sweden)

    Raghav Monika

    2016-02-01

    Full Text Available Background: Patello femoral pain Syndrome is an over use injury and one of the commonest problems seen in adolescents who are physically active. Till date no study has been done comparing the effect of adding specific hip strengthening exercises (gluteus medius, gluteus maximus & lateral rotators to conventional exercises in patients with Patello femoral Pain Syndrome (PFPS while minimizing the effect of minimizing the activation of tensor fascia lata (TFL. Methods: 30 subjects were randomly allocated using convenience random sampling into 2 Groups Group A and Group B with 15 subjects in each group. Readings were taken for Numeric Pain Rating Scale (NPRS, Manual Muscle Testing (MMT for hip abductors, extensors and external rotators muscles quadriceps and hamstrings, and Anterior Knee Pain Scale (AKPS on baseline and at the end of 4th week. Results: Analysis of the data collected for NPRS, AKPS and MMT of Quadriceps, Hamstrings, Hip Abductors and Hip External Rotators of 30 subjects was done by statistical analysis tests using STATA and software version 11.2. Although improvement was seen in both the groups but group B improved better compared to group A. Conclusion: Group B treatment protocol i.e. Hip specific strengthening (gluteus medius and gluteus maximus in addition to conventional treatment in patients with patello-femoral pain syndrome, was found to be effective in reducing pain, improving functional status and increasing muscle strength than Group A treatment protocol i.e. Knee strengthening and stretching.

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

    Directory of Open Access Journals (Sweden)

    Hunter David J

    2007-12-01

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

  10. EFFECT OF HIP ABDUCTOR STRENGTHENING AMONG NON-PROFESSIONAL CYCLISTS WITH ILIOTIBIAL BAND FRICTION SYNDROME

    Directory of Open Access Journals (Sweden)

    Jayanta Nath

    2015-02-01

    Full Text Available Background and Objectives: The study was carried out to find out the effect of hip abductor strengthening among non-professional cyclists with iliotibial band friction syndrome. Subjects: 40 non-professional cyclists with ipsilateral ITBFS subject including male and female age between 18 to 50 with positive ober’s and nobble test were included in this study. Methods: 40 subject were selected according to the inclusion criteria and they were assessed pre and post for ROM (hip adduction, IR, hip abductor strength and pain using goniometer,sphygmomanometer and VAS. Subject were assign experimental group(group A 20 subject who received IT band stretching,US,and hip abductor strengthening exercise and control group (group B 20 subject who received same treatment except hip abductor strengthening. Data Analysis and Results: Based on statistical analysis using Wilcoxon test to compare the pre and post test pain in both group,Mann- whitney U- test to compare the post test pain scores of between groups ,Paired t - test to compare the pre and post ROM and strength in both groups, Unpaired t – test to compare post test ROM in between groups showed that pre post difference within group A there was significant difference for adduction ROM (p value <.0001,IR (p value <.0001,VAS(p value <.0001,and strength improve pre mean 40.80 to post mean 66.30 (p value <.0001.However in group B adduction ROM and VAS were found to be significant. In comparision in difference between groups it was found that adduction ROM,IR ROM,VAS and strength all were significant. Baseline data for outcome variable were not statistically significant. Conclusion: Based on outcome variable there was significant difference of hip abductor strengthening among non-professional cyclist with iliotibial band friction syndrome.

  11. Changes in knee biomechanics after a hip-abductor strengthening protocol for runners with patellofemoral pain syndrome

    National Research Council Canada - National Science Library

    Ferber, Reed; Kendall, Karen D; Farr, Lindsay

    2011-01-01

    .... To investigate this relationship using a 3-week hip-abductor muscle-strengthening program to identify changes in strength, pain, and biomechanics in runners with patellofemoral pain syndrome (PFPS). Cohort study...

  12. A randomised trial into the effect of an isolated hip abductor strengthening programme and a functional motor control programme on knee kinematics and hip muscle strength.

    Science.gov (United States)

    Palmer, Kathryn; Hebron, Clair; Williams, Jonathan M

    2015-05-03

    Dynamic knee valgus and internal femoral rotation are proposed to be contributory risk factors for patellofemoral pain and anterior cruciate ligament injuries. Multimodal interventions including hip abductor strengthening or functional motor control programmes have a positive impact of pain, however their effect on knee kinematics and muscle strength is less clear. The aim of this study was to examine the effect of isolated hip abductor strengthening and a functional motor control exercise on knee kinematics and hip abductor strength. This prospective, randomised, repeated measures design included 29 asymptomatic volunteers presenting with increase knee valgus and femoral internal rotation. Participants completed either isolated hip abductor strengthening or a functional motor control exercise for 5 weeks. Knee kinematics were measured using inertial sensors during 2 functional activities and hip abductor strength measured using a load cell during isometric hip abduction. There were no significant differences in dynamic knee valgus and internal rotation following the isolated hip abductor or functional motor control intervention, and no significant differences between the groups for knee angles. Despite this, the actual magnitude of reduction in valgus was 10° and 5° for the functional motor control group and strengthening group respectively. The actual magnitude of reduction in internal rotation was 9° and 18° for the functional motor control group and strengthening group respectively. Therefore there was a tendency towards clinically significant improvements in knee kinematics in both exercise groups. A statistically significant improvement in hip abductor strength was evident for the functional motor control group (27% increase; p = 0.008) and strengthening group (35% increase; p = 0.009) with no significant difference between the groups being identified (p = 0.475). Isolated hip strengthening and functional motor control exercises resulted in

  13. Outcomes following Hip and Quadriceps Strengthening Exercises for Patellofemoral Syndrome: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Adebisi Bisi-Balogun

    2015-10-01

    Full Text Available There is growing evidence to support change in the rehabilitation strategy of patellofemoral pain syndrome (PFPS from traditional quadriceps strengthening exercises to inclusion of hip musculature strengthening in individuals with PFPS. Several studies have evaluated effects of quadriceps and hip musculature strengthening on PFPS with varying outcomes on pain and function. This systematic review and meta-analysis aims to synthesize outcomes of pain and function post-intervention and at follow-up to determine whether outcomes vary depending on the exercise strategy in both the short and long term. Electronic databases including MEDLINE, EMBASE, CINAHL, Web of Science, PubMed, Pedro database, Proquest, Science direct, and EBscoHost databases were searched for randomized control trials published between 1st of January 2005 and 31st of June 2015, comparing the outcomes of pain and function following quadriceps strengthening and hip musculature strengthening exercises in patients with PFPS. Two independent reviewers assessed each paper for inclusion and quality. Means and SDs were extracted from each included study to allow effect size calculations and comparison of results. Six randomized control trials met the inclusion criteria. Limited to moderate evidence indicates that hip abductor strengthening was associated with significantly lower pain post-intervention (SMD −0.88, −1.28 to −0.47 95% CI, and at 12 months (SMD −3.10, −3.71 to −2.50 95% CI with large effect sizes (greater than 0.80 compared to quadriceps strengthening. Our findings suggest that incorporating hip musculature strengthening in management of PFPS tailored to individual ability will improve short-term and long-term outcomes of rehabilitation. Further research evaluating the effects of quadriceps and hip abductors strengthening focusing on reduction in anterior knee pain and improvement in function in management of PFPS is needed.

  14. Effects of Hip Strengthening on Neuromuscular Control, Hip Strength, and Self-Reported Functional Deficits in Individuals With Chronic Ankle Instability.

    Science.gov (United States)

    Smith, Brent I; Docherty, Carrie L; Curtis, Denice

    2017-06-12

    Deficits in ankle and hip strength and lower extremity postural control are associated with chronic ankle instability (CAI). Following strength training, muscle groups demonstrate increased strength. This change is partially credited to improved neuromuscular control and many studies have investigated ankle protocols for subjects with CAI. The effects of isolating hip musculature in strength training protocols in this population is not well understood. Examine the effects of hip strengthening on clinical and self-reported outcomes in patients with CAI. Prospective randomized controlled clinical trial. Athletic Training facility. Twenty-six participants with CAI (12 males and 14 females, 20.9±1.5 years, 170.0±12.7 cm, 77.5±17.5 kg) were randomly assigned to training or control groups. The participants completed either four weeks of supervised hip strengthening (resistance bands 3x/week) or no intervention. Participants were assessed on four clinical measures (Star Excursion Balance Test (SEBT) in the anterior, posteromedial and posterolateral directions, Balance Error Scoring System (BESS), hip external rotation strength, hip abduction strength) and a patient reported measure (the Foot and Ankle Ability Measure (FAAM) activities of daily living and sports subscales) before and after the four-week training period. The training group displayed significantly improved post-test measures compared with the control group for: hip abduction strength (training 446.3±77.4 N, control 314.7±49.6 N, p control 169.4±34.6 N, p control 90.2±7.9%, p control 88.0±8.8 %, p control 86.6±9.6%, p control 21.2±6.3 errors, p control 84.8±10.9, p <.01). Improved clinical and patient-reported outcomes in the training group suggest hip strengthening is beneficial in the management and prevention of recurrent symptoms associated with CAI.

  15. Ultrasound Characteristics of Clinically Dislocated But Reducible Hips With DDH.

    Science.gov (United States)

    Striano, Brendan; Schaeffer, Emily K; Matheney, Travis H; Upasani, Vidayadhar V; Price, Charles T; Mulpuri, Kishore; Sankar, Wudbhav N

    2017-07-21

    Although ultrasound (US) is frequently used in diagnosis and management of infantile developmental dysplasia of the hip, precise ultrasonographic parameters of what constitutes a dislocation, subluxation etc remain poorly defined. The purpose of this study was (1) to describe the ultrasonographic characteristics of a large cohort of clinically dislocated but reducible hips and (2) to begin to develop ultrasonographic definitions for what constitutes a hip dislocation. A retrospective review of prospectively collected data from an international multicenter study group on developmental dysplasia of the hip was conducted on all patients under 6 months of age with hip(s) that were dislocated at rest but reducible based on initial physical examination (ie, Ortolani positive). Femoral head coverage (FHC), alpha angle (α), and beta angle (β) were measured on pretreatment US by the individual treating surgeon, and were recorded directly into the database. Based on 325 Ortolani positive hips, the median FHC on presentation was 10% with an interquartile range of 0% to 23%. A total of 126 of the 327 hips (39%) demonstrated 0% FHC. The 90th percentile was found to be at 33% FHC. Of 264 hips with sufficient α data, the median α was 43 degrees with an interquartile range from 37 to 49 degrees. The 90th percentile for α was at 54 degrees. A total of 164 hips had documented β with a median of 66 degrees and an interquartile range of 57 to 79 degrees; the 90th percentile was at 94 degrees. Analysis of a large cohort of patients with dislocated but reducible hips reveals a median percent FHC of 10%, a median α of 43 degrees, and a median β of 66 degrees on initial US. Using a threshold at the 90th percentile, a sensible ultrasonographic definition of a dislocated hip seems to be FHC≤33%, implying that FHC between 34% and 50% may be reasonably termed a subluxation. Although these findings are consistent with previous, smaller reports, further prospective research is

  16. Eccentric strengthening effect of hip-adductor training with elastic bands in soccer players

    DEFF Research Database (Denmark)

    Jensen, Jesper; Hölmich, Per; Bandholm, Thomas

    2014-01-01

    programme, including one hip-adduction exercise, on eccentric and isometric hip-adduction strength, using elastic bands as external load. METHODS: Thirty-four healthy, sub-elite soccer players, mean (±SD) age of 22.1 (±3.3) years, were randomised to either training or control. During the mid-season break...... sessions per week (weeks 7-8) with 3×8 RM. Eccentric hip-adduction (EHAD), isometric hip-adduction (IHAD) and isometric hip-abduction (IHAB) strength, and the IHAD/IHAB ratio were measured assessor-blinded preintervention and postintervention, using reliable hand-held dynamometry procedures. RESULTS...... or the IHAD/IHAB ratio existed (p>0.05). CONCLUSIONS: 8 weeks of hip-adduction strength training, using elastic bands, induce a relevant increase in eccentric hip-adduction strength in soccer players, and thus may have implications as a promising approach towards prevention of groin injuries in soccer....

  17. Nitride-strengthened reduced activation ferritic/martensitic steels

    Energy Technology Data Exchange (ETDEWEB)

    Hu Ping [Institute of Metal Research, Chinese Academy of Sciences, No. 72, Wenhua Road, Shenhe District, Shenyang, Liaoning 110016 (China); Graduate School of Chinese Academy of Sciences, Beijing 100049 (China); Yan Wei, E-mail: weiyan@imr.ac.cn [Institute of Metal Research, Chinese Academy of Sciences, No. 72, Wenhua Road, Shenhe District, Shenyang, Liaoning 110016 (China); Deng Lifen [Institute of Metal Research, Chinese Academy of Sciences, No. 72, Wenhua Road, Shenhe District, Shenyang, Liaoning 110016 (China); Graduate School of Chinese Academy of Sciences, Beijing 100049 (China); Sha Wei [School of Planning, Architecture and Civil Engineering, Queen' s University of Belfast, Belfast BT9 5AG (United Kingdom); Shan Yiyin; Yang Ke [Institute of Metal Research, Chinese Academy of Sciences, No. 72, Wenhua Road, Shenhe District, Shenyang, Liaoning 110016 (China)

    2010-12-15

    Two nitride-strengthened reduced activation ferritic/martensitic (RAFM) steels with different Mn contents were investigated. The experimental steels were designed based on the chemical composition of Eurofer 97 steel but the C content was reduced to an extremely low level. Microstructure observation and hardness tests showed that the steel with low Mn content (0.47 wt.%) could not obtain a full martensitic microstructure due to the inevitable {delta}-ferrite independent of cooling rate after soaking. This steel showed similar room temperature strength and higher strength at 600 deg. C, but lower impact toughness, compared with Eurofer 97 steel. Fractography of the Charpy impact specimen revealed that the low room temperature toughness should be related to the Ta-rich inclusions initiating the cleavage fracture. The larger amount of V-rich nitrides and more dissolved Cr in the matrix could be responsible for the strength being similar to Eurofer 97 steel. In the second steel developed from the first steel by increasing the Mn content from 0.47 wt.% to 3.73 wt.%, a microstructure of full martensite could be obtained.

  18. Decreasing nonmarital births and strengthening marriage to reduce poverty.

    Science.gov (United States)

    Amato, Paul R; Maynard, Rebecca A

    2007-01-01

    Since the 1970s, the share of U.S. children growing up in single-parent families has doubled, a trend that has disproportionately affected disadvantaged families. Paul Amato and Rebecca Maynard argue that reversing that trend would reduce poverty in the short-term and, perhaps more important, improve children's growth and development over the long term, thus reducing the likelihood that they would be poor when they grew up. The authors propose school and community programs to help prevent nonmarital births. They also propose to lower divorce rates by offering more educational programs to couples before and during marriage. Amato and Maynard recommend that all school systems offer health and sex education whose primary message is that parenthood is highly problematic for unmarried youth. They also recommend educating young people about methods to prevent unintended pregnancies. Ideally, the federal government would provide tested curriculum models that emphasize both abstinence and use of contraception. All youth should understand that unintended pregnancies are preventable and have enormous costs for the mother, the father, the child, and society. Strengthening marriage, argue the authors, is also potentially an effective strategy for fighting poverty. Researchers consistently find that premarital education improves marital quality and lowers the risk of divorce. About 40 percent of couples about to marry now participate in premarital education. Amato and Maynard recommend doubling that figure to 80 percent and making similar programs available for married couples. Increasing the number of couples receiving services could mean roughly 72,000 fewer divorces each year, or around 65,000 fewer children entering a single-parent family every year because of marital dissolution. After seven or eight years, half a million fewer children would have entered single-parent families through divorce. Efforts to decrease the share of children in single-parent households, say the

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

    Science.gov (United States)

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

    2017-01-01

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

  20. Development of a dispersion strengthened copper alloy using a MA-HIP method

    Directory of Open Access Journals (Sweden)

    T. Yamada

    2016-12-01

    Full Text Available A new Cu-Al alloy was fabricated by a MA-HIP method for application to the heat sink materials of divertors. With the increase in MA time, the grain size and Vickers hardness decreased and increased, respectively. At MA time of 32hrs, the hardness of the alloy was comparable to that of Glidcop® although the grain size was much larger. X-ray diffractometry, electrical resistivity measurements and STEM-EDS analyses suggested precipitation of Al-rich phase by MA for 32hrs followed by HIP.

  1. Martial arts fall techniques reduce hip impact forces in naive subjects after a brief period of training.

    NARCIS (Netherlands)

    Weerdesteijn, V.G.M.; Groen, B.E.; Swigchem, R. van; Duysens, J.

    2008-01-01

    Hip fractures are among the most serious consequences of falls in the elderly. Martial arts (MA) fall techniques may reduce hip fracture risk, as they are known to reduce hip impact forces by approximately 30% in experienced fallers. The purpose of this study was to investigate whether hip impact fo

  2. Martial arts fall techniques reduce hip impact forces in naive subjects after a brief period of training.

    NARCIS (Netherlands)

    Weerdesteijn, V.G.M.; Groen, B.E.; Swigchem, R. van; Duysens, J.

    2008-01-01

    Hip fractures are among the most serious consequences of falls in the elderly. Martial arts (MA) fall techniques may reduce hip fracture risk, as they are known to reduce hip impact forces by approximately 30% in experienced fallers. The purpose of this study was to investigate whether hip impact

  3. Orthogeriatric Service Reduces Mortality in Patients With Hip Fracture

    DEFF Research Database (Denmark)

    Stenqvist, Charlotte; Madsen, Christian Medom; Riis, Troels

    2016-01-01

    INTRODUCTION: Orthogeriatric service has been shown to improve outcomes in patients with hip fracture. The purpose of this study is to evaluate the effect of orthogeriatrics at Bispebjerg University Hospital, Denmark. The primary outcome is mortality inhospital and after 1, 3, and 12 months for p......, and ASA score. Future trials should include frail patients with other fracture types who can benefit from orthogeriatrics.......INTRODUCTION: Orthogeriatric service has been shown to improve outcomes in patients with hip fracture. The purpose of this study is to evaluate the effect of orthogeriatrics at Bispebjerg University Hospital, Denmark. The primary outcome is mortality inhospital and after 1, 3, and 12 months...... for patients with hip fracture. The secondary outcome is mortality for home dwellers and nursing home inhabitants. MATERIALS AND METHODS: This is a retrospective clinical cohort study with an historic control group including all patients with hip fracture admitted from 2007 to 2011. Patients with hip fracture...

  4. A comprehensive hip fracture program reduces complication rates and mortality

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Moltke, Finn Borgbjerg; Schousboe, B.

    2008-01-01

    OBJECTIVES: To evaluate the rate of postoperative complications, length of stay, and 1-year mortality before and after introduction of a comprehensive Multidisciplinary fast-track treatment and care program for hip fracture patients (the optimized program). DESIGN: Retrospective chart review...... with historical control. SETTING: Orthopedic ward (110 beds) at a university hospital (700 beds). PARTICIPANTS: Five hundred thirty-five consecutive patients aged 40 and older (94% >= 60) hospitalized for hip fracture between January 1, 2003, and March 3 1, 2004. Three hundred and thirty-six patients (70.3%) were...... tract infection (P mortality was 23% in the control group versus 12% in the intervention...

  5. HIPS-GLAD core shell nanorod array photodetectors with enhanced photocurrent and reduced dark current

    Science.gov (United States)

    Keles, Filiz; Cansizoglu, Hilal; Badraddin, Emad O.; Brozak, Matthew P.; Watanabe, Fumiya; Karabacak, Tansel

    2016-10-01

    Vertically aligned core/shell nanorod array photodetectors were fabricated by high pressure sputter (HIPS) deposition of copper indium sulfide (CIS) films on glancing angle deposited (GLAD) indium sulfide (In2S3) nanorods. For comparison, we also studied nanorod photodetectors with conventional low pressure sputtered (LPS) CIS film coatings and counterpart thin film devices incorporating HIPS or LPS-CIS on In2S3 films. HIPS-GLAD core/shell photodetectors have shown a superior photocurrent density response along with lowest dark current density. Photoresponsivity defined with the photocurrent density/dark current density ratio γ = |J ph/J dark| was about ˜1820 for HIPS-GLAD nanorod devices, which is several orders of magnitude higher compared to those of LPS-CIS thin film (γ ˜ 2) and HIPS-CIS thin film (γ ˜ 9) devices, and also about four-fold higher than LPS-CIS nanorod devices (γ ˜ 490). Enhanced photoresponsivity is attributed to the porous microstructure and improved conformality of HIPS-CIS film around the In2S3 nanorods confirmed by SEM and EDS measurements. Due to randomization of the sputtered flux at higher working gas pressures, HIPS can provide a more conformal while at the same time a voidy low-density film around nanostructured surfaces. Reduced interelectrode distance and improved p-n junction interface due to the more uniform conformality of HIPS-CIS result in a higher photocurrent in our HIPS-GLAD devices. In addition, the voids in HIPS-CIS film as a result of its porous nature can behave as highly resistive spots that lower the dark current. Therefore, we have demonstrated that by utilizing a simple and low-temperature HIPS-GLAD method, high-photocurrent and low-dark-current photodetectors can be achieved by controlling the conformality and microstructure of a shell layer around nanorod arrays. HIPS shell coating method can be extended to almost any type of nanostructured substrate.

  6. Comparison of the effects of knee and hip and single knee muscles strengthening/ stretching exercises on pain intensity and function in athletes with patellofemoral pain syndrome

    Directory of Open Access Journals (Sweden)

    Vahid Mazloum

    2016-08-01

    Full Text Available Background: Patellofemoral pain syndrome (PFPS is a common musculoskeletal condition among athletes. The evidence emphasizes on the importance of hip musculature strengthening exercises for such patients. Objective: To investigate the effects of strengthening-stretching knee muscles exercises and hip posterolateral musculature exercises in athletes with PFPS. Methods: In this clinical trial, 28 athletes with age average of 22.7±2.4 years with PFPS were allocated into conventional knee muscles exercises (CKME (n=14 and posterolateral hip muscles exercises (PHME (n=14. The subjects of both groups performed the supervised exercise protocols in 12 sessions. The Visual Analogue Scale and 6-minute walking tests were administrated respectively to evaluate pain intensity and function. The data were analyzed using Shapiro-wilk test, Independent-sample t test, and Repeated Measure ANOVA test. Findings: Demographic, pain intensity, and physical function data were similar between groups at baseline. Both groups significantly improved in pain intensity and function following a 4-week exercise program. Additionally, the athletes in PHME group had higher level of decreased pain intensity and improved function in follow-up assessment than the subjects in CKME group. Conclusion: Using hip posterolateral musculature exercises in addition to the knee conventional exercises is more effective for athletes with PFPS.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    AIMS: We chose unstable extra-capsular hip fractures as our study group because these types of fractures suffer the largest blood loss. We hypothesised that tranexamic acid (TXA) would reduce total blood loss (TBL) in extra-capsular fractures of the hip. PATIENTS AND METHODS: A single......-centre placebo-controlled double-blinded randomised clinical trial was performed to test the hypothesis on patients undergoing surgery for extra-capsular hip fractures. For reasons outside the control of the investigators, the trial was stopped before reaching the 120 included patients as planned in the protocol.......7) in the TXA group. The 90-day mortality was 27.2% (n = 9) in the TXA group and 10.2% (n = 4) in the placebo group (p = 0.07). We were not able to ascertain a reliable cause of death in these patients. DISCUSSION: TXA significantly reduced TBL in extra-capsular hip fractures, but concerns regarding its safety...

  9. Does reduced movement restrictions and use of assistive devices affect rehabilitation outcome after total hip replacement?

    DEFF Research Database (Denmark)

    Mikkelsen, Lone Ramer; Petersen, Annemette Krintel; Søballe, Kjeld

    2014-01-01

    . DESIGN: Non-randomized, controlled study. SETTING: Inpatient. POPULATION: 365 consecutively included THR patients. METHODS: Patients included the 3 initial month of the study underwent rehabilitation with restrictions in hip movement and a standard package of assistive devices (restricted group...... IMPACT: It is possible to reduce movement restrictions and use of assistive devices considerably. More research on safety issues is needed to elucidate the effect of unrestricted rehabilitation on hip dislocation....

  10. Noninvasive stimulation of prefrontal cortex strengthens existing episodic memories and reduces forgetting in the elderly.

    Directory of Open Access Journals (Sweden)

    Marco eSandrini

    2014-10-01

    Full Text Available Memory consolidation is a dynamic process. Reactivation of consolidated memories by a reminder triggers reconsolidation, a time-limited period during which existing memories can be modified (i.e. weakened or strengthened. Episodic memory refers to our ability to recall specific past events about what happened, including where and when. Difficulties in this form of long-term memory commonly occur in healthy aging. Because episodic memory is critical for daily life functioning, the development of effective interventions to reduce memory loss in elderly individuals is of great importance. A previous study in young adults showed that the dorsolateral prefrontal cortex (DLPFC plays a causal role in strengthening of verbal episodic memories through reconsolidation. The aim of the present study was to explore the extent to which facilitatory transcranial direct current stimulation (anodal tDCS over the left DLPFC would strengthen existing episodic memories through reconsolidation in elderly individuals. On Day 1, older adults learned a list of 20 words. On Day 2 (24h later, they received a reminder or not, and after 10 minutes tDCS was applied over the left DLPFC. Memory recall was tested on Day 3 (48h later and Day 30 (1 month later. Surprisingly, anodal tDCS over the left DLPFC (i.e. with or without the reminder strengthened existing verbal episodic memories and reduced forgetting compared to sham stimulation. These results provide a framework for testing the hypothesis that facilitatory tDCS of prefrontal cortex might strengthen existing episodic memories and reduce memory loss in older adults with amnesic mild cognitive impairment.

  11. Postural correction reduces hip pain in adult with acetabular dysplasia: A case report.

    Science.gov (United States)

    Lewis, Cara L; Khuu, Anne; Marinko, Lee N

    2015-06-01

    Developmental dysplasia of the hip is often diagnosed in infancy, but less severe cases of acetabular dysplasia are being detected in young active adults. The purpose of this case report is to present a non-surgical intervention for a 31-year-old female with mild acetabular dysplasia and an anterior acetabular labral tear. The patient presented with right anterior hip and groin pain, and she stood with the trunk swayed posterior to the pelvis (swayback posture). The hip pain was reproduced with the anterior impingement test. During gait, the patient maintained the swayback posture and reported 6/10 hip pain. Following correction of the patient's posture, the patient's pain rating was reduced to a 2/10 while walking. The patient was instructed to maintain the improved posture. At the 1 year follow-up, she demonstrated significantly improved posture in standing and walking. She had returned to recreational running and was generally pain-free. The patient demonstrated improvement on self-reported questionnaires for pain, function, and activity. These findings suggest that alteration of posture can have an immediate and lasting effect on hip pain in persons with structural abnormality and labral pathology. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Long-term genetic selection reduced prevalence of hip and elbow dysplasia in 60 dog breeds

    Science.gov (United States)

    Keller, G. G.; Famula, T. R.

    2017-01-01

    Canine hip dysplasia (CHD) and elbow dysplasia (ED) impact the health and welfare of all dogs. The first formally organized assessment scheme to improve canine health centered on reducing the prevalence of these orthopedic disorders. Phenotypic screening of joint conformation remains the currently available strategy for breeders to make selection decisions. The present study evaluated the efficacy of employing phenotypic selection on breed improvement of hips and elbows using the Orthopedic Foundation for Animals complete database spanning the 1970–2015 time period. Sixty breeds having more than 1000 unique hip evaluations and 500 elbow evaluations (1,056,852 and 275,129 hip and elbow records, respectively) were interrogated to derive phenotypic improvement, sex and age at time of assessment effects, correlation between the two joints, heritability estimates, estimated breeding values (EBV), and effectiveness of maternal/paternal selection. The data demonstrated that there has been overall improvement in hip and elbow conformation with a reduction in EBV for disease liability, although the breeds differed in the magnitude of the response to selection. Heritabilities also differed substantially across the breeds as did the correlation of the joints; in the absence of a universal association of these differences with breed size, popularity, or participation in screening, it appears that the breeds themselves vary in genetic control. There was subtle, though again breed specific, impact of sex and older ages on CHD and ED. There was greater paternal impact on a reduction of CHD. In the absence of direct genetic tests for either of these two diseases, phenotypic selection has proven to be effective. Furthermore, the data underscore that selection schemes must be breed specific and that it is likely the genetic profiles will be unique across the breeds for these two conditions. Despite the advances achieved with phenotypic selection, incorporation of EBVs into

  13. Strengthening effect of reduced graphene oxide in steel clad copper rod

    Science.gov (United States)

    Gao, Haitao; Liu, Xianghua; Ai, Zhengrong; Zhang, Shilong; Liu, Lizhong

    2016-11-01

    Reduced graphene oxide has been extensively used as reinforcing agent owing to their high mechanical properties. In this work, an attempt is made to synthesize steel clad copper rod reinforced with reduced graphene oxide (RGO) by the combination of powder-in-tube and intermediate annealing (IA). Experiments show that the Fe/RGO/Cu composites manifest better mechanical properties than Fe/Cu composites. In the process of groove rolling, RGO acts as effective binder, which can greatly improve the adhesive strength of copper scrap and two metals. Moreover, the strengthening effect of RGO is tightly related to its dispersion state. The RGO diffuses much more uniformly on the metallic substrate under the IA temperature of 1100 °C than 800 °C, which can be characterized by less deformation twins appearing at the interface of core copper and the formation of Fe-RGO-Cu transition belt at the bonding interface. In this case, the peak hardness, tensile strength and shear strength of Fe/RGO/Cu composites are 52 HV, 125 and 41 MPa higher than those of the Fe/Cu composites, respectively. The difference of strengthening effect and mechanisms of RGO under 800 and 1100 °C of IA are systematically discussed by referring to experimental results.

  14. How can we strengthen students’ social relations in order to reduce school dropout?

    DEFF Research Database (Denmark)

    Ingholt, Liselotte; Sørensen, Betina Bang; Andersen, Susan

    2015-01-01

    BACKGROUND: This article describes the rationale and contents of an intervention program aimed at strengthening students' social relations in order to reduce dropout from vocational schools in Denmark. Taking its theoretical cue from the concept of 'social participation', a qualitative study...... on ethnographic methods, including 22 qualitative interviews with students 17-19 years old and fieldwork with participant observations at four vocational schools over 40 days, including informal interviews and discussion meetings with managers, teachers, counselors and students. As part of the fieldwork, four...... additional qualitative interviews and four group interviews were conducted with students 16-25 years old. RESULTS: The qualitative data collection resulted in seven major themes to be addressed in the intervention: social relations, sole focus on professional skills, institutionalized individualization...

  15. Exercise, especially combined stretching and strengthening exercise, reduces myofascial pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Juliano Bergamaschine Mata Diz

    2017-01-01

    Full Text Available Question: Among people with myofascial pain, does exercise reduce the intensity of the pain and disability? Design: Systematic review of randomised and quasi-randomised controlled trials. Participants: People with myofascial pain of any duration. Intervention: Exercise versus minimal or no intervention and exercise versus other intervention. Outcome measures: Pain intensity and disability. Results: Eight studies involving 255 participants were included. Pooled estimates from six studies showed statistically significant effects of exercise when compared with minimal or no intervention (support and encouragement or no treatment on pain intensity at short-term follow-up. The weighted mean difference in pain intensity due to exercise was –1.2 points (95% CI –2.3 to –0.1 on a 0 to 10 scale. Pooled estimates from two studies showed a non-significant effect of exercise when compared with other interventions (electrotherapy or dry needling on pain intensity at short-term follow-up. The weighted mean difference in pain intensity due to exercise instead of other therapies was 0.4 points (95% CI –0.3 to 1.1 on a 0 to 10 scale. Individual studies reported no significant effects of exercise on disability compared with minimal intervention (–0.4, 95% CI –1.3 to 0.5 and other interventions (0.0, 95% CI –0.8 to 0.8 at short-term follow-up. Sensitivity analysis suggested that combining stretching and strengthening achieves greater short-term effects on pain intensity compared with minimal or no intervention (–2.3, 95% CI –4.1 to –0.5. Conclusion: Evidence from a limited number of trials indicates that exercise has positive small-to-moderate effects on pain intensity at short-term follow-up in people with myofascial pain. A combination of stretching and strengthening exercises seems to achieve greater effects. These estimates may change with future high-quality studies. [Mata Diz JB, de Souza JRLM, Leopoldino AAO, Oliveira VC (2016 Exercise

  16. Electrical stimulation and muscle strengthening

    National Research Council Canada - National Science Library

    Dehail, P; Duclos, C; Barat, M

    2008-01-01

    ...: muscular or neuromuscular, electromyostimulation, electrical stimulation, strengthening, strength training, immobilization, muscle dystrophy, bed-rest, bed-bound, knee or hip surgery, postoperative...

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

    Science.gov (United States)

    Nozawa, Takashi; Noh, Sanghoon; Tanigawa, Hiroyasu

    2012-08-01

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

  19. Characterization of microstructural and mechanical properties of a reduced activation ferritic oxide dispersion strengthened steel

    Science.gov (United States)

    Eiselt, Ch. Ch.; Klimenkov, M.; Lindau, R.; Möslang, A.

    2011-09-01

    For specific blanket and divertor applications in future fusion power reactors a replacement of presently considered Reduced Activation Ferritic Martensitic (RAFM) steels as structural material by suitable oxide dispersion strengthened (ODS) ferritic martensitic steels would allow a substantial increase of the operating temperature from ˜823 K to about 923 K. Temperatures above 973 K in the He cooled modular divertor concept necessitate the use of Reduced Activation Ferritic (RAF)-ODS-steels, which are not limited by a phase transition. The development concentrates on the ferritic ODS-steel Fe-13Cr-1W-0.3Ti-0.3Y 2O 3. The microstructures of a mechanically alloyed powder particle are observed by X-ray diffraction (XRD) and transmission electron microscopy (TEM). Ageing experiments for 1000 h and 3000 h at 1123.5 K and 1223.5 K of compacted Fe-13Cr-1W-0.3Ti-0.3Y 2O 3 were executed. The impact especially on the oxide particles in terms of segregation and decomposition effects were monitored by electron energy loss spectroscopy (EELS). Long term vacuum creep experiments have been performed with rolled Fe-13Cr-1W-0.3Ti-0.3Y 2O 3 at 923.5 K and 1023.5 K, which will be compared to reference alloys.

  20. Effect of Dynamic Platform Lateral Step-Up versus Stable Platform Lateral Step-Up Weight Bearing Exercise in Hip Abductor Strengthening on Healthy Male Volunteers - Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Jagatheesan Alagesan

    2011-07-01

    Full Text Available Objective & Background: To determine the effect of the dynamic platform lateral step-up and stable platform lateral step-up weight bearing standing exercise in strengthening of hip abductor. Many researchers have reported that strengthening of hip muscles as important component especially hip abductors in lower extremity rehabilitation program. Study Design: Single blinded randomized comparative clinical trial. Methodology: Sixty five healthy college going male subjects (Age group of 18 – 24 years volunteered for this study. They were randomly assigned to one of the 2 groups. One group received the dynamic platform lateral step-up and the other received stable platform lateral step-up weight bearing standing exercise. The strength measurements were recorded using hand held dynamometer. Results: The results indicate that both groups had a positive effect on the outcome measures. The strength of hip abductors in dynamic platform group improved from a mean value (SD of 19.47(3.59 to 26.93(3.19 and in stable platform group from 19.07(2.32 to 22.67(2.46. Significant difference is also observed between the two groups at p value .05. Conclusion: The study shows that dynamic platform lateral step-up exercise is more beneficial than stable platform lateral step-up weight bearing standing exercise in improving hip abductor muscle strength.

  1. ENVIRONMENTAL ENRICHMENT STRENGTHENS CORTICOCORTICAL INTERACTIONS AND REDUCES AMYLOID-β OLIGOMERS IN AGED MICE

    Directory of Open Access Journals (Sweden)

    Marco eMainardi

    2014-01-01

    Full Text Available Brain aging is characterized by global changes which are thought to underlie age-related cognitive decline. These include variations in brain activity and the progressive increase in the concentration of soluble amyloid-β (Aβ oligomers, directly impairing synaptic function and plasticity even in the absence of any neurodegenerative disorder. Considering the high social impact of the decline in brain performance associated to aging, there is an urgent need to better understand how it can be prevented or contrasted. Lifestyle components, such as social interaction, motor exercise and cognitive activity, are thought to modulate brain physiology and its susceptibility to age-related pathologies. However, the precise functional and molecular factors that respond to environmental stimuli and might mediate their protective action again pathological aging still need to be clearly identified. To address this issue, we exploited environmental enrichment (EE, a reliable model for studying the effect of experience on the brain based on the enhancement of cognitive, social and motor experience, in aged wild-type mice. We analyzed the functional consequences of EE on aged brain physiology by performing in vivo local field potential (LFP recordings with chronic implants. In addition, we also investigated changes induced by EE on molecular markers of neural plasticity and on the levels of soluble Aβ oligomers. We report that EE induced profound changes in the activity of the primary visual and auditory cortices and in their functional interaction. At the molecular level, EE enhanced plasticity by an upward shift of the cortical excitation/inhibition balance. In addition, EE reduced brain Aβ oligomers and increased synthesis of the Aβ-degrading enzyme neprilysin. Our findings strengthen the potential of EE procedures as a non-invasive paradigm for counteracting brain aging processes.

  2. Environmental enrichment strengthens corticocortical interactions and reduces amyloid-β oligomers in aged mice.

    Science.gov (United States)

    Mainardi, Marco; Di Garbo, Angelo; Caleo, Matteo; Berardi, Nicoletta; Sale, Alessandro; Maffei, Lamberto

    2014-01-01

    Brain aging is characterized by global changes which are thought to underlie age-related cognitive decline. These include variations in brain activity and the progressive increase in the concentration of soluble amyloid-β (Aβ) oligomers, directly impairing synaptic function and plasticity even in the absence of any neurodegenerative disorder. Considering the high social impact of the decline in brain performance associated to aging, there is an urgent need to better understand how it can be prevented or contrasted. Lifestyle components, such as social interaction, motor exercise and cognitive activity, are thought to modulate brain physiology and its susceptibility to age-related pathologies. However, the precise functional and molecular factors that respond to environmental stimuli and might mediate their protective action again pathological aging still need to be clearly identified. To address this issue, we exploited environmental enrichment (EE), a reliable model for studying the effect of experience on the brain based on the enhancement of cognitive, social and motor experience, in aged wild-type mice. We analyzed the functional consequences of EE on aged brain physiology by performing in vivo local field potential (LFP) recordings with chronic implants. In addition, we also investigated changes induced by EE on molecular markers of neural plasticity and on the levels of soluble Aβ oligomers. We report that EE induced profound changes in the activity of the primary visual and auditory cortices and in their functional interaction. At the molecular level, EE enhanced plasticity by an upward shift of the cortical excitation/inhibition balance. In addition, EE reduced brain Aβ oligomers and increased synthesis of the Aβ-degrading enzyme neprilysin. Our findings strengthen the potential of EE procedures as a non-invasive paradigm for counteracting brain aging processes.

  3. Reduced fasting time improves comfort and satisfaction of elderly patients undergoing anesthesia for hip fracture

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2015-04-01

    Full Text Available BACKGROUND AND OBJECTIVES: Patient's satisfaction is a standard indicator of care quality. The aim of this study was to evaluate whether a preoperative oral ingestion of 200 mL of a carbohydrate drink can improve comfort and satisfaction with anesthesia in elderly patients with hip fracture. METHOD: Prospective randomized clinical trial conducted in a Brazilian public hospital, with patients ASA I-III undergoing surgery for hip fracture. The control group (NPO received nothing by mouth after 9:00 p.m. the night before, while patients in the experimental group (CHO received 200 mL of a carbohydrate drink 2-4 h before the operation. Patients' characteristics, subjective perceptions, thirst and hunger and satisfaction were determined in four steps. Mann-Whitney U-test and Fisher exact test were used for comparison of control and experimental groups. A p-value <0.05 was considered significant. RESULTS: A total of 100 patients were included in one of the two regimens of preoperative fasting. Fasting time decreased significantly in the study group. Patients drank 200 mL 2:59 h before surgery and showed no hunger (p < 0.00 and thirst on arrival to OR (p < 0.00, resulting in increased satisfaction with the perioperative anesthesia care (p < 0.00. CONCLUSIONS: The satisfaction questionnaire for surgical patient could become a useful tool in assessing the quality of care. In conclusion, CHO significantly reduces preoperative discomfort and increases satisfaction with anesthesia care.

  4. Non-sedentary Lifestyle Can Reduce Hip Fracture Risk among Older Caucasians Adults: The Adventist Health Study-2

    Science.gov (United States)

    Lousuebsakul-Matthews, Vichuda; Thorpe, Donna; Knutsen, Raymond; Beeson, W. Larry; Fraser, Gary E.; Knutsen, Synnove F.

    2016-01-01

    Aims The beneficial effect of physical activity on reducing hip fracture risk has been supported in many previous studies. The present cohort study explores the relationship between total daily physical activity expressed as MET-hour/day and hip fracture risk among men over 50 years of age and postmenopausal women (n=22,836). Methodology Associations between self-reported hip fracture incidence and total daily physical activity and selected lifestyle factors were assessed using Cox proportional hazard regression. Results In gender-specific multivariable models, total activity above average (≥ 51 MET-hours per day for men, ≥ 48 MET-hours per day for women) compared to those with sedentary lifestyle (< 40 MET-hours per day) reduced the risk of hip fracture by 60% among men (HR=0.40, 95%CI: 0.23–0.70) (Ptrend=0.002) and 48% among women (HR=0.52, 95%CI: 0.32–0.84) (Ptrend=0.01). Conclusion Our findings suggest that a moderate level of physical activity and avoiding a sedentary lifestyle can reduce the risk of hip fracture among the elderly.

  5. Non-sedentary Lifestyle Can Reduce Hip Fracture Risk among Older Caucasians Adults: The Adventist Health Study-2.

    Science.gov (United States)

    Lousuebsakul-Matthews, Vichuda; Thorpe, Donna; Knutsen, Raymond; Beeson, W Larry; Fraser, Gary E; Knutsen, Synnove F

    2015-01-01

    The beneficial effect of physical activity on reducing hip fracture risk has been supported in many previous studies. The present cohort study explores the relationship between total daily physical activity expressed as MET-hour/day and hip fracture risk among men over 50 years of age and postmenopausal women (n=22,836). Associations between self-reported hip fracture incidence and total daily physical activity and selected lifestyle factors were assessed using Cox proportional hazard regression. In gender-specific multivariable models, total activity above average (≥ 51 MET-hours per day for men, ≥ 48 MET-hours per day for women) compared to those with sedentary lifestyle (< 40 MET-hours per day) reduced the risk of hip fracture by 60% among men (HR=0.40, 95%CI: 0.23-0.70) (Ptrend=0.002) and 48% among women (HR=0.52, 95%CI: 0.32-0.84) (Ptrend=0.01). Our findings suggest that a moderate level of physical activity and avoiding a sedentary lifestyle can reduce the risk of hip fracture among the elderly.

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  7. Martial arts fall techniques reduce hip impact forces in naive subjects after a brief period of training.

    Science.gov (United States)

    Weerdesteyn, V; Groen, B E; van Swigchem, R; Duysens, J

    2008-04-01

    Hip fractures are among the most serious consequences of falls in the elderly. Martial arts (MA) fall techniques may reduce hip fracture risk, as they are known to reduce hip impact forces by approximately 30% in experienced fallers. The purpose of this study was to investigate whether hip impact forces and velocities in MA falls would be smaller than in a 'natural' fall arrest strategy (Block) in young adults (without any prior experience) after a 30-min training session in sideways MA fall techniques. Ten subjects fell sideways from kneeling height. In order to identify experience-related differences, additional EMG data of both fall types were collected in inexperienced (n=10) and experienced fallers (n=5). Compared to Block falls, MA falls had significantly smaller hip impact forces (-17%) and velocities (-7%). EMG results revealed experience-related differences in the execution of the MA fall, indicative of less pronounced trunk rotation in the inexperienced fallers. This may explain their smaller reduction of impact forces compared to experienced fallers. In conclusion, the finding that a substantial reduction in impact forces can be achieved after a short training in MA techniques is very promising with respect to their use in interventions to prevent fall injuries.

  8. TIG and HIP joining of Reduced Activation Ferrite/Martensitic steel for the Korean ITER-TBM

    Energy Technology Data Exchange (ETDEWEB)

    Ku, Duck Young [ITER Korea, National Fusion Research Institute, Gwahangno 113, Yuseong-gu, Daejeon 305-333 (Korea, Republic of); Oh, Seungjin, E-mail: osj0423@gmail.com [Nuclear Engineering and Technology Institute, KHNP, 508 Keumbyeong-ro, Yuseong-gu, Daejeon 305-343 (Korea, Republic of); Ahn, Mu-Young; Yu, In-Keun; Kim, Duck-Hoi; Cho, Seungyon [ITER Korea, National Fusion Research Institute, Gwahangno 113, Yuseong-gu, Daejeon 305-333 (Korea, Republic of); Choi, Im-Sub; Kwon, Ki-Bum [Soles Co. LTD., 9-1 Horim-dong, Dalseo-gu, Daegu 704-249 (Korea, Republic of)

    2011-10-01

    Korea is developing a Helium Cooled Solid Breeder Test Blanket Module for ITER. The primary candidate structural material is a Reduced Activation Ferritic/Martensitic steel. The complex TBM structure requires developing joining technologies for successful fabrication. The characteristics of Tungsten Inert Gas welding and Hot Isostatic Pressing joining of RAFM steel were investigated. Metallurgical examinations showed that the steel grain size was increased after HIP joining and recovered by post joining heat treatment. Both TIG welding and HIP joining are found to be acceptable for ITER TBM based on mechanical tests and microstructure examination.

  9. The Value of Tranexamic Acid in Reducing Blood Loss following Hip Reconstruction in Children with Cerebral Palsy

    Science.gov (United States)

    Majid, I.; Alshryda, S.; Somanchi, B.; Morakis, E.; Foster, A.

    2015-01-01

    This is a retrospective study of 51 consecutive hip reconstructions in children with cerebral palsy performed between 2011 and 2013. Tranexamic acid (TXA) was used in 14 hip reconstructions only. Transfusion rate was higher, postoperative Hb was lower, and patients stayed longer in the TXA group. This did not reach a statistical significance (P = 0.75, 0.5, and 0.71, resp.). More than half of the patients who had TXA underwent bilateral hip reconstructions in comparison with 27% only in the non-TXA group. Bilateral hip reconstructions mean more surgery, more blood loss, and more blood transfusion. The patients who had TXA were significantly more disabled as evident by the higher proportions of patient with worse GMFCS levels. Although we have not been able to demonstrate the value of TXA in reducing blood loss and transfusion rate in children with CP who underwent hip reconstruction, it is hoped that an interest in exploring the value of TXA in paediatric orthopaedic surgery is generated. Ideally this should be explored further in an adequately powered, randomised controlled trial where risk of bias is minimized. PMID:26664830

  10. The Value of Tranexamic Acid in Reducing Blood Loss following Hip Reconstruction in Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    I. Majid

    2015-01-01

    Full Text Available This is a retrospective study of 51 consecutive hip reconstructions in children with cerebral palsy performed between 2011 and 2013. Tranexamic acid (TXA was used in 14 hip reconstructions only. Transfusion rate was higher, postoperative Hb was lower, and patients stayed longer in the TXA group. This did not reach a statistical significance (P = 0.75, 0.5, and 0.71, resp.. More than half of the patients who had TXA underwent bilateral hip reconstructions in comparison with 27% only in the non-TXA group. Bilateral hip reconstructions mean more surgery, more blood loss, and more blood transfusion. The patients who had TXA were significantly more disabled as evident by the higher proportions of patient with worse GMFCS levels. Although we have not been able to demonstrate the value of TXA in reducing blood loss and transfusion rate in children with CP who underwent hip reconstruction, it is hoped that an interest in exploring the value of TXA in paediatric orthopaedic surgery is generated. Ideally this should be explored further in an adequately powered, randomised controlled trial where risk of bias is minimized.

  11. Reduced length of stay following hip and knee arthroplasty in Denmark 2000-2009: from research to implementation

    DEFF Research Database (Denmark)

    Husted, Henrik; Jensen, Claus Munk; Solgaard, Søren

    2012-01-01

    Fast-track surgery is the combination of optimized clinical and organizational factors aiming at reducing convalescence and perioperative morbidity including the functional recovery resulting in reduced hospitalization. As the previous nationwide studies have demonstrated substantial variations...... in length of stay (LOS) following standardized operations such as total hip and knee arthroplasty (THA and TKA), this nationwide study was undertaken to evaluate the implementation process of fast-track THA and TKA in Denmark....

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

    Science.gov (United States)

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

    2014-03-01

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

  13. Vitamin D reduces falls and hip fractures in vascular Parkinsonism but not in Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Sato Y

    2013-04-01

    Full Text Available Yoshihiro Sato,1 Jun Iwamoto,2 Yoshiaki Honda,1 Nobuko Amano3 1Department of Neurology, Mitate Hospital, Tagawa, Japan; 2Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan; 3Department of Food and Nutrition, Tezukayama University, Nara, Japan Purpose: Vitamin D supplementation is suggested to reduce the risk of falls in older institutionalized or ambulatory individuals by 20%. The present study was undertaken to address the reduced risk, by vitamin D supplementation, of falls and hip fractures in patients with vascular Parkinsonism (VP and Parkinson’s disease (PD. Patients and methods: In the open-label-study, 94 elderly patients with VP and 92 age-matched patients with PD were followed for 2 years. All patients received 1200 IU ergocalciferol daily. The number of falls per person and incidence of hip fractures were compared between the two groups. Results: At baseline, serum 25-hydroxyvitamin D (25-OHD levels were in the deficient range (<25 nmol/L in all patients, and vitamin D treatment enhanced serum 25-OHD and 1,25-dihydroxyvitamin D levels in both groups. Improved muscle strength of lower extremities was observed in both groups. There was significant difference between the two groups in the number of falls per subject during the 2 years (1.9 ± 0.5 in the PD group and 0.8 ± 0.4 in the VP group, P < 0.001. Hip fractures occurred in seven of 88 in the PD group and one in 90 of the VP group during the 2-year study period (P = 0.035. Conclusion: It is suggested that vitamin D decreases falls and hip fractures in VP by increasing muscle strength but not in PD. Keywords: fall, hip fracture, Parkinson’s disease, vascular Parkinsonism, vitamin D

  14. Reducing the failure rate of hip resurfacing in dysplasia patients: a retrospective analysis of 363 cases.

    Science.gov (United States)

    Gaillard, Melissa D; Gross, Thomas P

    2016-06-07

    Arthritis secondary to developmental hip dysplasia often mandates implant surgery at a relatively young age. Hip resurfacing arthroplasty (HRA), compared with standard stemmed total hip arthroplasty (THA), affords a more active lifestyle including extreme-motion activities but stimulates concerns pertaining to implant failure. We addressed the primary modes of failure through a series of interventions, including a new guideline for achieving proper implant alignment through intraoperative x-rays. We then compared two sequential cohorts in a single-surgeon practice: patients with developmental dysplasia who underwent HRA before (Group 1; 121 hips in 105 patients) and after (Group 2; 242 hips in 210 patients) June 2008, at which time the four interventions were all in place. Implants in Group 2 failed less frequently within two years (0.8 % vs. 6.6 %, p = 0.002) and were more likely to have projected seven-year Kaplan-Meier survivorship (99 % vs. 89 %, p dysplasia a more active lifestyle with favorable implant survival.

  15. Zoledronic Acid in Reducing Clinical Fracture and Mortality after Hip Fracture

    DEFF Research Database (Denmark)

    Lyles, Kenneth W; Colón-Emeric, Cathleen S; Magaziner, Jay S

    2007-01-01

    BACKGROUND: Mortality is increased after a hip fracture, and strategies that improve outcomes are needed. METHODS: In this randomized, double-blind, placebo-controlled trial, 1065 patients were assigned to receive yearly intravenous zoledronic acid (at a dose of 5 mg), and 1062 patients were...... assigned to receive placebo. The infusions were first administered within 90 days after surgical repair of a hip fracture. All patients received supplemental vitamin D and calcium. The median follow-up was 1.9 years. The primary end point was a new clinical fracture. RESULTS: The rates of any new clinical...... infusion of zoledronic acid within 90 days after repair of a low-trauma hip fracture was associated with a reduction in the rate of new clinical fractures and improved survival. (ClinicalTrials.gov number, NCT00046254.)....

  16. Does Biolox Delta ceramic reduce the rate of component fractures in total hip replacement?

    Science.gov (United States)

    Massin, P; Lopes, R; Masson, B; Mainard, D

    2014-10-01

    Biolox Delta ceramic has been optimized with nano-sized, yttria-stabilized tetragonal zirconium and strontium oxide to help limit cracking propagation. Although its mechanical properties are better than those of earlier generation ceramics, existing data on this material are limited, thus the goals of this study were to determine: 1) the remaining rate of implant fracture; 2) the ideal combination of head diameter and component position. Hypothesis. We hypothesized that the use of the ceramic composite Biolox Delta had reduced the risk of implant fracture. Materials and methods. The bibliographic search (in Pubmed database with the key words «ceramic fracture» and «total hip prosthesis ») identified 46 articles on fractures in third or fourth generation ceramic components, including 5 involving Biolox Delta. Manufacturer's data and ANSM (Agence nationale de sécurité du médicament et des produits de santé) (National Agency for Safety of Drugs and Medical Products) reports were compared with the few clinical cases published in the literature. Results. According to the manufacturer (CeramTec GmbH, Plochingen, Germany), the use of Biolox Delta ceramic has reduced the rate of femoral head fractures to 0.003% compared to 0.021% with alumina ceramic. The fracture rate of liners has remained stable, at approximately 0.03%. The number of ANSM reports confirmed these tendencies. The rate of head component fractures decreases as the head diameter increases. The quality of impaction on the morse taper (cleanliness of the taper, insertion along the axis) plays an important role. Although it is generally only available for cup sizes above 50mm, a 36-mm head diameter seems to be optimal because it prevents impingement between the cup rim and the neck of the stem, without increasing micro-separation with larger diameters. Conclusion. Although Biolox Delta ceramic is more resistant to fractures than alumina ceramic, it can be fractured under suboptimal implantation

  17. Bacteria and derived products to strengthen defences and reduce risk of illness

    OpenAIRE

    Sanz, Yolanda; Palma, Giada de; Sánchez Sánchez, Esther; Medina, Marcela Susana

    2008-01-01

    [EN] This invention provides a new strain of the genus Bifidobacterium and the components of the cultivation supernatants thereof in the form of diverse preparations (functional and new foods, probiotics, symbiotics, supplements, nutraceuticals and drugs) destined to improve defences and reduce the risk of illness. The mechanisms of action thereof include: (i) regulation of intestinal glycosylation promoting that of healthy individuals, (ii) modulation of interactions between epithelial ce...

  18. Consequence of reduced necrotic bone elastic modulus in a Perthes' hip

    DEFF Research Database (Denmark)

    Salmingo, Remel A.; Skytte, Tina Lercke; Mikkelsen, Lars Pilgaard

    in the femoral head using Finite Element Analysis (FEA). Methods The femoral and necrotic bone of the affected hip of a Perthes’ patient was segmented from the MR images using Simpleware. The segmented parts were exported to SolidWorks to build the 3D solid model and Comsol for FEA. A load of 750 N (300% body...

  19. Stability of the strengthening nanoprecipitates in reduced activation ferritic steels under Fe2+ ion irradiation

    Science.gov (United States)

    Tan, L.; Katoh, Y.; Snead, L. L.

    2014-02-01

    The stability of MX-type precipitates is critical to retain mechanical properties of both reduced activation ferritic-martensitic (RAFM) and conventional FM steels at elevated temperatures. Radiation resistance of TaC, TaN, and VN nanoprecipitates irradiated up to ∼49 dpa at 500 °C using Fe2+ is investigated in this work. Transmission electron microscopy (TEM) utilized in standard and scanning mode (STEM) reveals the non-stoichiometric nature of the nanoprecipitates. Irradiation did not alter their crystalline nature. The radiation resistance of these precipitates, in an order of reduced resistance, is TaC, VN, and TaN. Particle dissolution, growth, and reprecipitation were the modes of irradiation-induced instability. Irradiation also facilitated formation of Fe2W type Laves phase limited to the VN and TaN bearing alloys. This result suggests that nitrogen level should be controlled to a minimal level in alloys to gain greater radiation resistance of the MX-type precipitates at similar temperatures as well as postpone the formation and subsequent coarsening of Laves phase.

  20. Oxinium modular femoral heads do not reduce polyethylene wear in cemented total hip arthroplasty at five years: a randomised trial of 120 hips using radiostereometric analysis.

    Science.gov (United States)

    Jonsson, B A; Kadar, T; Havelin, L I; Haugan, K; Espehaug, B; Indrekvam, K; Furnes, O; Hallan, G

    2015-11-01

    We report the five-year outcome of a randomised controlled trial which used radiostereometric analysis (RSA) to assess the influence of surface oxidised zirconium (OxZr, Oxinium) on polyethylene wear in vivo. A total of 120 patients, 85 women and 35 men with a mean age of 70 years (59 to 80) who were scheduled for primary cemented total hip arthroplasty were randomly allocated to four study groups. Patients were blinded to their group assignment and received either a conventional polyethylene (CPE) or a highly cross-linked (HXL) acetabular component of identical design. On the femoral side patients received a 28 mm head made of either cobalt-chromium (CoCr) or OxZr. The proximal head penetration (wear) was measured with repeated RSA examinations over five years. Clinical outcome was measured using the Harris hip score. There was no difference in polyethylene wear between the two head materials when used with either of the two types of acetabular component (p = 0.3 to 0.6). When comparing the two types of polyethylene there was a significant difference in favour of HXLPE, regardless of the head material used (p < 0.001). In conclusion, we found no advantage of OxZr over CoCr in terms of polyethylene wear after five years of follow-up. Our findings do not support laboratory results which have shown a reduced rate of wear with OxZr. They do however add to the evidence on the better resistance to wear of HXLPE over CPE.

  1. Fully porous 3D printed titanium femoral stem to reduce stress-shielding following total hip arthroplasty.

    Science.gov (United States)

    Arabnejad, Sajad; Johnston, Burnett; Tanzer, Michael; Pasini, Damiano

    2016-09-24

    Current hip replacement femoral implants are made of fully solid materials which all have stiffness considerably higher than that of bone. This mechanical mismatch can cause significant bone resorption secondary to stress shielding, which can lead to serious complications such as peri-prosthetic fracture during or after revision surgery. In this work, a high strength fully porous material with tunable mechanical properties is introduced for use in hip replacement design. The implant macro geometry is based off of a short stem taper-wedge implant compatible with minimally invasive hip replacement surgery. The implant micro-architecture is fine-tuned to locally mimic bone tissue properties which results in minimum bone resorption secondary to stress shielding. We present a systematic approach for the design of a 3D printed fully porous hip implant that encompasses the whole activity spectrum of implant development, from concept generation, multiscale mechanics of porous materials, material architecture tailoring, to additive manufacturing, and performance assessment via in vitro experiments in composite femurs. We show that the fully porous implant with an optimized material micro-structure can reduce the amount of bone loss secondary to stress shielding by 75% compared to a fully solid implant. This result also agrees with those of the in vitro quasi-physiological experimental model and the corresponding finite element model for both the optimized fully porous and fully solid implant. These studies demonstrate the merit and the potential of tuning material architecture to achieve a substantial reduction of bone resorption secondary to stress shielding. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

  2. A short tapered stem reduces intraoperative complications in primary total hip arthroplasty.

    Science.gov (United States)

    Molli, Ryan G; Lombardi, Adolph V; Berend, Keith R; Adams, Joanne B; Sneller, Michael A

    2012-02-01

    While short-stem design is not a new concept, interest has surged with increasing utilization of less invasive techniques. Short stems are easier to insert through small incisions. Reliable long-term results including functional improvement, pain relief, and implant survival have been reported with standard tapered stems, but will a short taper perform as well? We compared short, flat-wedge, tapered, broach-only femoral stems to standard-length, double-tapered, ream and broach femoral stems in terms of intraoperative complications, short-term survivorship, and pain and function scores. We retrospectively reviewed the records of 606 patients who had 658 THAs using a less invasive direct lateral approach from January 2006 to March 2008. Three hundred sixty patients (389 hips) had standard-length stems and 246 (269 hips) had short stems. Age averaged 63 years, and body mass index averaged 30.7 kg/m(2). We recorded complications and pain and function scores and computed short-term survival. Minimum followup was 0.8 months (mean, 29.2 months; range, 0.8-62.2 months). We observed a higher rate of intraoperative complications with the standard-length stems (3.1%; three trochanteric avulsions, nine femoral fractures) compared with the shorter stems (0.4%; one femoral fracture) and managed all complications with application of one or more cerclage cables. There were no differences in implant survival, Harris hip score, and Lower Extremity Activity Scale score between groups. Fewer intraoperative complications occurred with the short stems, attesting to the easier insertion of these devices. While longer followup is required, our early results suggest shortened stems can be used with low complication rates and do not compromise the survival and functional outcome of cementless THA. Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

  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. Hip Ultrasound

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Hip Ultrasound Hip ultrasound uses sound waves to produce pictures ... of Ultrasound Imaging of the Hip? What is Ultrasound Imaging of the Hip? Ultrasound images of the ...

  5. Effectively Exerting the Reinforcement of Dopamine Reduced Graphene Oxide on Epoxy-Based Composites via Strengthened Interfacial Bonding.

    Science.gov (United States)

    Li, Wenbin; Shang, Tinghua; Yang, Wengang; Yang, Huichuan; Lin, Song; Jia, Xiaolong; Cai, Qing; Yang, Xiaoping

    2016-05-25

    The effects of dopamine reduced graphene oxide (pDop-rGO) on the curing activity and mechanical properties of epoxy-based composites were evaluated. Taking advantage of self-polymerization of mussel-inspired dopamine, pDop-rGO was prepared through simultaneous functionalization and reduction of graphene oxide (GO) via polydopamine coating. Benefiting from the universal binding ability of polydopamine, good dispersion of pDop-rGO in epoxy matrix was able to be achieved as the content of pDop-rGO being below 0.2 wt %. Curing kinetics of epoxy composites with pDop-rGO were systematically studied by nonisothermal differential scanning calorimetry (DSC). Compared to the systems of neat epoxy or epoxy composites containing GO, epoxy composites loaded with pDop-rGO showed lower activation energy (Eα) over the range of cure (α). It revealed that the amino-bearing pDop-rGO was able to react with epoxy matrix and enhance the curing reactions as an amine-type curing agent. The nature of the interactions at GO-epoxy interface was further evaluated by Raman spectroscopy, confirming the occurrence of chemical bonding. The strengthened interfacial adhesion between pDop-rGO and epoxy matrix thus enhanced the effective stress transfer in the composites. Accordingly, the tensile and flexural properties of EP/pDop-rGO composites were enhanced due to both the well dispersion and strong interfacial bonding of pDop-rGO in epoxy matrix.

  6. General ultrasound screening reduces the rate of first operative procedures for developmental dysplasia of the hip: a case-control study.

    Science.gov (United States)

    von Kries, Rüdiger; Ihme, Nicola; Altenhofen, Lutz; Niethard, Fritz Uwe; Krauspe, Rüdiger; Rückinger, Simon

    2012-02-01

    To assess the effectiveness of general ultrasound screening to prevent first operative procedures of the hip. We conducted a case-control study in a population in which general ultrasound screening supplementing clinical screening is recommended and offered free of charge for all children. Participation in ultrasound screening before week 7 as recommended in Germany was the exposure of interest. Case ascertainment was based on active surveillance in orthopedic hospitals. The case definition was: first operative procedure for developmental dysplasia of the hip (closed reduction, open reduction, or osteotomy) in children >9 weeks old and dysplasia of the hip (n = 446) were compared with 1173 control subjects for ultrasound screening. Effectiveness of ultrasound screening to prevent first operative procedures for developmental dysplasia of the hip was estimated as 52% (95% CI, 32-67). Effectiveness did not vary substantially for closed and open reductions and osteotomy. General ultrasound screening reduces the rate of operative procedures for developmental dysplasia of the hip; the impact on developmental dysplasia of the hip. Treatment rates and avascular necrosis need further assessment to balance the benefit against potential overtreatment and adverse effects. Copyright © 2012 Mosby, Inc. All rights reserved.

  7. Medication Management in Schools: A Systems Approach to Reducing Risk and Strengthening Quality in School Medication Management

    Science.gov (United States)

    Center for Health and Health Care in Schools, 2004

    2004-01-01

    This paper and the invitational meeting for which it has been prepared make certain assumptions about the challenge of strengthening the quality of medication management in school. The participants believe that recent research on improving the safety and quality of patient care has relevance for health services in school, particularly the safety…

  8. Isolated GH deficiency due to a GHRH receptor mutation causes hip joint problems and genu valgum, and reduces size but not density of trabecular and mixed bone.

    Science.gov (United States)

    Epitácio-Pereira, Carlos C; Silva, Gabriella M F; Salvatori, Roberto; Santana, João A M; Pereira, Francisco A; Gois-Junior, Miburge B; Britto, Allan V O; Oliveira, Carla R P; Souza, Anita H O; Santos, Elenilde G; Campos, Viviane C; Pereira, Rossana M C; Valença, Eugênia H O; Barbosa, Rita A A; Farias, Maria Isabel T; de Paula, Francisco J A; Ribeiro, Taisa V; Oliveira, Mario C P; Aguiar-Oliveira, Manuel H

    2013-11-01

    The GH/IGF-I axis is important for bone growth, but its effects on joint function are not completely understood. Adult-onset GH-deficient individuals have often reduced bone mineral density (BMD). However, there are limited data on BMD in adult patients with untreated congenital isolated GH-deficient (IGHD). We have shown that adult IGHD individuals from the Itabaianinha, homozygous for the c.57+1G>A GHRHR mutation, have reduced bone stiffness, but BMD and joint status in this cohort are unknown. The goal is to study BMD, joint function, and osteoarthritis score in previously untreated IGHD adults harboring the c.57+1G>A GHRHR mutation. This is a cross-sectional study. Areal BMD by dual-energy X-ray absorptiometry was measured in 25 IGHD and 23 controls (CO). Volumetric BMD (vBMD) was calculated at the lumbar spine and total hip. Joint function was assessed by goniometry of elbow, hips, and knees. X-rays were used to measure the anatomic axis of knee and the severity of osteoarthritis, using a classification for osteophytes (OP) and joint space narrowing (JSN). Genu valgum was more prevalent in IGHD than CO. The osteoarthritis knees OP score was similar in both groups, and knees JSN score showed a trend to be higher in IGHD. The hips OP score and JSN score were higher in IGHD. Areal BMD was lower in IGHD than CO, but vBMD was similar in the two groups. Range of motion was similar in elbow, knee, and hip in IGHD and CO. Untreated congenital IGHD due to a GHRHR mutation causes hip joint problems and genu valgum, without apparent clinical significance, reduces bone size, but does not reduce vBMD of the lumbar spine and hip.

  9. Effectiveness of acute in-hospital physiotherapy with knee-extension strength training in reducing strength deficits in patients with a hip fracture

    DEFF Research Database (Denmark)

    Kronborg, Lise; Bandholm, Thomas; Palm, Henrik

    2017-01-01

    QUESTION: Is acute in-hospital physiotherapy with additional progressive knee-extension strength training (ST) of the fractured limb more effective in reducing knee-extension strength deficit at follow-up compared to physiotherapy without strength training in patients with a hip fracture? DESIGN......: Assessor blinded, randomised controlled trial with intention-to-treat analysis. PARTICIPANTS: 90 patients with a hip fracture admitted to an acute orthopaedic Hip Fracture Unit at a university hospital between October 2013 and May 2015. INTERVENTION: Daily physiotherapy with or without progressive knee...... strength training from baseline to follow-up. In the per-protocol analysis of non-missing data, significant between-group improvements by 10.5% (95% CI 0.3; 20.7) were found in favour of additional ST. No significant between-group differences were found in any secondary outcome. CONCLUSION: Physiotherapy...

  10. Can Early Rehabilitation after Total Hip Arthroplasty Reduce Its Major Complications and Medical Expenses? Report from a Nationally Representative Cohort

    Directory of Open Access Journals (Sweden)

    Daniel Chiung-Jui Su

    2015-01-01

    Full Text Available Objective. To investigate whether early rehabilitation reduces the occurrence of posttotal hip arthroplasty (THA complications, adverse events, and medical expenses within one postoperative year. Method. We retrospectively retrieve data from Taiwan’s National Health Insurance Research Database. Patients who had undergone THA during the period from 1998 to 2010 were recruited, matched for propensity scores, and divided into 2 groups: early rehabilitation (Early Rehab and delayed rehabilitation (Delayed Rehab. Results. Eight hundred twenty of 999 THA patients given early rehabilitation treatments were matched to 205 of 233 THA patients given delayed rehabilitation treatments. The Delayed Rehab group had significantly (all p<0.001 higher medical and rehabilitation expenses and more outpatient department (OPD visits than the Early Rehab group. In addition, the Delayed Rehab group was associated with more prosthetic infection (odds ratio (OR: 3.152; 95% confidence interval (CI: 1.211–8.203; p<0.05 than the Early Rehab group. Conclusions. Early rehabilitation can significantly reduce the incidence of prosthetic infection, total rehabilitation expense, total medical expenses, and number of OPD visits within the first year after THA.

  11. Comprehensive geriatric care reduces acute perioperative delirium in elderly patients with hip fractures: A meta-analysis.

    Science.gov (United States)

    Wang, Yiyang; Tang, Jun; Zhou, Feiya; Yang, Lei; Wu, Jianbin

    2017-06-01

    The aim of the current meta-analysis was to assess the treatment effect of comprehensive geriatric care in reducing acute perioperative delirium in older patients with hip fractures, compared with the effect of a routine orthopedic treatment protocol. We conducted a search of multiple databases to identify randomized controlled trials (RCTs) and quasi-RCTs comparing comprehensive geriatric care and routine orthopedic treatment regarding the following outcomes: incidence of delirium, assessment of cognitive status, and duration of delirium. Odds ratios (ORs) and mean differences (MDs) were pooled using either a fixed-effects or a random-effects model, depending on the heterogeneity of the trials included in the analysis. Six RCTs and 1 quasi-RCT provided data from 1840 patients. These data revealed that comprehensive geriatric care may reduce the incidence of perioperative delirium (OR = 0.71; 95% confidence interval [CI], 0.57-0.89; P = .003) and that it was associated with higher cognitive status during hospitalization or at 1 month postoperatively (MD = 1.03; 95% CI, 0.93-1.13; P ≤ .00001). There was no significant difference in duration of perioperative delirium between the 2 treatment groups (MD = -2.48; 95% CI, -7.36 to 2.40; P = .32). Based on the quality of evidence provided, comprehensive geriatric care may reduce the incidence of perioperative delirium. To obtain evidence regarding the merits of comprehensive geriatric care in reducing severity of delirium and shortening the duration of delirium, there is a need for multicenter RCTs with high methodological quality.

  12. Hip Ultrasound

    Science.gov (United States)

    ... be used in infants to check for developmental dysplasia of the hip. Ultrasound is safe, noninvasive, and does not use ... be used to check the hips for developmental dysplasia of the hip (DDH), which in infants can range from a ...

  13. Hip Fracture

    Science.gov (United States)

    Diseases and Conditions Hip fracture By Mayo Clinic Staff A hip fracture is a serious injury, with complications that can be life-threatening. The risk of hip fracture rises with age. Older people are at a ...

  14. Can Surgeons Reduce the Risk for Dislocation After Primary Total Hip Arthroplasty Performed Using the Posterolateral Approach?

    DEFF Research Database (Denmark)

    Seagrave, Kurt G; Troelsen, Anders; Madsen, Bjørn G

    2017-01-01

    receiving THA via the posterolateral approach. METHODS: We assessed 1326 consecutive primary THAs performed between 2010 and 2015. Patient information was documented, and plain radiographic films were used to evaluate cup positioning, hip offset, and hip length change. A multiple logistic regression...... compared with that in nondislocating THA. Independent risk factors for cup dislocation were increased age, body mass index 30 kg/m(2), and leg shortening of >5 mm. CONCLUSION: Surgeons should aim for a shortening of leg length primary THA...

  15. Punching strengthen

    Directory of Open Access Journals (Sweden)

    Hazem M.F. Elbakry

    2015-12-01

    Full Text Available An experimental and analytical study on the punching strengthening of reinforced concrete two-way slabs using external steel plates is presented. Five reinforced concrete square slabs of 100 mm thickness were tested over simply supported four sides of 1000 mm span under central square patch load of 100 mm size up to failure. One control slab was tested without strengthening; however, four tested slabs were strengthened using four configurations of square steel plates provided with steel anchor shear studs. Such configurations considered two different plate thickness, two plate side dimensions and different arrangement and diameter of shear studs. The strengthened four slabs showed improved stiffness and punching shear capacity. The magnitude of improvement depended on the plate dimensions and the studs diameter and arrangement. An analytical approach was proposed for predicting the punching shear strength increase due to using the strengthening steel plate. The proposed approach was applied to the tested specimens with the use of the punching shear strength equations adopted by several codes of practice and proved to be in good agreement with the test results. Generally, this research presented a practical strengthening concept that can be used to increase the punching shear capacity of two-way slabs.

  16. Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults: results from the study of hyperkyphosis, exercise, and function (SHEAF) randomized controlled trial.

    Science.gov (United States)

    Katzman, W B; Vittinghoff, E; Lin, F; Schafer, A; Long, R K; Wong, S; Gladin, A; Fan, B; Allaire, B; Kado, D M; Lane, N E

    2017-07-08

    A 6-month randomized controlled trial of spine-strengthening exercise and posture training reduced both radiographic and clinical measures of kyphosis. Participants receiving the intervention improved self-image and satisfaction with their appearance. Results suggest that spine-strengthening exercise and postural training may be an effective treatment option for older adults with hyperkyphosis. The purpose of the present study is to determine in a randomized controlled trial whether spine-strengthening exercises improve Cobb angle of kyphosis in community-dwelling older adults. We recruited adults ≥60 years with kyphosis ≥40° and enrolled 99 participants (71 women, 28 men), mean age 70.6 ± 0.6 years, range 60-88, with baseline Cobb angle 57.4 ± 12.5°. The intervention included group spine-strengthening exercise and postural training, delivered by a physical therapist, 1-h, three times weekly for 6 months. Controls received four group health education meetings. The primary outcome was change in the gold standard Cobb angle of kyphosis measured from standing lateral spine radiographs. Secondary outcomes included change in kyphometer-measured kyphosis, physical function (modified Physical Performance Test, gait speed, Timed Up and Go, Timed Loaded Standing, 6-Min Walk), and health-related quality of life (HRQoL) (PROMIS global health and physical function indexes, SRS-30 self-image domain). ANCOVA was used to assess treatment effects on change from baseline to 6 months in all outcomes. There was a -3.0° (95% CI -5.2, -0.8) between-group difference in change in Cobb angle, p = 0.009, favoring the intervention and approximating the magnitude of change from an incident vertebral fracture. Kyphometer-measured kyphosis (p = 0.03) and SRS-30 self-esteem (p  0.05. Spine-strengthening exercise and posture training over 6 months reduced kyphosis compared to control. Our randomized controlled trial results suggest that a targeted kyphosis

  17. Clinical decision making in a patient with secondary hip-spine syndrome.

    Science.gov (United States)

    Burns, Scott A; Mintken, Paul E; Austin, Gary P

    2011-07-01

    The prevalence of lumbar and hip pathology is on the rise; however, treatment outcomes have not improved, highlighting the difficulty in identifying and treating the correct impairments. The purpose of this case report is to describe the clinical decision making in the examination and treatment of an individual with secondary hip-spine syndrome. Our case study was a 62-year-old male with low back pain with concomitant right hip pain. His Oswestry Disability Index (ODI) was 18%, back numeric pain rating scale (NPRS) was 4/10, fear avoidance beliefs questionnaire (FABQ) work subscale was 0, FABQ physical activity subscale was 18, and patient specific functional scale (PSFS) was 7.33. Physical examination revealed findings consistent with secondary hip-spine syndrome. He was treated for four visits with joint mobilization/manipulation and strengthening exercises directed at the hip. At discharge, all standardized outcome measures achieved full resolution. Clinical decision making in the presence of lumbopelvic-hip pain is often difficult. Previous literature has shown that some patients with lumbopelvic-hip pain respond favorably to manual therapy and exercise targeting regions adjacent to the lumbar spine. The findings of this case report suggest that individuals with a primary complaint of LBP with hip impairments may benefit from interventions to reduce hip impairments.

  18. Increased intake of vegetables, but not fruits, may be associated with reduced risk of hip fracture: A meta-analysis

    Science.gov (United States)

    Luo, Si yang; Li, Yan; Luo, Hong; Yin, Xin hai; Lin, Du ren; Zhao, Ke; Huang, Guang lei; Song, Ju kun

    2016-01-01

    Association between dietary intake of vegetables and fruits and risk of hip fracture has been reported for many years. However, the findings remain inconclusive. We conducted a meta-analysis to evaluate the relationship between intake of vegetables and fruits, and risk of hip fracture. Literature search for relevant studies was performed on PubMed and Embase databases. Five observational studies were included in the meta-analysis. Summary hazard ratio (HR) with corresponding 95% confidence interval (CI) was calculated from pooled data using the random-effects model irrespective of heterogeneity. Sensitivity and subgroup analysis were performed to explore possible reasons for heterogeneity. The summary HR for hip fracture in relation to high intake vs. low intake of only vegetables, only fruits, and combined intake of fruits and vegetables, was 0.75 (95% CI, 0.61–0.92), 0.87 (95% CI, 0.74–1.04), and 0.79 (95% CI, 0.61–1.03), respectively. Subgroup analyses based on study design, geographical location, number of cases, and gender showed similar results. Increased intake of vegetables, but not fruits, was found to be associated with a lower risk of hip fracture. Large prospective clinical trials with robust methodology are required to confirm our findings. PMID:26806285

  19. Stability of the strengthening nanoprecipitates in reduced activation ferritic steels under Fe{sup 2+} ion irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Tan, L., E-mail: tanl@ornl.gov; Katoh, Y.; Snead, L.L.

    2014-02-01

    The stability of MX-type precipitates is critical to retain mechanical properties of both reduced activation ferritic–martensitic (RAFM) and conventional FM steels at elevated temperatures. Radiation resistance of TaC, TaN, and VN nanoprecipitates irradiated up to ∼49 dpa at 500 °C using Fe{sup 2+} is investigated in this work. Transmission electron microscopy (TEM) utilized in standard and scanning mode (STEM) reveals the non-stoichiometric nature of the nanoprecipitates. Irradiation did not alter their crystalline nature. The radiation resistance of these precipitates, in an order of reduced resistance, is TaC, VN, and TaN. Particle dissolution, growth, and reprecipitation were the modes of irradiation-induced instability. Irradiation also facilitated formation of Fe{sub 2}W type Laves phase limited to the VN and TaN bearing alloys. This result suggests that nitrogen level should be controlled to a minimal level in alloys to gain greater radiation resistance of the MX-type precipitates at similar temperatures as well as postpone the formation and subsequent coarsening of Laves phase.

  20. A hip abduction exercise prior to prolonged standing increased movement while reducing cocontraction and low back pain perception in those initially reporting low back pain.

    Science.gov (United States)

    Viggiani, Daniel; Callaghan, Jack P

    2016-12-01

    Persons who develop low back pain from prolonged standing exhibit increased muscle cocontraction, decreased movement and increased spine extension. However, it is unclear how these factors relate to pain development. The purpose of this study was to use hip abductor fatigue to manipulate muscle activity patterns and determine its effects on standing behaviours and pain development. Forty participants stood for two hours twice, once following a hip abductor fatigue exercise (fatigue), and once without exercise beforehand (control). Trunk and gluteal muscle activity were measured to determine cocontraction. Lumbo-pelvic angles and force plates were used to assess posture and movement strategies. Visual analog scales differentiated pain (PDs) and non-pain developers (NPDs). PDs reported less low back pain during the fatigue session, with females having earlier reductions of similar scale than males. The fatigue session reduced gluteal and trunk cocontraction and increased centre of pressure movement; male and female PDs had opposing spine posture compensations. Muscle fatigue prior to standing reduced cocontraction, increased movement during standing and reduced the low back pain developed by PDs; the timing of pain reductions depended on spine postures adopted during standing. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. HIP osteoarthritis and work.

    Science.gov (United States)

    Harris, E Clare; Coggon, David

    2015-06-01

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

  2. Surgical hip dislocation for treatment of cam femoroacetabular impingement

    Directory of Open Access Journals (Sweden)

    Milind M Chaudhary

    2015-01-01

    Conclusion: Cam femoroacetabular Impingement causing pain and limitation of hip movements was treated by open osteochondroplasty after surgical hip dislocation. This reduced pain, improved hip motion and gave good to excellent results in the short term.

  3. Prevention of hip fractures.

    Science.gov (United States)

    Meunier, P J

    1993-11-30

    For a 50-year old Caucasian woman today, the risk of a hip fracture over her remaining life-time is about 17%. Tomorrow the situation will clearly be worse because the continuous increase in life expectancy will cause a three-fold increase in worldwide fracture incidence over the next 60 years. Through diagnostic bone mass measurements at the hip and assessment of biochemical parameters, a great deal has been learned in recent years about reduction of hip fracture risk. Preventive strategies are based on prevention of falls, use of hip protectors, and prevention of bone fragility. The latter includes the optimization of peak bone mass during childhood, postmenopausal estrogen replacement therapy, and also late prevention consisting in reversing senile secondary hyperparathyroidism, which plays an important role in the decrease of skeletal strength. This secondary hyperparathyroidism, which results from both vitamin D insufficiency and low calcium intake, is preventable with vitamin D3 and calcium supplements. They have recently been shown capable of providing effective prevention of hip fractures in elderly women living in nursing homes, with a reduction of about 25% in the number of hip fractures noted in a 3-year controlled study in 3,270 women (intention-to-treat analysis). In conclusion, it is never too early to reduce the risk of osteoporosis and never too late to prevent hip fractures.

  4. High Eccentric Hip Abduction Strength Reduces the Risk of Developing Patellofemoral Pain Among Novice Runners Initiating a Self-Structured Running Program

    DEFF Research Database (Denmark)

    Ramskov, Daniel; Barton, Christian; Nielsen, R.O.

    2015-01-01

    indicates gluteal muscle weakness in individuals with PFP. However, current prospective research is limited to evaluation of isometric strength, producing inconsistent findings. Considering hip muscles including gluteus maximus and medius activate eccentrically to control hip and pelvic motion during weight...

  5. Polycrystalline strengthening

    DEFF Research Database (Denmark)

    Hansen, Niels

    1985-01-01

    . The strength-grain size relationships can be described in a number of empirical equations relating the yield stress and the flow stress in tension to various structural parameters. A number of such equations are reviewed and their predictive capability is discussed. Structural information of importance...... found, and this structural information is correlated with a number of strength structural equations. Finally, the flow stress of fcc and bcc polycrystalline specimens is related to the occurrence of microstructures formed by macroscopic and microscopic strain accommodation processes during plastic...... for the understanding of polycrystalline strengthening is obtained mainly from surface relief patterns and from bulk structures observed by transmission electron microscopy of thin foils. The results obtained by these methods are discussed and correlations are proposed. A number of features characterizing the deformed...

  6. [Juvenile hip pain. 2. Femur head epiphysiolysis, hip dysplasia, tumors].

    Science.gov (United States)

    Hackenbruch, W; von Gumppenberg, S; Karpf, P M

    1978-11-09

    The early symptom in hip joint diseases in children is pain. Pain is localized in the groin and thight, but mostly in the knee. Other important signs are limping and reduced internal rotation. If a hip disease is suspected it is necessary to take X-rays in two planes. If diagnosis is early and special therapy started immediately, the results are usually excellent without deformation of the hip. Otherwise early osteoarthritis can develop. This is important because osteoarthritis in the hip joint is in 75% of the cases due to hip joint diseases in childhood. The problems of diagnosis and treatment of the most common hip joint diseases in children (transient synovitis, rheumatoid arthritis, osteomyelitis, Legg-Perthes disease, slipped capital femoral epiphysis, dysplasia, tumors) are discussed.

  7. EPA Strengthens Ozone Standards to Protect Public Health/Science-based standards to reduce sick days, asthma attacks, emergency room visits, greatly outweigh costs

    Science.gov (United States)

    WASHINGTON - Based on extensive scientific evidence on effects that ground-level ozone pollution, or smog, has on public health and welfare, the U.S. Environmental Protection Agency (EPA) has strengthened the National Ambient Air Quality Standards (

  8. Does a micro-grooved trunnion stem surface finish improve fixation and reduce fretting wear at the taper junction of total hip replacements? A finite element evaluation.

    Science.gov (United States)

    Ashkanfar, Ariyan; Langton, David J; Joyce, Thomas J

    2017-08-10

    The generation of particulate debris at the taper junction of total hip replacements (THRs), can cause failure of the artificial hip. The taper surfaces of femoral heads and trunnions of femoral stems are generally machined to a certain roughness to enhance fixation. However, the effect of the surface roughness of these surfaces on the fixation, wear and consequently clinical outcomes of the design is largely unknown. In this study, we asked whether a micro-grooved trunnion surface finish (1) improves the fixation and (2) reduces the wear rate at the taper junction of THRs. We used 3D finite element (FE) models of THRs to, firstly, investigate the effect of initial fixation of a Cobalt-Chromium femoral head with a smooth taper surface mated with a Titanium (1) micro-grooved and (2) smooth, trunnion surface finishes. Secondly, we used a computational FE wear model to compare the wear evolution between the models, which was then validated against wear measurements of the taper surface of explanted femoral heads. The fixation at the taper junction was found to be better for the smooth couplings. Over a 7 million load cycle analysis in-silico, the linear wear depth and the total material loss was around 3.2 and 1.4 times higher for the femoral heads mated with micro-grooved trunnions. It was therefore concluded that smooth taper and trunnion surfaces will provide better fixation at the taper junction and reduce the volumetric wear rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. as the Strengthening Precipitates

    Science.gov (United States)

    Lu, Qi; Xu, Wei; van der Zwaag, Sybrand

    2014-12-01

    Generally, Laves phase and M23C6 are regarded as undesirable phases in creep-resistant steels due to their very high-coarsening rates and the resulting depletion of beneficial alloying elements from the matrix. In this study, a computational alloy design approach is presented to develop martensitic steels strengthened by Laves phase and/or M23C6, for which the coarsening rates are tailored such that they are at least one order of magnitude lower than those in existing alloys. Their volume fractions are optimized by tuning the chemical composition in parallel. The composition domain covering 10 alloying elements at realistic levels is searched by a genetic algorithm to explore the full potential of simultaneous maximization of the volume fraction and minimization of the precipitates coarsening rate. The calculations show that Co and W can drastically reduce the coarsening rate of Laves and M23C6 and yield high-volume fractions of precipitates. Mo on the other hand was shown to have a minimal effect on coarsening. The strengthening effects of Laves phase and M23C6 in the newly designed alloys are compared to existing counterparts, showing substantially higher precipitation-strengthening contributions especially after a long service time. New alloys were designed in which both Laves phase and M23C6 precipitates act as strengthening precipitates. Successfully combining MX and M23C6 was found to be impossible.

  10. Hip arthroscopy

    Directory of Open Access Journals (Sweden)

    Henrique Antônio Berwanger de Amorim Cabrita

    2015-06-01

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

  11. Rose Hip

    Science.gov (United States)

    ... dropsy or edema), gout, back and leg pain (sciatica), diabetes, high cholesterol, weight loss, high blood pressure, ... Painful menstruation. Some evidence suggests that applying an aromatherapy formula containing lavender, clary sage, and rose hip ...

  12. 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.

  13. Vitamin D reduces falls and hip fractures in vascular Parkinsonism but not in Parkinson’s disease

    OpenAIRE

    Sato Y; Iwamoto J; Honda Y; Amano N.

    2013-01-01

    Yoshihiro Sato,1 Jun Iwamoto,2 Yoshiaki Honda,1 Nobuko Amano3 1Department of Neurology, Mitate Hospital, Tagawa, Japan; 2Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan; 3Department of Food and Nutrition, Tezukayama University, Nara, Japan Purpose: Vitamin D supplementation is suggested to reduce the risk of falls in older institutionalized or ambulatory individuals by 20%. The present study was undertaken to address the reduced risk, by vitamin D s...

  14. A cost-effectiveness modelling study of strategies to reduce risk of infection following primary hip replacement based on a systematic review.

    Science.gov (United States)

    Graves, Nicholas; Wloch, Catherine; Wilson, Jennie; Barnett, Adrian; Sutton, Alex; Cooper, Nicola; Merollini, Katharina; McCreanor, Victoria; Cheng, Qinglu; Burn, Edward; Lamagni, Theresa; Charlett, Andre

    2016-07-01

    A deep infection of the surgical site is reported in 0.7% of all cases of total hip arthroplasty (THA). This often leads to revision surgery that is invasive, painful and costly. A range of strategies is employed in NHS hospitals to reduce risk, yet no economic analysis has been undertaken to compare the value for money of competing prevention strategies. To compare the costs and health benefits of strategies that reduce the risk of deep infection following THA in NHS hospitals. To make recommendations to decision-makers about the cost-effectiveness of the alternatives. The study comprised a systematic review and cost-effectiveness decision analysis. 77,321 patients who had a primary hip arthroplasty in NHS hospitals in 2012. Nine different treatment strategies including antibiotic prophylaxis, antibiotic-impregnated cement and ventilation systems used in the operating theatre. Change in the number of deep infections, change in the total costs and change in the total health benefits in quality-adjusted life-years (QALYs). Literature searches using MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trials were undertaken to cover the period 1966-2012 to identify infection prevention strategies. Relevant journals, conference proceedings and bibliographies of retrieved papers were hand-searched. Orthopaedic surgeons and infection prevention experts were also consulted. English-language papers only. The selection of evidence was by two independent reviewers. Studies were included if they were interventions that reported THA-related deep surgical site infection (SSI) as an outcome. Mixed-treatment comparisons were made to produce estimates of the relative effects of competing infection control strategies. Twelve studies, six randomised controlled trials and six observational studies, involving 123,788 total hip replacements (THRs) and nine infection control strategies, were identified. The quality of

  15. INL HIP Plate Fabrication

    Energy Technology Data Exchange (ETDEWEB)

    B. H. Park; C. R. Clark; J. F. Jue

    2010-02-01

    This document outlines the process used to bond monolithic fuel plates by Hot Isostatic Pressing (HIP). This method was developed at Idaho National Laboratory (INL) for the Reduced Enrichment for Research and Test Reactors (RERTR) program. These foils have been used in a number of irradiation experiments in support of the United States Global Threat Reduction Initiative (GTRI) program.

  16. Hip Microfracture

    Science.gov (United States)

    McGill, Kevin C.; Bush-Joseph, Charles A.; Nho, Shane J.

    2010-01-01

    Microfracture is a marrow-stimulating technique used in the hip to treat cartilage defects associated with femoro-acetabular impingement, instability, or traumatic hip injury. These defects have a low probability of healing spontaneously and therefore often require surgical intervention. Originally adapted from the knee, microfracture is part of a spectrum of cartilage repair options that include palliative procedures such as debridement and lavage, reparative procedures such as marrow-stimulating techniques (abrasion arthroplasty and microfracture), and restorative procedures such as autologous chondrocyte implantation and osteochondral allograft/autografts. The basic indications for microfracture of the hip include focal and contained lesions typically less than 4 cm in diameter, full-thickness (Outerbridge grade IV) defects in weightbearing areas, unstable lesions with intact subchondral bone, and focal lesions without evidence of surrounding chondromalacia. Although not extensively studied in the hip, there are some small clinical series with promising early outcomes. Although the widespread use of microfracture in the hip is hindered by difficulties in identifying lesions on preoperative imaging and instrumentation to circumvent the femoral head, this technique continues to gain acceptance as an initial treatment for small, focal cartilage defects. PMID:26069544

  17. Electrical stimulation and muscle strengthening.

    Science.gov (United States)

    Dehail, P; Duclos, C; Barat, M

    2008-07-01

    To identify the effects of application methods and indications of direct muscle electrostimulation on strength gain. Literature review and analysis of articles from Medline database with the following entries: muscular or neuromuscular, electromyostimulation, electrical stimulation, strengthening, strength training, immobilization, muscle dystrophy, bed-rest, bed-bound, knee or hip surgery, postoperative phase, cachexia, sarcopenia, and their French equivalent. Because of its specific muscle recruitment order, different from that of voluntary contraction, direct muscle electrostimulation is theoretically a complementary tool for muscle strengthening. It can be used in healthy subjects and in several affections associated with muscle function loss. Its interest seems well-established for post-traumatic or postsurgery lower-limb immobilizations but too few controlled studies have clearly shown the overall benefits of its application in other indications. Whatever the indication, superimposed or combined electrostimulation techniques are generally more efficient than electrostimulation alone. Even though widely used, the level of evidence for the efficiency of electromyostimulation is still low. For strength gains, it yielded no higher benefits than traditional strengthening methods. Its interest should be tested in medical affections leading to major muscle deconditioning or in sarcopenia.

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

    Science.gov (United States)

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

    2008-01-01

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

  19. Increased external hip-rotation strength relates to reduced frontal-plane knee control during drop jumping in recreational female athletes: paradox or adaptation?

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Thorborg, Kristian; Andersson, Elin;

    2011-01-01

    The purpose of the present study was to examine the relationship between hip muscle strength (abduction and external rotation) and frontal-plane knee control during drop jumping in recreational female athletes. Thirty-three healthy young recreational female athletes were included. Maximal isometric...... hip abduction and external rotation torque were measured using hand-held dynamometry, and frontal-plane knee control during drop jumping was assessed using three-dimensional motion analysis. Frontal-plane knee control during drop jumping was expressed as the absolute (cm) and relative (cm/cm body...... in knee marker distance during drop jumping. Maximal hip-abduction torque did not correlate with the absolute (r=0.18, P=0.31) or relative (r=0.19, P=0.29) change in knee marker distance during drop jumping. Contrary to our expectations, greater maximal external hip-rotation torque was related to greater...

  20. Reducing the effects of metal artefact using high keV monoenergetic reconstruction of dual energy CT (DECT) in hip replacements

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, Mark [Norfolk and Norwich University Hospital, Norwich (United Kingdom); Norwich Radiology Academy, Norwich (United Kingdom); Reid, Karen [Norfolk and Norwich University Hospital, Norwich (United Kingdom); Toms, Andoni P. [Norfolk and Norwich University Hospital and University of East Anglia, Norwich (United Kingdom)

    2013-02-15

    The aim of this study was to determine whether high keV monoenergetic reconstruction of dual energy computed tomography (DECT) could be used to overcome the effects of beam hardening artefact that arise from preferential deflection of low energy photons. Two phantoms were used: a Charnley total hip replacement set in gelatine and a Catphan 500. DECT datasets were acquired at 100, 200 and 400 mA (Siemens Definition Flash, 100 and 140 kVp) and reconstructed using a standard combined algorithm (1:1) and then as monoenergetic reconstructions at 10 keV intervals from 40 to 190 keV. Semi-automated segmentation with threshold inpainting was used to obtain the attenuation values and standard deviation (SD) of the streak artefact. High contrast line pair resolution and background noise were assessed using the Catphan 500. Streak artefact is progressively reduced with increasing keV monoenergetic reconstructions. Reconstruction of a 400 mA acquisition at 150 keV results in reduction in the volume of streak artefact from 65 cm{sup 3} to 17 cm{sup 3} (74 %). There was a decrease in the contrast to noise ratio (CNR) at higher tube voltages, with the peak CNR seen at 70-80 keV. High contrast spatial resolution was maintained at high keV values. Monoenergetic reconstruction of dual energy CT at increasing theoretical kilovoltages reduces the streak artefact produced by beam hardening from orthopaedic prostheses, accompanied by a modest increase in heterogeneity of background image attenuation, and decrease in contrast to noise ratio, but no deterioration in high contrast line pair resolution. (orig.)

  1. Strengthening cancer biology research, prevention, and control while reducing cancer disparities: student perceptions of a collaborative master's degree program in cancer biology, preventions, and control.

    Science.gov (United States)

    Jillson, I A; Cousin, C E; Blancato, J K

    2013-09-01

    This article provides the findings of a survey of previous and current students in the UDC/GU-LCCC master's degree program. This master's degree program, Cancer Biology, Prevention, and Control is administered and taught jointly by faculty of a Minority Serving Institution, the University of the District of Columbia, and the Lombardi Comprehensive Cancer Center to incorporate the strengths of a community-based school with a research intensive medical center. The program was initiated in 2008 through agreements with both University administrations and funding from the National Cancer Institute. The master's degree program is 36 credits with a focus on coursework in biostatistics, epidemiology, tumor biology, cancer prevention, medical ethics, and cancer outreach program design. For two semesters during the second year, students work full-time with a faculty person on a laboratory or outreach project that is a requirement for graduation. Students are supported and encouraged to transition to a doctoral degree after they obtain the master's and many of them are currently in doctorate programs. Since the inception of the program, 45 students have initiated the course of study, 28 have completed the program, and 13 are currently enrolled in the program. The survey was designed to track the students in their current activities, as well as determine which courses, program enhancements, and research experiences were the least and most useful, and to discern students' perceptions of knowledge acquired on various aspects of Cancer Biology Prevention, and Control Master's Program. Thirty of the 35 individuals to whom email requests were sent responded to the survey, for a response rate of 85.7%. The results of this study will inform the strengthening of the Cancer Biology program by the Education Advisory Committee. They can also be used in the development of comparable collaborative master's degree programs designed to address the significant disparities in prevalence of

  2. Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Blønd, Lars; Sonne-Holm, Stig;

    2003-01-01

    INTRODUCTION: We performed a prospective, randomized, double-blind study on 40 patients scheduled for primary total hip arthroplasty due to arthrosis or osteonecrosis to determine the effect of tranexamic acid on per- and postoperative blood losses and on the number of blood transfusions needed...

  3. Hip flexor strain - aftercare

    Science.gov (United States)

    ... flexor - aftercare; Hip flexor injury - aftercare; Hip flexor tear - aftercare; Iliopsoas strain - aftercare; Strained iliopsoas muscle - aftercare; Torn iliopsoas muscle - aftercare; Psoas strain - aftercare

  4. Imaging findings of anterior hip dislocations

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-06-15

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

  5. Economic viability of geriatric hip fracture centers.

    Science.gov (United States)

    Clement, R Carter; Ahn, Jaimo; Mehta, Samir; Bernstein, Joseph

    2013-12-01

    Management of geriatric hip fractures in a protocol-driven center can improve outcomes and reduce costs. Nonetheless, this approach has not spread as broadly as the effectiveness data would imply. One possible explanation is that operating such a center is not perceived as financially worthwhile. To assess the economic viability of dedicated hip fracture centers, the authors built a financial model to estimate profit as a function of costs, reimbursement, and patient volume in 3 settings: an average US hip fracture program, a highly efficient center, and an academic hospital without a specific hip fracture program. Results were tested with sensitivity analysis. A local market analysis was conducted to assess the feasibility of supporting profitable hip fracture centers. The results demonstrate that hip fracture treatment only becomes profitable when the annual caseload exceeds approximately 72, assuming costs characteristic of a typical US hip fracture program. The threshold of profitability is 49 cases per year for high-efficiency hip fracture centers and 151 for the urban academic hospital under review. The largest determinant of profit is reimbursement, followed by costs and volume. In the authors’ home market, 168 hospitals offer hip fracture care, yet 85% fall below the 72-case threshold. Hip fracture centers can be highly profitable through low costs and, especially, high revenues. However, most hospitals likely lose money by offering hip fracture care due to inadequate volume. Thus, both large and small facilities would benefit financially from the consolidation of hip fracture care at dedicated hip fracture centers. Typical US cities have adequate volume to support several such centers.

  6. Ultrasound: Infant Hip

    Science.gov (United States)

    ... ultrasound when they suspect a problem called developmental dysplasia of the hip (DDH) . DDH is a hip deformity that can ... THIS TOPIC X-Ray Exam: Leg Length Developmental Dysplasia of the Hip X-Ray Exam: Hip Contact Us Print Resources ...

  7. Hip Resurfacing. Case presentation.

    Directory of Open Access Journals (Sweden)

    Pedro Gonzalo González González

    2008-12-01

    Full Text Available Hip resurfacing in youngest patients is an excellent surgical technique for Avascular Necrosis compare with a traditional Total Hip Replacement. Report about a 21 years old female patient involved in a car accident in February 2004 with Fracture of the neck of femur treated with compression hip screw Richard’s type. Two years later the patient was diagnose with avascular necrosis of the contra lateral hip. Hip resurfacing Metal-Metal was carry out in the above mentioned patient.

  8. Value-of-Information Analysis to Reduce Decision Uncertainty Associated with the Choice of Thromboprophylaxis after Total Hip Replacement in the Irish Healthcare Setting.

    LENUS (Irish Health Repository)

    McCullagh, Laura

    2012-06-05

    Background: The National Centre for Pharmacoeconomics, in collaboration with the Health Services Executive, considers the cost effectiveness of all new medicines introduced into Ireland. Health Technology Assessments (HTAs) are conducted in accordance with the existing agreed Irish HTA guidelines. These guidelines do not specify a formal analysis of value of information (VOI). Objective: The aim of this study was to demonstrate the benefits of using VOI analysis in decreasing decision uncertainty and to examine the viability of applying these techniques as part of the formal HTA process for reimbursement purposes within the Irish healthcare system. Method: The evaluation was conducted from the Irish health payer perspective. A lifetime model evaluated the cost effectiveness of rivaroxaban, dabigatran etexilate and enoxaparin sodium for the prophylaxis of venous thromboembolism after total hip replacement. The expected value of perfect information (EVPI) was determined directly from the probabilistic analysis (PSA). Population-level EVPI (PEVPI) was determined by scaling up the EVPI according to the decision incidence. The expected value of perfect parameter information (EVPPI) was calculated for the three model parameter subsets: probabilities, preference weights and direct medical costs. Results: In the base-case analysis, rivaroxaban dominated both dabigatran etexilate and enoxaparin sodium. PSA indicated that rivaroxaban had the highest probability of being the most cost-effective strategy over a threshold range of &U20AC;0-&U20AC;100 000 per QALY. At a threshold of &U20AC;45 000 per QALY, the probability that rivaroxaban was the most cost-effective strategy was 67%. At a threshold of &U20AC;45 000 per QALY, assuming a 10-year decision time horizon, the PEVPI was &U20AC;11.96 million and the direct medical costs subset had the highest EVPPI value (&U20AC;9.00 million at a population level). In order to decrease uncertainty, a more detailed costing

  9. Does reduced movement restrictions and use of assistive devices affect rehabilitation outcome after total hip replacement? A non-randomized, controlled study in 365 patients with six week follow up

    DEFF Research Database (Denmark)

    Mikkelsen, Lone Ramer; Petersen, Annemette Krintel; Søballe, Kjeld

    a standard package of assistive devices (restricted group, RG). This group was compared to patients included into the study the following 3 months with a less restricted hip movement regime and use of assistive devices according to individual needs (unrestricted group, UG). Questionnaires on function...... (difference ≤5 points). Yet, there is a beneficial or equal effect of the unrestricted regime concerning secondary outcomes. It seems possible to reduce the use of assistive devices considerably and thereby induce cost savings. More research on safety issues is needed to elucidate the effect of unrestricted...

  10. Reduced hospital stay and narcotic consumption, and improved mobilization with local and intraarticular infiltration after hip arthroplasty: a randomized clinical trial of an intraarticular technique versus epidural infusion in 80 patients

    DEFF Research Database (Denmark)

    Andersen, Karen Vestergaard; Pfeiffer-Jensen, Mogens; Haraldsted, Viggo;

    2007-01-01

    BACKGROUND: Epidural analgesia gives excellent pain relief but is associated with substantial side effects. We compared wound infiltration combined with intraarticular injection of local anesthetics for pain relief after total hip arthroplasty (THA) with the well-established practice of epidural....../mL at the conclusion of surgery combined with one postoperative intraarticular injection of the same substances through an intraarticular catheter (group A). RESULTS: Narcotic consumption was significantly reduced in group A compared to group E (p = 0.004). Pain levels at rest and during mobilization were similar...

  11. Hip fracture: diagnosis, treatment, and secondary prevention.

    Science.gov (United States)

    LeBlanc, Kim Edward; Muncie, Herbert L; LeBlanc, Leanne L

    2014-06-15

    Hip fractures cause significant morbidity and are associated with increased mortality. Women experience 80% of hip fractures, and the average age of persons who have a hip fracture is 80 years. Most hip fractures are associated with a fall, although other risk factors include decreased bone mineral density, reduced level of activity, and chronic medication use. Patients with hip fractures have pain in the groin and are unable to bear weight on the affected extremity. During the physical examination, displaced fractures present with external rotation and abduction, and the leg will appear shortened. Plain radiography with cross-table lateral view of the hip and anteroposterior view of the pelvis usually confirms the diagnosis. If an occult hip fracture is suspected and plain radiography is normal, magnetic resonance imaging should be ordered. Most fractures are treated surgically unless the patient has significant comorbidities or reduced life expectancy. The consulting orthopedic surgeon will choose the surgical procedure. Patients should receive prophylactic antibiotics, particularly against Staphylococcus aureus, before surgery. In addition, patients should receive thromboembolic prophylaxis, preferably with low-molecular-weight heparin. Rehabilitation is critical to long-term recovery. Unless contraindicated, bisphosphonate therapy should be used to reduce the risk of another hip fracture. Some patients may benefit from a fall-prevention assessment.

  12. Talking about how to strengthen cost management and reduce project cost%谈如何加强成本管理降低项目成本

    Institute of Scientific and Technical Information of China (English)

    李元英

    2011-01-01

    This paper summarizes many building construction project cost management experience, describes cost influences and controlling from aspects of organization setting, cost check, technological progress, quality and security etc, and proposes several measures on how to reduce project cost, with a view to improve enterprise economic benefits.%总结了众多建筑施工项目成本管理的经验,从机构设置、成本核算、技术进步、质量和安全等方面对成本的影响和控制进行了阐述,提出了如何降低项目成本的几个措施,以提高企业经济效益。

  13. Efficacy of posterolateral hip muscles strengthening on patellofemoral pain

    Directory of Open Access Journals (Sweden)

    Ramandeep Kaur

    2016-07-01

    Results: Significant improvements in VAS and WOMAC scores were observed in both groups from 0th-week to 2nd week and 0-week to 4th-week follow-up (P<0.05. Improvements in VAS and WOMAC scores in group B were superior to those in group A at 4-week follow-up (P<0.05. Conclusions: The present study has concluded that both Group A and Group B were effective in the management of patello-femoral pain but statistically it was concluded that Group B is more effective as compared to Group A. [Int J Res Med Sci 2016; 4(7.000: 2921-2925

  14. Complications after Hip Arthroscopy

    Science.gov (United States)

    Larson, Christopher M.; Clohisy, John C.; Beaule, Paul; Kelly, Bryan T.; Giveans, Russell; Stone, Rebecca M.; Samuelson, Kathryn M.

    2013-01-01

    Objectives: There is very little published literature looking at comprehensive complication rates after hip arthroscopy with current techniques and indications. Methods: Between 01/2011 and 11/2012, 1,026 consecutive hips (507 males, 519 females) with a mean age of 31.2 years (range 12 - 73) underwent hip arthroscopy at three institutions. The diagnosis, demographic information, and procedures were recorded, and a validated complications grading classification for hip joint surgery (Clavian classification) was utilized for all patients prospectively. Results: There were 951 primary hip arthroscopies and 75 revision hip arthroscopies. Arthroscopy was performed for FAI in 936 hips (91.2%), and 760 hips (74.1%) had a labral repair and 229 hips (22.3%) had a labral debridement. The most common event (18.7% of hips) noted was post-operative sensory disturbance adjacent to the portals or involving the distal anterolateral thigh consistent with LFC nerve disturbance. This was typically not noticed by patients and found on physical examination and only persisted beyond 6 months in 7 hips (0.7%). Iatrogenic chondral injury was noted for 20 hips (1.9%), iatrogenic labral puncture in 11 hips (1.1%), superficial portal infection in 6 hips (0.6%), sensory deficit about the foot in 9 hips (0.9%), deep venous thrombosis in 3 hips (0.3%), pulminary embolism in 1 hip (0.1%), pulmonary edema in 1 hip (0.1%), wound hematoma in 2 hips (0.2%), perineal numbness (pudendal nerve) in 9 hips (0.9%), heterotopic ossification in 4 hips (0.4%), reflex sympathetic dystrophy in 1 hip (0.1%) and wound/skin (traction) dehiscence in 1 hips (0.1%). There were no femoral neck fractures, iatrogenic instability, AVN, or extra-abdominal fluid extravasation in this cohort. The overall complication rate not including temporary periportal and thigh numbness (sequalae) was 6.9% (71 hips). Overall 88.7% had a grade 1, 5.6% Grade 2, 4.2% grade 3, and 1.4% grade 4 complication. There was no difference in the

  15. Osteochondritis Dissecans of the Hip

    Energy Technology Data Exchange (ETDEWEB)

    Linden, B. [Hoeglands Hospital, Eksjoe (Sweden). Dept. of Orthopedic Surgery; Jonsson, K. [Univ. Hospital, Lund (Sweden). Center for Medical Imaging and Physiology; Redlund-Johnell, I. [Univ. Hospital, Malmoe (Sweden). Dept. of Diagnostic Radiology

    2003-03-01

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

  16. Physical cues of ovulatory status: a failure to replicate enhanced facial attractiveness and reduced waist-to-hip ratio at high fertility.

    Science.gov (United States)

    Bleske-Rechek, April; Harris, Heather D; Denkinger, Kelly; Webb, Rose Mary; Erickson, Leah; Nelson, Lyndsay A

    2011-08-24

    We investigated women's facial attractiveness and body shape as a function of menstrual cycle phase, with the expectation from previous research that both would be enhanced during the high fertile phase. To control for the effects of women's daily behaviors on their appearance and waistline, we visited 37 normally cycling women twice in their dorm, where we photographed and measured them at low and high fertile days of their cycle immediately upon their waking. Seventy-four judges from a separate institution chose, for each woman, the picture they thought was more attractive. We analyzed a subset of 20 women who, by forward counting, had a High Fertility visit between Days 10-13 and a Low Fertility visit between Days 20-23; and we also analyzed a subsample of 17 women who, by reverse counting, had a High Fertility visit on the days leading to ovulation and a Low Fertility visit one week after ovulation. In neither set of analyses were women's waist- to-hip ratios lower nearer ovulation, and in neither set were women's high fertile pictures chosen at an above-chance rate by either male or female judges. We did not find evidence that facial attractiveness and waist-to-hip ratio are reliable physical cues of ovulatory status.

  17. Early discharge and home intervention reduces unit costs after total hip replacement: results of a cost analysis in a randomized study.

    Science.gov (United States)

    Sigurdsson, Eyjolfur; Siggeirsdottir, Kristin; Jonsson, Halldor; Gudnason, Vilmundur; Matthiasson, Thorolfur; Jonsson, Brynjolfur Y

    2008-09-01

    Total hip replacement (THR) is a common and costly procedure. The number of THR is expected to increase over the coming years. Two pathways of postoperative treatment were compared in a randomized study. Fifty patients from two hospitals were randomized into a study group (SG) of 27 patients receiving preoperative and postoperative education programs, as well as home visits from an outpatient team. A control group (CG) of 23 patients received "conventional" rehabilitation augmented by a stay at a rehabilitation center if needed. All costs for the two groups both in hospitals and after discharge were collected and analyzed. On average total costs for the SG were $8,550 and $11,952 for the CG, a 28% cost reduction. Total inpatient costs were $5,225 for the SG and $6,515 for the CG. In a regression analysis the group difference is statistically significant. Adjusting for changes in the Oxford Hip Score gives effective costs (C/E). The ratio of the SGs C/E to the CGs is 0.60. That is a cost-effectiveness gain of 40%. A shorter hospital stay augmented with better preoperative education and home treatment appears to be more effective and costs less than the traditional in hospital pathway of treatment.

  18. Physical Cues of Ovulatory Status: A Failure to Replicate Enhanced Facial Attractiveness and Reduced Waist-to-Hip Ratio at High Fertility

    Directory of Open Access Journals (Sweden)

    April Bleske-Rechek

    2011-07-01

    Full Text Available We investigated women's facial attractiveness and body shape as a function of menstrual cycle phase, with the expectation from previous research that both would be enhanced during the high fertile phase. To control for the effects of women's daily behaviors on their appearance and waistline, we visited 37 normally cycling women twice in their dorm, where we photographed and measured them at low and high fertile days of their cycle immediately upon their waking. Seventy-four judges from a separate institution chose, for each woman, the picture they thought was more attractive. We analyzed a subset of 20 women who, by forward counting, had a High Fertility visit between Days 10–13 and a Low Fertility visit between Days 20–23; and we also analyzed a subsample of 17 women who, by reverse counting, had a High Fertility visit on the days leading to ovulation and a Low Fertility visit one week after ovulation. In neither set of analyses were women's waist-to-hip ratios lower nearer ovulation, and in neither set were women's high fertile pictures chosen at an above-chance rate by either male or female judges. We did not find evidence that facial attractiveness and waist-to-hip ratio are reliable physical cues of ovulatory status.

  19. A comparison of leg length and femoral offset discrepancies in hip resurfacing, large head metal-on- metal and conventional total hip replacement: a case series

    Directory of Open Access Journals (Sweden)

    Herman Katie A

    2011-12-01

    Full Text Available Abstract Background A discrepancy in leg length and femoral offset restoration is the leading cause of patient dissatisfaction in hip replacement surgery and has profound implications on patient quality of life. The aim of this study is to compare biomechanical hip reconstruction in hip resurfacing, large-diameter femoral head hip arthroplasty and conventional total hip replacement. Method Sixty patient's post-operative radiographs were reviewed; 20 patients had a hip resurfacing (HR, 20 patients had a Large Head Metal-on-metal (LHM hip replacement and 20 patients had a conventional small head Total Hip Replacement (THR. The leg length and femoral offset of the operated and unoperated hips were measured and compared. Results Hip resurfacing accurately restored hip biomechanics with no statistical difference in leg length (P = 0.07 or femoral offset (P = 0.95 between the operated and non-operative hips. Overall HR was superior for reducing femoral offset discrepancies where it had the smallest bilateral difference (-0.2%, P = 0.9. The traditional total hip replacement was least effective at restoring the hip anatomy. Conclusion The use of a larger-diameter femoral head in hip resurfacing does not fully account for the superior biomechanical restoration, as LHM did not restore femoral offset as accurately. We conclude that restoration of normal hip biomechanics is best achieved with hip resurfacing.

  20. Groin and hip quandaries

    African Journals Online (AJOL)

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

  1. Hip fracture - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000168.htm Hip fracture - discharge To use the sharing features on this page, please enable JavaScript. Hip fracture surgery is done to repair a break in ...

  2. 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 ...

  3. Hip fracture in hospitalized medical patients

    Directory of Open Access Journals (Sweden)

    Zapatero Antonio

    2013-01-01

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

  4. The Hip Restoration Algorithm

    Science.gov (United States)

    Stubbs, Allston Julius; Atilla, Halis Atil

    2016-01-01

    Summary Background Despite the rapid advancement of imaging and arthroscopic techniques about the hip joint, missed diagnoses are still common. As a deep joint and compared to the shoulder and knee joints, localization of hip symptoms is difficult. Hip pathology is not easily isolated and is often related to intra and extra-articular abnormalities. In light of these diagnostic challenges, we recommend an algorithmic approach to effectively diagnoses and treat hip pain. Methods In this review, hip pain is evaluated from diagnosis to treatment in a clear decision model. First we discuss emergency hip situations followed by the differentiation of intra and extra-articular causes of the hip pain. We differentiate the intra-articular hip as arthritic and non-arthritic and extra-articular pain as surrounding or remote tissue generated. Further, extra-articular hip pain is evaluated according to pain location. Finally we summarize the surgical treatment approach with an algorithmic diagram. Conclusion Diagnosis of hip pathology is difficult because the etiologies of pain may be various. An algorithmic approach to hip restoration from diagnosis to rehabilitation is crucial to successfully identify and manage hip pathologies. Level of evidence: V. PMID:28066734

  5. Hip Injuries and Disorders

    Science.gov (United States)

    ... problems. Osteoarthritis can cause pain and limited motion. Osteoporosis of the hip causes weak bones that break easily. Both of these are common in older people. Treatment for hip disorders may include rest, medicines, physical therapy, or surgery, including hip replacement.

  6. Ultrasound: Infant Hip

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Ultrasound: Infant Hip KidsHealth > For Parents > Ultrasound: Infant Hip A A A What's in this ... en los lactantes What It Is A hip ultrasound is a safe and painless test that uses ...

  7. Hip Problems in Infants

    Science.gov (United States)

    ... hip problems later in life? ResourcesScreening for Developmental Dysplasia of the Hip by LM French, M.D., and FR Dietz, ... 2014 Categories: Family Health, Infants and ToddlersTags: dislocation, dysplasia, external, femoral, hip, infants, internal, problems, socket, torsion Family Health, Infants ...

  8. Does the use of laminar flow and space suits reduce early deep infection after total hip and knee replacement?: the ten-year results of the New Zealand Joint Registry.

    Science.gov (United States)

    Hooper, G J; Rothwell, A G; Frampton, C; Wyatt, M C

    2011-01-01

    We have investigated whether the use of laminar-flow theatres and space suits reduced the rate of revision for early deep infection after total hip (THR) and knee (TKR) replacement by reviewing the results of the New Zealand Joint Registry at ten years. Of the 51 485 primary THRs and 36 826 primary TKRs analysed, laminar-flow theatres were used in 35.5% and space suits in 23.5%. For THR there was a significant increase in early infection in those procedures performed with the use of a space suit compared with those without (p space suit (p space suit (p space suits were used in those theatres (p deep infection has not been reduced by using laminar flow and space suits. Our results question the rationale for their increasing use in routine joint replacement, where the added cost to the health system seems to be unjustified.

  9. Reducing Maternal Mortality by Strengthening Community Maternal ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    One rural community each reported the existence of community savings for obstetric .... also indicates the value of integrating these with ..... permission each time before leaving the house) ... communities have to travel long distances to reach.

  10. HIP-HOP教室

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    从现在开始我们要为了Hip-hop而奋斗,使身边的人改变对Hip-hop文化的看法,让他们知道什么是真正的Hip-hop,更要让大家学会怎样用肢体去表达,Yo,在这里,永远不会出现半吊子的Hip-hop,因为我们都是来真的,Yo,来真的,因为我要将Hip-hop发扬到底,Yeah!

  11. Hip arthroscopy in the setting of hip dysplasia

    OpenAIRE

    Yeung, M; Kowalczuk, M.; Simunovic, N.; Ayeni, O. R.

    2016-01-01

    Objective Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. Methods A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to Ju...

  12. Bilaterally Primary Cementless Total Hip Arthroplasty for Severe Hip Ankylosis with Ankylosing Spondylitis.

    Science.gov (United States)

    Feng, Dong-Xu; Zhang, Kun; Zhang, Yu-Min; Nian, Yue-Wen; Zhang, Jun; Kang, Xiao-Min; Wu, Shu-Fang; Zhu, Yang-Jun

    2016-08-01

    Total hip arthroplasty is a reliable therapeutic intervention in patients with ankylosing spondylitis, in whom the aims of surgery are to reduce pain, restore hip function and improve quality of life. The current study is a retrospective analysis of the clinical and radiographic findings in a consecutive series of patients with hip ankylosis associated with severe ankylosing spondylitis who underwent bilateral primary total hip arthroplasty using non-cemented components. From June 2008 to May 2012, total hip arthroplasty was performed on 34 hips in 17 patients with bilateral ankylosis caused by ankylosing spondylitis. The study patients included 13 men and 4 women with a mean age of 24.2 years. The mean duration of disease was 8.3 years and the average duration of hip involvement was 7.6 years. All patients had severe hip pain and dysfunction with bilateral bony ankylosis and no range of motion preoperatively and all underwent bilateral cementless total hip arthroplasty performed by a single surgeon. Joint pain, range of motion (ROM), and Harris hip scores were assessed to evaluate the postoperative results. At a mean follow-up of 31.7 months, all patients had experienced significant clinical improvement in function, ROM, posture and ambulation. At the final follow-up, the mean postoperative flexion ROM was 134.4° compared with 0° preoperatively. Similar improvements were seen in hip abduction, adduction, internal rotation and external rotation. Postoperatively, 23 hips were completely pain-free, six had only occasional discomfort, three mild to moderate pain and two severe pain. The average Harris Hip Score improved from 23.7 preoperatively to 65.8 postoperatively. No stems had loosened at the final follow-up in any patient, nor had any revision surgery been required. Bilateral severe hip ankylosis in patients with ankylosing spondylitis can be treated with cementless bilateral synchronous total hip arthroplasty, which can greatly improve hip joint function and

  13. Strengthening Resilience in Families

    Science.gov (United States)

    Guild, Diane; Espiner, Deborah

    2014-01-01

    Rolling with Resilience (RwR) provides a springboard for developing strategies that build strengths and supports to foster developmental assets in children and youth (Benson, Scales, & Roehlkepartain, 2011). In Circle of Courage terms, resilience is strengthened by opportunities for Belonging, Mastery, Independence, and Generosity (Brendtro,…

  14. Development of ITER shielding blanket prototype mockup by HIP bonding

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Satoshi; Furuya, Kazuyuki; Hatano, Toshihisa; Kuroda, Toshimasa; Enoeda, Mikio; Ohara, Yoshihiro [Japan Atomic Energy Research Inst., Naka, Ibaraki (Japan). Naka Fusion Research Establishment; Takatsu, Hideyuki [Japan Atomic Energy Research Inst., Office of ITER Project Promotion, Tokyo (Japan)

    2000-07-01

    A prototype ({approx}900{sup H} x 1700{sup W} x 350{sup T} mm) of the ITER shielding blanket module has been fabricated following the previous successful fabrication of a small-scale ({approx}500{sup H} x 400{sup W} x 150{sup T} mm) and mid-scale ({approx}800{sup H} x 500{sup W} x 350{sup T} mm) mock-ups. This prototype incorporates most of key design features essential to the fabrication of the ITER shielding blanket module such as 1) the first wall heat sink made of Al{sub 2}O{sub 3} dispersion strengthened Cu (DSCu) with built-in SS316L coolant tubes bonded to a massive SS316LN shield block, 2) toroidally curved first wall with a radius of 5106 mm while straight in poloidal direction, 3) coolant channels oriented in poloidal direction in the first wall and in toroidal direction in the shield block, 4) the first wall coolant channel routing to avoid the interference with the front access holes, 5) coolant channels drilled through the forged SS316LN-IG shield block, and 6) four front access holes of 30 mm in diameter penetrated through the first wall and the shield block. For the joining method, especially for the first wall/side wall parts and the shield block, the solid HIP (Hot Isostatic Pressing) process was applied. It is difficult to apply conventional joining methods such as field welding, brazing, explosion bonding and mechanical one-axial diffusion bonding to a wide area bonding because sufficient mechanical strengths can not be obtained and excessive deformations occurs. In order to solve these fabrication issues, HIP bonding was applied. The first wall stainless steel (SS) coolant tubes of 10 mm in inner diameter and l mm in thickness were sandwiched by semi-circular grooved DSCu plates at the first wall and the front region of the side wall, and by semi-circular grooved SS plates at the back region of the side wall. After assembling of these first wall/side wall parts with the shield block, they were simultaneously bonded by single step HIP in order to

  15. Adaptation to climate change for peace and stability. Strengthening of approaches and instruments as well as promotion of processes to reduce the security risks posed by climate change in the context of climate change adaptation

    Energy Technology Data Exchange (ETDEWEB)

    Taenzler, Dennis; Mohns, Till; Ziegenhagen, Katherina [Adelphi Research, Berlin (Germany)

    2013-10-15

    The findings of the project ''Strengthening of approaches and instruments as well as promotion of processes to reduce the security risks posed by climate change in the context of climate change adaptation'' are summarized in this report. The main objective of the project is to outline the potential contribution of adaptation measures to avoid crisis and conflicts caused or exacerbated by water scarcity, food shortages or extreme weather events. As discussed in the conceptual chapter of the report, adaptation can contribute to peace and stability even in conflict-prone areas given that a conflict-sensitive approach is applied. On the basis of a comprehensive regional analysis, we show that adaptation is not yet a prominent element of regional cooperation. To address this gap, we design three regional adaptation roadmaps for the Andes region, Central and South Asia based on desk review of regional processes and programs as well as expert consultations. To ensure that the results of the projects can be considered in national and international policy processes and to strengthen international governance for adaptation we close with a Memorandum for action outlining major principles to support processes for adaptation and peace. [German] Das Vorhaben ''Entwicklung von Ansaetzen und Instrumenten sowie Foerderung von Prozessen zur Eindaemmung der Sicherheitsrisiken des Klimawandels im Rahmen der Anpassung an den Klimawandel'' untersucht den moeglichen Beitrag, den Massnahmen zur Anpassung an den Klimawandel fuer Frieden und Stabilitaet leisten koennen. Kernanliegen des Vorhabens ist die Vermeidung von durch den Klimawandel erzeugten oder verstaerkten Sicherheitsrisiken wie Wasserknappheit, Nahrungsmittelengpaesse oder extreme Wetterereignisse. Wie die konzeptionelle Eingangsbetrachtung des Endberichts zeigt, koennen Anpassungsprozesse - auch in konfliktgepraegten Gebieten - einen friedensfoerdernden Beitrag leisten, allerdings bedarf

  16. Mechanical Evaluation of Polymer Composite Hip Protectors

    Directory of Open Access Journals (Sweden)

    Jose Daniel Diniz Melo

    2010-01-01

    Full Text Available Hip fractures often result in serious health implications, particularly in the geriatric population, and have been related to long-term morbidity and death. In most cases, these fractures are caused by impact loads in the area of the greater trochanter, which are produced in a fall. This work is aimed at developing hip protectors using composite materials and evaluating their effectiveness in preventing hip fractures under high impact energy (120 J. The hip protectors were developed with an inner layer of energy absorbing soft material and an outer rigid shell of fiberglass-reinforced polymer composite. According to the experimental results, all tested configurations proved to be effective at reducing the impact load to below the average fracture threshold of proximal femur. Furthermore, an addition of Ethylene Vinyl Acetate (EVA to the impacted area of the composite shell proved to be beneficial to increase impact strength of the hip protectors. Thus, composite hip protectors proved to be a viable alternative for a mechanically efficient and cost-effective solution to prevent hip fractures.

  17. Imaging of hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Theodore T., E-mail: millertt@hss.edu [Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 (United States)

    2012-12-15

    The imaging evaluation of the prosthetic hip begins with radiography, but arthrography, aspiration, scintigraphy, sonography, CT and MR imaging all have roles in the evaluation of the painful prosthesis. This article will review the appearance of normal hip arthroplasty including hemiarthroplasty, total arthroplasty, and hip resurfacing, as well as the appearances of potential complications such as aseptic loosening and osteolysis, dislocation, infection, periprosthetic fracture, hardware failure, and soft tissue abnormalities.

  18. Hip resurfacing arthroplasty

    OpenAIRE

    2010-01-01

    Background and purpose 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. Methods An extensive literature search was performed using the PubMed, Embase, and Cochrane databases. Results 9 patient series, 1 case-control study, and 1 randomized controlled trial (RCT) were included. Clin...

  19. Foot muscles strengthener

    Directory of Open Access Journals (Sweden)

    Boris T. Glavač

    2012-04-01

    Full Text Available Previous experience in the correction of flat feet consisted of the use of insoles for shoes and exercises with toys, balls, rollers, inclined planes, etc. A device for strengthening foot muscles is designed for the correction of flat feet in children and, as its name suggests, for strengthening foot muscles in adults. The device is made of wood and metal, with a mechanism and technical solutions, enabling the implementation of specific exercises to activate muscles responsible for the formation of the foot arch. It is suitable for home use with controlled load quantities since it has calibrated springs. The device is patented with the Intellectual Property Office, Republic of Serbia, as a petty patent.

  20. MR imaging with metal artifact-reducing sequences and gadolinium contrast agent in a case-control study of periprosthetic abnormalities in patients with metal-on-metal hip prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Gunilla M.; Mueller, Markus F.; Ekberg, Olle [Lund University, Skaane University Hospital, Department of Radiology, Malmoe (Sweden); Maansson, Sven [Lund University, Skaane University Hospital, Department of Medical Radiation Physics, Malmoe (Sweden); Schewelov, Thord von [Lund University, Skaane University Hospital, Department of Orthopedic Surgery, Malmoe (Sweden); Nittka, Mathias [Siemens AG, Healthcare Sector, Erlangen (Germany); Lundin, Bjoern [Lund University, Skaane University Hospital, Department of Radiology, Lund (Sweden)

    2014-08-15

    To apply and compare magnetic resonance imaging (MRI) metal artifact reducing sequences (MARS) including subtraction imaging after contrast application in patients with metal-on-metal (MoM) hip prostheses, investigate the prevalence and characteristics of periprosthetic abnormalities, as well as their relation with pain and risk factors. Fifty-two MoM prostheses (35 cases with pain and or risk factors, and 17 controls) in 47 patients were examined in a 1.5-T MR scanner using MARS: turbo spin echo (TSE) with high readout bandwidth with and without view angle tilting (VAT), TSE with VAT and slice encoding for metal artifact correction (SEMAC), short tau inversion recovery (STIR) with matched RF pulses, and post-contrast imaging. The relations of MRI findings to pain and risk factors were analyzed and in five revised hips findings from operation, histology, and MRI were compared. TSE VAT detected the highest number of osteolyses. Soft tissue mass, effusion, and capsular thickening were common, whereas osteolysis in acetabulum and femur were less frequent. Contrast enhancement occurred in bone, synovia, joint capsule, and the periphery of soft tissue mass. There was no significant relation between MRI findings and pain or risk factors. MARS and gadolinium subtraction imaging are useful for evaluation of complications to MoM prosthesis. TSE VAT had the highest sensitivity for osteolysis. Contrast enhancement might indicate activation of aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL). Pain, small head, or steep prosthesis inclination angle are not useful predictors of periprosthetic abnormalities, and wide indications for MR follow-up are warranted. (orig.)

  1. Fracture After Total Hip Replacement

    Science.gov (United States)

    ... osteolysis. Symptoms The most common symptoms of periprosthetic hip fracture include: • Pain around the hip or thigh • Swelling ... o en very painful, someone with a periprosthetic hip fracture will most likely go directly to the emergency ...

  2. Hip Fractures among Older Adults

    Science.gov (United States)

    ... online training for health care providers. Learn More Hip Fractures Among Older Adults Recommend on Facebook Tweet Share ... get older. What You Can Do to Prevent Hip Fractures You can prevent hip fractures by taking steps ...

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

    Science.gov (United States)

    Lewis, Cara L; Ferris, Daniel P

    2011-03-15

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

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

    Science.gov (United States)

    Lewis, Cara L.; Ferris, Daniel P.

    2011-01-01

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

  5. Rehabilitation following hip arthroscopy - A systematic review

    Directory of Open Access Journals (Sweden)

    Jeffrey S Grzybowski

    2015-05-01

    Full Text Available CONTEXT: Rehabilitation following hip arthroscopy is an integral component of the clinical outcome of the procedure. Given the increase in quantity, complexity, and diversity of procedures performed, a need exists to define the role of rehabilitation following hip arthroscopy.OBJECTIVES: 1 To determine the current rehabilitation protocols utilized following hip arthroscopy in the current literature, 2 to determine if clinical outcomes are significantly different based on different post-operative rehabilitation protocols; and 3 to propose the best-available evidence-based rehabilitation program following hip arthroscopy.DATA SOURCES: Per PRISMA guidelines and checklist, Medline, SciVerse Scopus, SportDiscus, and Cochrane Central Register of Controlled Trials were searched.STUDY SELECTION: Level I-IV evidence clinical studies with minimum two-year follow-up reporting outcomes of hip arthroscopy with post-operative rehabilitation protocols described were included. DATA EXTRACTION: All study, subject, and surgery parameters were collected. All elements of rehabilitation were extracted and analyzed. Descriptive statistics were calculated. Study methodological quality was analyzed using the Modified Coleman Methodology Score (MCMS.RESULTS: 18 studies were included (2,092 subjects; 52% male, mean age 35.1 +/- 10.6 years, mean follow-up 3.2 +/- 1.0 years. Labral tear and femoroacetabular impingement were the most common diagnoses treated and labral debridement and femoral/acetabular osteochondroplasty the most common surgical techniques performed. Rehabilitation protocol parameters (weight-bearing, motion, strengthening, and return-to-sport were poorly reported. Differences in clinical outcomes were unable to be assessed given heterogeneity in study reporting. Time-, phase-, goal-, and precaution-based guidelines were extracted and reported.CONCLUSIONS: The current literature of hip arthroscopy rehabilitation lacks high-quality evidence to support a

  6. CT findings of traumatic posterior hip dislocation after reduction

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Kyoung; Park, Ji Seon; Ryu, Kyung Nam; Jin, Wook [Kyung Hee University Medical Center, Seoul (Korea, Republic of); Jin Wook

    2008-06-15

    To evaluate the CT images of reduced hips after posterior hip dislocation and to propose specific diagnostic criteria based on the CT results. We retrospectively reviewed the CT findings on 18 reduced hips from 17 patients with radiographs and clinical histories of traumatic posterior hip dislocations by evaluating 18 corresponding CT scans for joint space asymmetry, intra-articular abnormalities (intra-articular fat obliteration, loose bodies, and joint effusion), changes in posterior soft tissue (capsule, muscles, and adjacent fat), the presence, and location of fractures (acetabulum and femoral head). All 18 hips (100%) showed posterior soft tissue changes. In total, 17 hips (94.4%) had intra-articular abnormalities and 15 hips (83.3%) had joint space asymmetries. In addition, 17 hips (94.4%) had fractures involving the acetabula (15 cases, 88.2%) the femoral head (13 cases, 76.5%), or on both sides (11 cases, 64.7%). The most frequent fracture location was in he posterior wall (13/15, 86.7%) of the acetabulum and in the anterior aspect (10/13, 76.9%) of the femoral head. Patients with a prior history of posterior hip dislocation showed specific CT findings after reduction, suggesting the possibility of previous posterior hip dislocations in patients.

  7. Exploration of Strategies of Strengthening the Management of Western Medicine Pharmacy and Reducing the Dispute%探讨加强西药药房管理以及减少药患纠纷的策略

    Institute of Scientific and Technical Information of China (English)

    詹观明

    2016-01-01

    目的::探讨西药药房发生药品差错的原因,以提出加强西药药房管理及减少药患纠纷的策略。方法:选取2014年1月~2015年2月某院门诊西药房12间发药窗口为观察对象。单号窗口为观察组,对药品差错的原因分析,制定相应对策;双号窗口作为对照组,常规处理。对西药房采取对策后发生药品差错、纠纷事件及患者满意度对比。结果:采取措施前,两组药品差错事件及患者满意度无显著差异;采取措施后,观察组药品差错事件发生率较对照组显著降低、患者满意度显著提高、药品差错事件的发生率均显著低于对照组、医患纠纷事件发生情况显著降低。结论:西药房发生药品差错原因较多,药学人员应增强工作责任心,以减少药患纠纷的发生。%Objective:To discuss the reasons for the occurrence of drug errors in western medicine phar-macy,in order to strengthen the management of the western medicine pharmacy and to reduce the risk of drug disputes.Methods:Select 12 drug delivery windows in a hospital from January 2014 to February 2015 as observing obj ects.Take odd number windows as the observation group,analyze the reason for the drug er-rors and formulate the corresponding countermeasure;even number windows as the control group and gave routine treatment.Compare drug errors,disputes and patients'satisfaction after taking countermeasures in both the groups.Results:Before taking measures,drug error incident rate and the degree of satisfaction of pa-tients in the two groups had no significant difference;after taking measures,drug error incident rate in the observation group was significantly lower than that in the control group,patients satisfaction improved sig-nificantly,doctor-patient dispute occurrence decreased significantly.Conclusion:There are many reasons for the occurrence of drug errors in the western medicine room,pharmaceutical personnel should

  8. 加强药品管理降低药品调配中心使用差错率%Strengthen Drug Management and Reduce the use of Error Rate in Drug Distribution Center

    Institute of Scientific and Technical Information of China (English)

    郭玉侠

    2015-01-01

    目的 探讨医院静脉药品调配中心差错原因, 分析采用药品管理后对医院静脉药品调配中心使用差错率状况的影响. 方法 对该院2014年6月—2015年6月间静脉用药调配中心使用差错状况进行回顾性分析,对比加强管理前后医院药品调配中心药品使用差错率状况. 结果 医院静脉用药调配中心2014年6月—2014年12月共配置静脉药品23080份,差错63份,差错率2.73%,2015年1月—2015年6月共配置静脉药品23510份,差错10份,差错率0.47%. 药品管理后药品审核、药品调配、药品混淆、药品标签差错发生率及总差错率与药品管理前相比均明显较低,差异具有统计学意义,P<0.05. 结论 加强医院药品管理能有效减少医院药品使用差错率,促进医院静脉药品调配中心安全运作,保证患者治疗安全性,减少医疗纠纷.%Objective To explore hospital intravenous drug procurement center error reason, after analysis using drug man-agement of hospital intravenous drug procurement center using the influence of the error rate conditions. Methods In our hospital between June 2014- June 2015 intravenous drug use control center using error condition were analyzed retrospec-tively, compared before and after strengthening management of hospital drug procurement center drug use error rate. Re-sults Intravenous drug use control center hospital on June 6, 2014-December 2014 23080 configuration intravenous drugs, error 63,Error rate 2.73%, January 2015-June 2015, a total of 23510 intravenous drug, mistake 10, Error rate 0.47%. Af-ter drug administration drug review, drug procurement, medicines, confusion, drug labels error rate and the total error rate and drug management were significantly lower than before, difference have statistical significance, P<0.05). Conclusion To strengthen the hospital medicine management can effectively reduce the hospital drug use error rate, promote hospital intra-venous drug procurement center

  9. CONSERVATIVE TREATMENT OF HIP DYSPLASIA

    OpenAIRE

    Михаил Михайлович Камоско; Махмуд Станиславович Познович

    2014-01-01

    Hip dysplasia in children is the subject of careful study by specialists both in our country and abroad. There are three basic variants of hip dysplasia: congenital acetabular dysplasia, congenital subluxation of the hip and congenital dislocation of the hip. However, treatment of congenital dislocation of the hip, which is the most severe form of hip dysplasia in children, currently remains one of the topical problems of children’s orthopedics, despite the significant achievements of modern ...

  10. A new algorithm for hip fracture surgery

    DEFF Research Database (Denmark)

    Palm, Henrik; Krasheninnikoff, Michael; Holck, Kim

    2012-01-01

    Background and purpose Treatment of hip fracture patients is controversial. We implemented a new operative and supervision algorithm (the Hvidovre algorithm) for surgical treatment of all hip fractures, primarily based on own previously published results. Methods 2,000 consecutive patients over 50...... years of age who were admitted and operated on because of a hip fracture were prospectively included. 1,000 of these patients were included after implementation of the algorithm. Demographic parameters, hospital treatment, and reoperations within the first postoperative year were assessed from patient...... by reoperations was reduced from 24% of total hospitalization before the algorithm was introduced to 18% after it was introduced. Interpretation It is possible to implement an algorithm for treatment of all hip fracture patients in a large teaching hospital. In our case, the Hvidovre algorithm both raised...

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

    Science.gov (United States)

    Bennell, Kim L; Hinman, Rana S

    2011-01-01

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

  12. Identification of binding sites in Huntingtin for the Huntingtin Interacting Proteins HIP14 and HIP14L.

    Directory of Open Access Journals (Sweden)

    Shaun S Sanders

    Full Text Available Huntington disease is an adult onset neurodegenerative disease characterized by motor, cognitive, and psychiatric dysfunction, caused by a CAG expansion in the HTT gene. Huntingtin Interacting Protein 14 (HIP14 and Huntingtin Interacting Protein 14-like (HIP14L are palmitoyl acyltransferases (PATs, enzymes that mediate the post-translational addition of long chain fatty acids to proteins in a process called palmitoylation. HIP14 and HIP14L interact with and palmitoylate HTT and are unique among PATs as they are the only two that have an ankyrin repeat domain, which mediates the interaction between HIP14 and HTT. These enzymes show reduced interaction with and palmitoylation of mutant HTT, leading to increased mutant HTT inclusion formation and toxicity. The interaction between HIP14 and HTT goes beyond that of only an enzyme-substrate interaction as HTT is essential for the full enzymatic activity of HIP14. It is important to further understand and characterize the interactions of HTT with HIP14 and HIP14L to guide future efforts to target and enhance this interaction and increase enzyme activity to remediate palmitoylation of HTT and their substrates, as well as to understand the relationship between the three proteins. HIP14 and HIP14L have been previously shown to interact with HTT amino acids 1-548. Here the interaction of HIP14 and HIP14L with N- and C-terminal HTT 1-548 deletion mutations was assessed. We show that HTT amino acids 1-548 were sufficient for full interaction of HTT with HIP14 and HIP14L, but partial interaction was also possible with HTT 1-427 and HTT 224-548. To further characterize the binding domain we assessed the interaction of HIP14-GFP and HIP14L-GFP with 15Q HTT 1-548Δ257-315. Both enzymes showed reduced but not abolished interaction with 15Q HTT 1-548Δ257-315. This suggests that two potential binding domains exist, one around residues 224 and the other around 427, for the PAT enzymes HIP14 and HIP14L.

  13. Muscle mass and function after total hip arthroplasty

    OpenAIRE

    Rasch, Anton

    2009-01-01

    Osteoarthritis (OA) of the hip is a common disease among elderly causing pain, joint stiffness and reduced mobility. Outcome studies have shown total hip arthroplasy (THA) to be a successful surgical procedure. Studies of muscle strength and function after THA are more scarce and results vary. It has been suggested that unloading of the OA limb due to pain, results in hip and thigh muscle weakness and atrophy causing an abnormal gait and impaired postural control. Muscle atr...

  14. Hip joint pathology

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  15. Hip Arthropathy in Haemophilia

    Directory of Open Access Journals (Sweden)

    Christian Carulli

    2017-04-01

    Full Text Available Hip arthropathy in haemophilic patients is disabling for hip and other common target joints. Even if bleedings in the hip are not frequent, femoroacetabular alterations may affect the functional ability of patients at a very young age. A haematologic prophylaxis combined with an adequate lifestyle and regular and low-traumatic physical activity are the keys to preventing such arthropathy. In the early stages of arthropathy, anti-inflammatory drugs and physical therapy may be sufficient to limit its progression. In cases of recurrent symptoms, viscosupplementation with hyaluronic acid, and chemical synoviorthesis are useful options. In more advanced stages, hip arthroscopy may be treated by synovectomy or loose body removal. For late stages, total hip arthroplasty (THA is mandatory. Until a few decades ago, the clinical outcomes after hip arthroplasty were variable, due to the different management of patients and the use of old generation implants and couplings. In the last decade, the introduction of the multidisciplinary management and the use of modern cementless implants with high performing materials and less invasive surgical techniques have dramatically improved the functional results. Nowadays, as is the case for other target joints, the purpose of the management in haemophilia centers is the early detection of any hip alterations—by clinical and ultrasound (US evaluations of patients in childhood—to reveal any early articular damage and to provide adequate treatment in case of symptoms. The present paper represents an updated review of the several approaches to hip arthropathy in haemophilia.

  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. Hip Resurfacing Implants.

    Science.gov (United States)

    Cadossi, Matteo; Tedesco, Giuseppe; Sambri, Andrea; Mazzotti, Antonio; Giannini, Sandro

    2015-08-01

    EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: 1. Describe the advantages of hip resurfacing. 2. Describe the disadvantages of hip resurfacing. 3. Identify the population in which hip resurfacing is most often indicated. 4. Demonstrate how to properly postoperatively manage patients with metal-on-metal prostheses. Hip resurfacing offers a suitable solution for young patients affected by hip disease who have high function demands and good bone quality. Bone stock preservation, restoration of the normal proximal femur anatomy, the lack of stress shielding, and the possibility of resuming sporting activity are proven advantages of hip resurfacing. However, there are some disadvantages, such as fracture of the femoral neck, onset of neck narrowing, and possible complications due to the metal-on-metal bearings, including pseudotumors, peri-implant osteolysis, and chronic elevation of metal ions in serum levels. Recent data suggest that the ideal candidate for hip resurfacing is an active male, younger than 65 years, with primary or posttraumatic osteoarthritis, and with a femoral head diameter larger than 50 to 54 mm. Based on these selection criteria, the literature reports implant survival to be similar to that of total hip arthroplasty. The current authors' experience confirms a low failure rate and excellent functional outcomes, with metal ion serum levels becoming stable over time in well-functioning implants. Proper surgical technique, correct patient selection, and the right choice of a well-established prosthetic model are essential elements for the long-term success of these implants.

  18. Forecasting for strengthening technological development

    Directory of Open Access Journals (Sweden)

    Aida Mayerly Fúquene Montañez

    2010-05-01

    Full Text Available Producing technological innovation is currently one of the key items in being more competitive. However, production sectors are facing great challenges, including analysing a large amount of available technological and market information regarding the en- vironment for strategic decision-making and being able to launch themselves onto the market with technological developments bringing the desired economic returns. Several tools for analysing information have emerged for reducing the uncertainty of tech- nological and market changes. This article provides conceptual and reflective elements so that forecasting strengthens technolo- gical development (TD. Forecasting is initially proposed as being one of the future methods of analysis having a significant im- pact on decision-making, mainly within the field of economics but which could be extrapolated to making a contribution to TD. The techniques which have been the recent instrument for collecting information for producing forecasting are described, as is work about the concept of surveillance/monitoring and the processes used for coordinating such approaches. It can thus be sta- ted that they provide an excellent basis for strengthening TD by providing platforms for new or improved developments in pro- cesses or products. Reflection about these aspects provides perspectives for implementing technological forecasting (TF in pro- duction systems so that they obtain efficient and concrete results via deterministic methods as input in decision-making in techno- logy regarding its middle- and long-term competitiveness.

  19. Pathogenesis of osteoporotic hip fractures.

    Science.gov (United States)

    McClung, Michael R

    2003-01-01

    Osteoporosis is characterized late in the course of the disease by an increased risk of fracture, particularly in the elderly. It occurs in both sexes, affecting approximately 8 million women and 2 million men aged > or = 50 years (1). While low bone density is a predictor of fractures, it is not the only determinant of fracture risk. Other factors include advanced age, altered bone quality, a personal or family history of falls, frailty, poor eyesight, debilitating diseases, and high bone turnover. A diet with sufficient calcium and vitamin D is important to minimize bone loss and, along with regular exercise, to maintain muscle strength. Bisphosphonates have been shown to reduce the risk of hip fracture. For elderly patients, the use of hip protectors may be used as a treatment of last resort. Regardless of the age of the patient, individual patient risk factors must be considered to target appropriate treatment and prevent fracture.

  20. Strengthening of Shear Walls

    DEFF Research Database (Denmark)

    Hansen, Christian Skodborg

    -plane loaded walls and disks is however not included in any guidelines, and only a small fraction of scientists have initiated research within this topic. Furthermore, studies of the principal behavior and response of a strengthened disk has not yet been investigated satisfactorily, and this is the principal...... be altered to fit the surrounding boundary conditions. The effective cohesive law will then become a function of the investigated structural geometry. A simplified approach for the latter topic was used to predict the load capacity of concrete beams in shear. Results obtained were acceptable, but the model...

  1. Formed HIP Can Processing

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, Kester Diederik [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-07-27

    The intent of this report is to document a procedure used at LANL for HIP bonding aluminum cladding to U-10Mo fuel foils using a formed HIP can for the Domestic Reactor Conversion program in the NNSA Office of Material, Management and Minimization, and provide some details that may not have been published elsewhere. The HIP process is based on the procedures that have been used to develop the formed HIP can process, including the baseline process developed at Idaho National Laboratory (INL). The HIP bonding cladding process development is summarized in the listed references. Further iterations with Babcock & Wilcox (B&W) to refine the process to meet production and facility requirements is expected.

  2. Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Blønd, Lars; Sonne-Holm, Stig;

    2003-01-01

    = 0.001), a total blood loss of 814 mL versus 1231 mL (p = 0.001) and a total need for 4 blood transfusions versus 25 (p = 0.04). No patient in either group had symptoms of deep venous thrombosis, pulmonary embolism or prolonged wound drainage. INTERPRETATION: Transemic acid is effective in reducing...

  3. Luster Polish Strengthening Treatment for Raceway Surface of Aeroengine Bearings

    Institute of Scientific and Technical Information of China (English)

    DENG Si-er; TENG Hong-fei; MA Fu-jian; HAO Jian-jun; CHEN Tao

    2007-01-01

    A new surface strengthening technology, luster polish strengthening treatnent, was proposed to treat the raceway surface of aeroengine bearings (9Cr18Mo) with the centrifugal strengthening machine exclusively designed for luster polish strengthening treatment. The experimental results showed that luster polish strengthening treatment produced a compressive residual stress layer with a depth of over 80 μm below the surface of the bearing raceway, and thus effectively removed the metamorphic layer in the raceway surface. After luster polish strengthening treatment, the average surface hardness of the aeroengine bearing raceway was increased from 61.02 HRC to 63.01 HRC, the surface roughness was reduced from 0.06 μm to 0.03 μm, and the contact fatigue life of the aeroengine bearings was improved by about 90%, with the dispersion of fatigue life being reduced remarkably.Theoretical calculation result agrees with that obtained by experiment.

  4. Strengthening Family Practices for Latino Families

    Science.gov (United States)

    Chartier, Karen G.; Negroni, Lirio K.; Hesselbrock, Michie N.

    2010-01-01

    This study examined the effectiveness of a culturally adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9- to 12-year-old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted…

  5. Strengthening Family Practices for Latino Families

    Science.gov (United States)

    Chartier, Karen G.; Negroni, Lirio K.; Hesselbrock, Michie N.

    2010-01-01

    This study examined the effectiveness of a culturally adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9- to 12-year-old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted…

  6. The other hip in unilateral hip dysplasia

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Rømer, Lone; Søballe, Kjeld

    2006-01-01

    We reviewed transverse pelvic computed tomography scans of 197 consecutively referred adult patients with hip pain thought to be secondary to developmental dysplasia. A center-edge angle of 20 degrees or less was considered the upper normal value. Four groups were identified: 69 patients with app...

  7. Total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Slavković Nemanja

    2012-01-01

    Full Text Available Total hip arthroplasty is most common reconstructive hip procedure in adults. In this surgery we replace some parts of the upper femur and acetabulum with biocompatible materials. The main goal of this surgery is to eliminate pain and regain full extent of joint motion, maintaining hip stability. Surgical technique, biomaterials, design of the prosthesis and fixation techniques have evolved with time adjusting to each other. After total hip arthroplasty patients’ quality of life should be improved. There are many various postoperative complications. Some of them are fatal, and some are minor, which may become manifested years after surgery. Each next surgical procedure following previous hip surgery is associated with considerably lower chances to be successful. Therefore, in primary total hip arthroplasty, preoperative evaluation and preparation of patients are essential. Every orthopaedic surgeon needs to improve already adopted surgical skills applying them with precision and without compromise, with the main goal to achieve long-term durability of the selected implant. The number of total hip arthroplasties will also increase in future, and newer and higher quality materials will be used.

  8. Celiac Disease in Women with Hip Fractures

    Science.gov (United States)

    LeBoff, Meryl S.; Cobb, Haley; Gao, Lisa Y.; Hawkes, William; Yu-Yahiro, Janet; Kolatkar, Nikheel S.; Magaziner, Jay

    2014-01-01

    Objective Celiac disease is associated with decreased bone density, however, the risk of fractures in celiac disease patients is unclear. We compared the prevalence of celiac disease between a group of women with hip fractures and a group of women undergoing elective joint replacement surgery and the association between celiac disease and vitamin D levels. Methods Two hundred eight community dwelling and postmenopausal women were recruited from Boston, MA (n=81) and Baltimore, MD (n=127). We measured tissue transglutaminase IgA by ELISA to diagnose celiac disease and 25-hydroxyvitamin D (25(OH)D) levels by radioimmunoassay in both women with hip fractures (n=157) and the control group (n=51), all of whom were from Boston. Subjects were excluded if they took any medications or had medical conditions that might affect bone. Results Median serum 25(OH)D levels were significantly lower (p< 0.0001) in the hip fracture cohorts compared to the elective joint replacement cohort (14.1 ng/ml vs. 21.3 ng/ml, respectively). There were no differences in the percentage of subjects with a positive tissue transglutaminase in the women with hip fractures versus the control group (1.91% vs. 1.61%, respectively). Conclusion Vitamin D levels are markedly reduced in women with hip fractures, however hip fracture patients did not show a higher percentage of positive tissue transglutaminase levels compared with controls. These data suggest that routine testing for celiac disease among hip fracture patients may not prove useful, although larger prospective studies among hip fracture subjects are needed. PMID:23732553

  9. Epidemiology of hip fracture: Worldwide geographic variation

    Directory of Open Access Journals (Sweden)

    Dinesh K Dhanwal

    2011-01-01

    Full Text Available Osteoporosis is a major health problem, especially in elderly populations, and is associated with fragility fractures at the hip, spine, and wrist. Hip fracture contributes to both morbidity and mortality in the elderly. The demographics of world populations are set to change, with more elderly living in developing countries, and it has been estimated that by 2050 half of hip fractures will occur in Asia. This review conducted using the PubMed database describes the incidence of hip fracture in different regions of the world and discusses the possible causes of this wide geographic variation. The analysis of data from different studies show a wide geographic variation across the world, with higher hip fracture incidence reported from industrialized countries as compared to developing countries. The highest hip fracture rates are seen in North Europe and the US and lowest in Latin America and Africa. Asian countries such as Kuwait, Iran, China, and Hong Kong show intermediate hip fracture rates. There is also a north-south gradient seen in European studies, and more fractures are seen in the north of the US than in the south. The factors responsible of this variation are population demographics (with more elderly living in countries with higher incidence rates and the influence of ethnicity, latitude, and environmental factors. The understanding of this changing geographic variation will help policy makers to develop strategies to reduce the burden of hip fractures in developing countries such as India, which will face the brunt of this problem over the coming decades.

  10. Traumatic bilateral hip dislocation with bilateral sciatic nerve palsy

    Institute of Scientific and Technical Information of China (English)

    Ajay Pal Singh; Amarjit Singh Sidhu; Arun Pal Singh

    2010-01-01

    Bilateral hip dislocation rarely occurs.In this paper, a case of bilateral hip dislocation associated with bilateral sciatic nerve palsy resulted from a road traffic acci-dent is reported.Both hips were emergently reduced under general anaesthesia.Acetabular reconstruction was done bilaterally due to the unstable hips.The patient subsequently developed heterotopic ossification and avascular necrosis on the left hip and underwent total hip arthroplasty.The sciatic nerve on the right side achieved complete recovery but that on the left side only partly recovered and was aug-mented by tendon transfer.Such injuries are serious and one should be aware of the complications because they can resurface and so patients should be followed up for a long time.To the best of our knowledge, this kind of injury has not been reported in the English .language literature.

  11. [Clinical pathway for hip fracture patients].

    Science.gov (United States)

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

    2015-01-01

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

  12. Strengthening regional safeguards

    Energy Technology Data Exchange (ETDEWEB)

    Palhares, L.; Almeida, G.; Mafra, O. [Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials, Rio de Janeiro (Brazil)] [and others

    1996-08-01

    Nuclear cooperation between Argentina and Brazil has been growing since the early 1980`s and as it grew, so did cooperation with the US Department of Energy (DOE). The Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC) was formed in December 1991 to operate the Common System of Accounting and Control of Nuclear Materials (SCCC). In April 1994, ABACC and the DOE signed an Agreement of Cooperation in nuclear material safeguards. This cooperation has included training safeguards inspectors, exchanging nuclear material measurement and containment and surveillance technology, characterizing reference materials, and studying enrichment plant safeguards. The goal of the collaboration is to exchange technology, evaluate new technology in Latin American nuclear facilities, and strengthen regional safeguards. This paper describes the history of the cooperation, its recent activities, and future projects. The cooperation is strongly supported by all three governments: the Republics of Argentina and Brazil and the United States.

  13. Strengthening Aboriginal community wellbeing

    Directory of Open Access Journals (Sweden)

    Bronwyn Batten

    2012-11-01

    Full Text Available Since 2008 the NSW Government has been investigating the concept of ‘wellbeing’ as it relates to Aboriginal communities. Adopting a focus on wellbeing has meant delving into questions about what makes communities strong, and what factors are unique to creating strong Aboriginal communities, as well as considering the government’s role (if any in supporting Aboriginal community wellbeing. This paper seeks to convey the essence of the journey into wellbeing to date. It details the positions and assumptions that this work started with, and analyses why this has shifted over time. It examines what worked and was feasible, and what didn’t. In particular, the paper overviews the creation of the Strengthening Aboriginal Community Wellbeing Framework (the policy context, and the development of a resource in the form of a user friendly software program for communities wishing to holistically assess their wellbeing – the ‘toolkit’ (the practical outcome of the work to date.

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

    Institute of Scientific and Technical Information of China (English)

    Wei YANG; Can-jun YANG‡; Ting XU

    2016-01-01

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

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

    Science.gov (United States)

    Lee, Su-Kyoung; Park, Du-Jin

    2013-07-01

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

  16. Lateral femoral cutaneous nerve block after total hip arthroplasty

    DEFF Research Database (Denmark)

    Thybo, K H; Mathiesen, O; Dahl, J B

    2016-01-01

    reduce movement-related pain after total hip arthroplasty (THA) in patients with moderate-to-severe pain. METHODS: Sixty patients with visual analogue scale (VAS) score > 40 mm during 30-degree active flexion of the hip on either the first or second postoperative day after THA were included....... The overall non-responder rate (analgesic treatment regimen....

  17. Thiazide diuretics and the risk for hip fracture

    NARCIS (Netherlands)

    M. van de Klift (Marjolein); C.E.D. de Laet (Chris); R.M.C. Herings (Ron); Th. Stijnen (Theo); H.A.P. Pols (Huib); B.H.Ch. Stricker (Bruno); M.W.C.J. Schoofs (Marlette); A. Hofman (Albert)

    2003-01-01

    textabstractBACKGROUND: Since most hip fractures are related to osteoporosis, treating accelerated bone loss can be an important strategy to prevent hip fractures. Thiazides have been associated with reduced age-related bone loss by decreasing urinary calcium excretion. OBJECTIVE: To examine the ass

  18. Hip arthroscopy in the setting of hip dysplasia

    Science.gov (United States)

    Yeung, M.; Kowalczuk, M.; Simunovic, N.

    2016-01-01

    Objective Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. Methods A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to July 2015. Study parameters including sample size, definition of dysplasia, outcomes measures, and re-operation rates were obtained. Furthermore, the levels of evidence of studies were collected and quality assessment was performed. Results The systematic review identified 18 studies investigating hip arthroscopy in the setting of hip dysplasia, with 889 included patients. Criteria used by the studies to diagnose hip dysplasia and borderline hip dysplasia included centre edge angle in 72% of studies but the range of angles were quite variable. Although 89% of studies reported improved post-operative outcome scores in the setting of hip dysplasia, revision rates were considerable (14.1%), with 9.6% requiring conversion to total hip arthroplasty. Conclusion The available orthopaedic literature suggests that although improved outcomes are seen in hip arthroscopy in the setting of hip dysplasia, there is a high rate of re-operation and conversion to total hip arthroplasty. Furthermore, the criteria used to define hip dysplasia vary considerably among published studies. Cite this article: M. Yeung, M. Kowalczuk, N. Simunovic, O. R. Ayeni. Hip arthroscopy in the setting of hip dysplasia: A systematic review. Bone Joint Res 2016;5:225–231. DOI: 10.1302/2046-3758.56.2000533. PMID:27313136

  19. Hip Implant Systems

    Science.gov (United States)

    ... made of metal or ceramic, and the socket (acetabulum) is removed and replaced with a prosthetic cup. ... its socket in the hip bone (pelvis) Bone fracture Joint infection Local nerve damage with numbness/weakness ...

  20. Hip-Hop

    Institute of Scientific and Technical Information of China (English)

    张敬伟

    2008-01-01

    Hip-Hop是一种美国街头黑人文化,可分成五个要素:音乐、舞蹈、涂鸦、刺青和衣著。源自80年代美国纽约的黑人社区BRONX,他们将生活上的娱乐发展成为现今多样的HIP-HOP文化,发挥黑

  1. Family Strengthening Research: FY2014. OPRE Report 2015-22

    Science.gov (United States)

    Administration for Children & Families, 2015

    2015-01-01

    This report provides detailed summaries of major research investments by OPRE's Division of Family Strengthening (DFS) along with brief overviews of past projects. The featured projects cover topics that include strengthening relationships within families, supporting fatherhood, nurturing children through their families, reducing teen pregnancy,…

  2. Martial arts fall techniques decrease the impact forces at the hip during sideways falling.

    NARCIS (Netherlands)

    Groen, B.E.; Weerdesteijn, V.G.M.; Duysens, J.E.J.

    2007-01-01

    Falls to the side and those with impact on the hip are risky for hip fractures in the elderly. A previous study has indicated that martial arts (MA) fall techniques can reduce hip impact force, but the underlying mechanism is unknown. Furthermore, the high impact forces at the hand used to break the

  3. Martial arts fall techniques decrease the impact forces at the hip during sideways falling.

    NARCIS (Netherlands)

    Groen, B.E.; Weerdesteijn, V.G.M.; Duysens, J.E.J.

    2007-01-01

    Falls to the side and those with impact on the hip are risky for hip fractures in the elderly. A previous study has indicated that martial arts (MA) fall techniques can reduce hip impact force, but the underlying mechanism is unknown. Furthermore, the high impact forces at the hand used to break the

  4. Hip abductor weakness is not the cause for iliotibial band syndrome.

    Science.gov (United States)

    Grau, S; Krauss, I; Maiwald, C; Best, R; Horstmann, T

    2008-07-01

    Muscular deficits in the hip abductors are presumed to be a major factor in the development of Iliotibial Band Syndrome in runners. No definite relationship between muscular weakness of the hip abductors and the development of Iliotibial Band Syndrome or different ratios between hip adduction to abduction have been reported so far. Isokinetic measurements were taken from 10 healthy runners and 10 runners with Iliotibial Band Syndrome. Primary outcome variables were concentric, eccentric, and isometric peak torque of the hip abductors and adductors at 30 degrees/s, and a concentric endurance quotient at the same angle velocity. Differences in muscle strength of the hip abductors between healthy (CO) and injured runners (ITBS) were not statistically significant in any of the muscle functions tested. Both groups showed the same strength differences between hip adduction and abduction, and increased strength in hip adduction. Weakness of hip abductors does not seem to play a role in the etiology of Iliotibial Band Syndrome in runners, since dynamic and static strength measurements did not differ between groups, and differences between hip abduction and adduction were the same. Strengthening of hip abductors seems to have little effect on the prevention of Iliotibial Band Syndrome in runners.

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

    Science.gov (United States)

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

    2016-07-25

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

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

    Science.gov (United States)

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

    2014-10-01

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

  7. Huntingtin-interacting Proteins, HIP14 and HIP14L, Mediate Dual Functions, Palmitoyl Acyltransferase and Mg2+ Transport*S⃞

    Science.gov (United States)

    Goytain, Angela; Hines, Rochelle M.; Quamme, Gary A.

    2008-01-01

    Polyglutamine expansions of huntingtin protein are responsible for the Huntington neurological disorder. HIP14 protein has been shown to interact with huntingtin. HIP14 and a HIP14-like protein, HIP14L, with a 69% similarity reside in the Golgi and possess palmitoyl acyltransferase activity through innate cysteine-rich domains, DHHC. Here, we used microarray analysis to show that reduced extracellular magnesium concentration increases HIP14L mRNA suggesting a role in cellular magnesium metabolism. Because HIP14 was not on the microarray platform, we used real-time reverse transcriptase-PCR to show that HIP14 and HIP14L transcripts were up-regulated 3-fold with low magnesium. Western analysis with a specific HIP14 antibody also showed that endogenous HIP14 protein increased with diminished magnesium. Furthermore, we demonstrate that when expressed in Xenopus oocytes, HIP14 and HIP14L mediate Mg2+ uptake that is electrogenic, voltage-dependent, and saturable with Michaelis constants of 0.87 ± 0.02 and 0.74 ± 0.07 mm, respectively. Diminished magnesium leads to an apparent increase in HIP14-green fluorescent protein and HIP14L-green fluorescent fusion proteins in the Golgi complex and subplasma membrane post-Golgi vesicles of transfected epithelial cells. We also show that inhibition of palmitoylation with 2-bromopalmitate, or deletion of the DHHC motif HIP14ΔDHHC, diminishes HIP14-mediated Mg2+ transport by about 50%. Coexpression of an independent protein acyltransferase, GODZ, with the deleted HIP14ΔDHHC mutant restored Mg2+ transport to values observed with wild-type HIP14. Although we did not directly measure palmitoylation of HIP14 in these studies, the data are consistent with a regulatory role of autopalmitoylation in HIP14-mediated Mg2+ transport. We conclude that the huntingtin interacting protein genes, HIP14 and HIP14L, encode Mg2+ transport proteins that are regulated by their innate palmitoyl acyltransferases thus fulfilling the characteristics of

  8. Hip Pain: Dry Needling Versus Cortisone Injections.

    Science.gov (United States)

    2017-04-01

    Greater trochanteric pain syndrome (GTPS) is chronic, intermittent pain and tenderness on the outside of the hip. The medical community once thought that a swollen hip bursa was the source of such pain, which led to the use of corticosteroid injections to the bursa to help decrease swelling and pain. However, researchers now believe that injuries to the muscles and tendons around the hip are the actual cause of this pain, and that inflammation is often not involved. A study published in the April 2017 issue of JOSPT explores dry needling as an alternative to cortisone injections to reduce pain and improve function in patients with GTPS. J Orthop Sports Phys Ther 2017;47(4):240. doi:10.2519/jospt.2017.0504.

  9. Changes of gluteus medius muscle in the adult patients with unilateral developmental dysplasia of the hip

    Directory of Open Access Journals (Sweden)

    Liu RuiYu

    2012-06-01

    Full Text Available Abstract Background The gluteus medius muscle is essential for gait and hip stability. Changes that occur in the gluteus medius muscles in patients with developmental dysplasia of the hip (DDH are not well understood. A better understanding of DDH related changes will have positive repercussions toward hip soft tissue reconstruction. Methods 19 adult patients with unilateral DDH scheduled for total hip arthroplasty were assessed for: cross-sectional area (CSA, radiological density (RD and the length of gluteus medius using computed tomograhpy(CT (scanned before THA. Hip abductor moment arm and gluteus medius activation angle were also measured via hip anteroposterior radiographs. Results Both CSA and RD of gluteus medius muscle were significantly reduced (p  Conclusions The gluteus medius showed substantial loss of CSA, RD as well as decreased length in patients with DDH in the affected hip. These changes should be considered in both hip reconstruction and postoperative rehabilitation training in patients with DDH.

  10. 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.

  11. 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

  12. 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 ... The majority (76%) of patients were ambulatory within. 3 days after the surgery. ... Conclusion: Using the SIGN Hip Construct, hip fracture fixation can be ... elderly has made stable reduction and internal fixation.

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

    Science.gov (United States)

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

    2016-10-01

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

  14. Treatment of developmental dislocation of hip: does changing the hip abduction angle in the hip spica affect the rate of avascular necrosis of the femoral head?

    Science.gov (United States)

    Madhu, Tiruveedhula S; Akula, Maheswara; Scott, Brian W; Templeton, Peter A

    2013-05-01

    Avascular necrosis (AVN) of the femoral head is a serious complication in the management of developmental dislocation of the hip. Increasing the abduction angle increases its stability but compromises the vascularity of the femoral head. From our database of 240 children treated for developmental dislocation of hip by the two senior authors between 1998 and 2008, we defined two groups of children who underwent closed or medial open reduction of the hip after a failed Pavlik treatment or if patients presented late. In group 1, the reduced hip was immobilized in around 90° flexion, 60° abduction, and 0-10° internal rotation. In group 2 the hip was immobilized in around 45° of hip abduction with flexion and internal rotation as before. The first and second authors independently analysed these two groups blinded to the hip abduction angle. Our hypothesis was that a reduction in the hip abduction angle would reduce the incidence of AVN in the second group without compromising the stability. All eligible children were included, and there were 42 children in group 1 and 44 children in group 2. An almost equal number of children underwent closed and medial open reduction in both the groups. The age at reduction was a mode of 6 months (range 6-13 months) and 7 months (range 7-12 months), respectively. The abduction angle in the first group had a mode of 60° (range 52-70°) and the second group had a mode of 45° (range 38-50°). Radiographic evidence of AVN as described by Salter and colleagues was seen in eight children (19%) in the first group and seven children (16%) in the second group (P=0.78). Redislocation occurred in one child in the second group and none in the first group. In summary, the results show a nonsignificant reduction in the incidence of AVN when the hip abduction angle was reduced with no significant increased risk of redislocation.

  15. HIP-HOP

    Institute of Scientific and Technical Information of China (English)

    QunyKing; 人在羽中; 钱李明

    2005-01-01

    自从一群摇滚青年开始跟风 Elvis 的《Blue SuedeShoes》风格,hip-hop 似乎就成为了全球最具影响力的音乐风格。它最初起源于美国的黑人和拉丁美洲人,之后迅速在全世界流行,成为80年代、90年代和新千年的主流音乐。无论是在广告界还是在电影业,从各类排行榜到各种酒吧,hip-hop 的影响逐年增加。在1997年,英国的 hip-hop 还只是一种地下音

  16. Developmental Dysplasia of the Hip

    Science.gov (United States)

    ... in the motion of the hip and obvious shortening of the affected leg in older kids, an ... socket. During the procedure, doctors loosen the tight muscles and tissues around the hip joint and then ...

  17. Hip resurfacing: a technology reborn

    OpenAIRE

    2006-01-01

    In recent years there has been a resurgence of interest in the concept of hip resurfacing. Much of this interest has stemmed from the work of McMinn in the West Midlands. Hip resurfacing is now emerging as a viable alternative to conventional hip replacement. In this article, we discuss the conceptual advantages offered by hip resurfacing and review the early clinical results and the ongoing clinical concerns regarding this technology.

  18. X-Ray Exam: Hip

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Hip KidsHealth > For Parents > X-Ray Exam: Hip A A A What's in ... español Radiografía: cadera What It Is A hip X-ray is a safe and painless test that ...

  19. Total Hip Replacement

    Science.gov (United States)

    ... the help of a walking support and a physical therapist the day after surgery. In some cases, patients ... walking on the actual day of surgery. The physical therapist will teach you specific exercises to strengthen your ...

  20. Treatment of hip instability.

    Science.gov (United States)

    Robbins, G M; Masri, B A; Garbuz, D S; Greidanus, N; Duncan, C P

    2001-10-01

    Instability after total hip arthroplasty is a major source of patient morbidity, second only to aseptic loosening. Certain patient groups have been identified as having a greater risk of instability, including patients undergoing revision arthroplasty as early or late treatment for proximal femoral fractures.

  1. Hip fracture in hospitalized medical patients.

    Science.gov (United States)

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

    2013-01-08

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

  2. Hip Arthroscopy: A Brief History.

    Science.gov (United States)

    Kandil, Abdurrahman; Safran, Marc R

    2016-07-01

    Hip arthroscopy is a fast-growing and evolving field. Like knee and shoulder arthroscopy, hip arthroscopy began as a diagnostic procedure and then progressed to biopsy and resection of abnormalities. Subsequently, it has evolved to repair of various tissues and treatment of underlying causes. As the understanding of the hip joint and its associated pathophysiology grows, indications will continue to expand for this diagnostic and therapeutic modality. This article outlines the historic developments of hip arthroscopy, including advancements in instrumentation and techniques from the days of the first hip arthroscopies to the present day.

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

    Science.gov (United States)

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

    2014-06-01

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

  4. Prioritization of interventions for strengthening architectural heritage

    Directory of Open Access Journals (Sweden)

    Fatemeh Mehdizadeh Saradj

    2017-09-01

    Full Text Available Architectural heritage is continuously exposed to natural disasters, such as strong earthquakes and this highlights the importance of reducing their vulnerability. While it is not possible to simultaneously strengthen all architectural heritage structures due to the limited skilled labour and budget restrictions, different buildings may need different treatments due to differences in exposure to seismic hazard, relative importance and vulnerability. Therefore, there is a need for a decision making strategy to find optimized solutions to achieve the highest possible stability and benefits. The primary objective of this research is to develop a practical step-by-step decision making process for the planning and prioritization of interventions in architectural heritage structures based on the level of seismic hazard, vulnerability and condition assessment, available preservation and strengthening techniques, compatibility with conservation ethics, available budget and expected benefits in various time schedules. The proposed methodology, is shown by diagram and mathematical formulae, and is demonstrated through a case study example.

  5. Cementing constrained acetabular liners in revision hip replacement: clinical and laboratory observations.

    Science.gov (United States)

    Mountney, John; Garbuz, Donald S; Greidanus, Nelson V; Masri, Bassam A; Duncan, Clive P

    2004-01-01

    During revision hip arthroplasty, removal of a well-fixed, ingrown metal acetabular component may not be possible. Therefore, a new polyethylene liner can be cemented into the existing shell via the cement locking mechanism. This technique is well recognized, and the cement locking mechanism has proved to be sufficiently strong and durable for clinical use. A constrained polyethylene liner is designed to reduce the risk of hip dislocation by capturing the femoral head. However, there are increased shear forces created at the liner interface as the dislocation is resisted. If a constrained liner is cemented into an ingrown acetabular component, then there is the theoretical risk that these increased shear forces will damage the cement locking mechanism, thus leading to failure of the construct. There are a few clinical series in which a constrained liner has been used with the cement locking mechanism. Overall, the failure rate of the cement locking mechanism is no greater if a constrained liner instead of a standard liner is used. The cement locking mechanism can be strengthened by roughening the backside of a smooth polyethylene liner to improve the cement-polyethylene interface, or by using an all-polyethylene acetabular component that is designed to be used with cement. Whether a smooth metal shell needs to be roughened as well is a matter of debate.

  6. Does bone mineral density affect hip fracture severity?

    Science.gov (United States)

    Spencer, Simon J; Blyth, Mark J G; Lovell, Frances; Holt, Graeme

    2012-06-01

    The association between hip fracture and reduced bone mineral density is well documented, with reduced bone mineral density predisposing to fracture. However, it is unknown whether an association exists between the magnitude of bone density lost and the severity of the hip fracture sustained. One hundred forty-two patients (96 women, 46 men) with a mean age of 74 years (range, 49-92 years) who sustained a hip fracture following a simple ground-level fall and were treated for this injury were reviewed. All patients had undergone dual-energy x-ray absorptiometry bone scanning of the contralateral hip and lumbar spine. Fractures were classified as intra- or extracapsular or subtrochanteric and then subclassified by degree of severity as simple (stable) or multifragmentary (unstable) fracture patterns.Although a low hip bone mineral density (T- or Z score fracture (P=.025) compared with other fracture types, no association existed between bone mineral density and the severity of the resultant hip fracture. Although an association exists between bone mineral density and the risk of fragility fractures, the results of the current study suggest that the severity of hip fractures does not follow this correlation. Therefore, no assumption can be made about bone mineral density of the proximal femur based on the severity of the fracture observed on plain radiographs. Copyright 2012, SLACK Incorporated.

  7. Strengthening the control of nosocomial infections to reduce the incidence of surgical incision infections%加强手术室内感染的控制措施降低手术切口感染率

    Institute of Scientific and Technical Information of China (English)

    江媚霞

    2013-01-01

    OBJECTIVE To explore the effective measures for the control of infections in the operating rooms so as to prevent the nosocomial infections. METHODS The causes of nosocomial infections and the infection routes were analyzed, the operation procedure was optimized, the rules and regulations of the operating rooms were improved, at the same time, the aseptic principle and technology of medical staff was strengthened, and the management of surgical instrument was improved, and the monitoring of the nosocomial infections was made to be perfect, and the reward and punishment measures were implemented. RESULTS After the control measures were implemented in the operating rooms, the incidence rate of the incision infections was significantly decreased, both the average hospitalization duration and the hospitalization cost were decreased, and the aseptic concept of the medical staff was significantly improved; the healing rate of the class A surgical incision was higher than 98. 0% in 5 consecutive years. CONCLUSION It is an effective way to prevent the nosocomial infections by strengthening the infection control in the operating rooms, strictly implementing the rules and regulations, regularly monitoring the nosocomial infections, and finding out the problems in timely manner to correct it.%目的 探讨控制手术室内感染的有效措施,以预防医院感染.方法 分析引起医院感染发生的源头以及感染的途径,优化手术室操作流程,完善手术室的规章制度,加强医务人员的无菌原则,提高手术物品的管理,健全医院感染的监控和奖惩措施.结果 加强手术室内感染控制措施后,医院手术患者切口感染率较前显著下降,患者平均住院天数和住院费用均有所降低,医务人员的无菌观念得到明显提高;医院连续5年无菌手术切口甲级愈合率>98.0%.结论 加强手术室的感染控制,严格执行手术室规章制度,定期监测医医院感染,及时发现问题并纠

  8. Conus hip prosthesis.

    Science.gov (United States)

    Wagner, H; Wagner, M

    2001-01-01

    50 years ago, prosthetic replacement of the hip joint ushered in a new epoch in orthopaedics. Total hip replacement made it possible to remove a severely diseased, painful hip and restore normal function and a normal quality of life to the afflicted patient. The early results of total hip replacement are almost all spectacular and hip replacement has become the most successful type of orthopaedic surgery. These good results using an approach that was technically relatively simple resulted in a temptation to implant prosthetic hip joints with ever increasing frequency in ever younger patients. This led to the emergence of new problems, which were not so clearly recognised at the outset: it emerged that the stability of prosthetic hip joints was of limited duration. This had the following consequence: If a total hip prosthesis is implanted in an elderly person whose remaining life-expectancy is shorter than the longevity of the prosthesis, hip replacement is a life-long solution. We can therefore say that, for a patient who has only 10 to 15 years left to live, their hip problem is solved by total hip replacement. For young people, who still have a long life expectancy in front of them, it is different. They will experience failure of the artificial joint and require further surgery. The commonest and most important type of failure in total hip prostheses is aseptic loosening, which is associated with resorption of bone at the site of the prosthesis. The cause of this phenomenon has only gradually been recognised in the course of the years. Initially, the unanimous opinion was that the methacrylate cement, used to fix the components of the prosthesis in the bone, was the definitive cause of aseptic loosening because fissures and fractures of the cement were almost always found during surgical revision of loosened joints. There was talk of "cement disease" and great efforts were made to improve the quality of the cement and the cementing technique. Moreover, even

  9. Strategy for Strengthening Farmer Groups by Institutional Strengthening

    Directory of Open Access Journals (Sweden)

    Purbayu Budi Santoso

    2015-08-01

    Full Text Available Agriculture sector becomes a spotlight because this sector will be full of potential but the welfare of farmers who become the leading actor is not guaranteed and has a poor tendency. The purpose of this study is to formulate strategies to strengthen farmers' groups in order to create the marketing of the agricultural sector that benefit farmers. The method used to achieve this goal is to use a qualitative approach and Analytical Network Process. In addition to the secondary data obtained from several agencies, this study also uses primary data obtained by in-depth interviews and observations. This research results a priority of aspects of the institutional strengthening of farmer groups as well as priority issues and priorities of the solution of each aspect. In addition, the priority of alternative strategies resulted based on the problems and solutions that have been analyzed in order to solve the problems in the institutional strengthening of farmer groups in Demak.

  10. Strengthening Building Retrofit Markets

    Energy Technology Data Exchange (ETDEWEB)

    Templeton, Mary [Michigan Saves; Jackson, Robert [Michigan Energy Office

    2014-04-15

    The Business Energy Financing (BEF) program offered commercial businesses in Michigan affordable financing options and other incentives designed to support energy efficiency improvements. We worked through partnerships with Michigan utilities, lenders, building contractors, trade associations, and other community organizations to offer competitive interest rates and flexible financing terms to support energy efficiency projects that otherwise would not have happened. The BEF program targeted the retail food market, including restaurants, grocery stores, convenience stores, and wholesale food vendors, with the goal of achieving energy efficiency retrofits for 2 percent of the target market. We offered low interest rates, flexible payments, easy applications and approval processes, and access to other incentives and rebates. Through these efforts, we sought to help customers strive for energy savings retrofits that would save 20 percent or more on their energy use. This program helped Michigan businesses reduce costs by financing energy efficient lighting, heating and cooling systems, insulation, refrigeration, equipment upgrades, and more. Businesses completed the upgrades with the help of our authorized contractors, and, through our lending partners, we provided affordable financing options.

  11. The relation between hip impact velocity and hip impact force differs between sideways fall techniques.

    NARCIS (Netherlands)

    Groen, B.E.; Weerdesteijn, V.G.M.; Duysens, J.

    2008-01-01

    Fall techniques that reduce fall severity may decrease the risk of hip fractures. A fundamental variable for fall severity is impact force, but impact velocity is also used. The purpose of the study was to determine whether impact velocity is valid to determine differences in fall severity between

  12. The relation between hip impact velocity and hip impact force differs between sideways fall techniques.

    NARCIS (Netherlands)

    Groen, B.E.; Weerdesteijn, V.G.M.; Duysens, J.

    2008-01-01

    Fall techniques that reduce fall severity may decrease the risk of hip fractures. A fundamental variable for fall severity is impact force, but impact velocity is also used. The purpose of the study was to determine whether impact velocity is valid to determine differences in fall severity between d

  13. In-situ formation of complex oxide precipitates during processing of oxide dispersion strengthened ferritic steels

    Energy Technology Data Exchange (ETDEWEB)

    Jayasankar, K., E-mail: jayasankar.met@gmail.com [CSIR-Institute of Minerals & Materials Technology, Bhubaneswar 751013 (India); Pandey, Abhishek [CSIR-Advanced Materials & Processes Research Institute, Bhopal 462026 (India); Mishra, B.K. [CSIR-Institute of Minerals & Materials Technology, Bhubaneswar 751013 (India); Das, Siddhartha [Indian Institute of Technology, Kharagpur 721302 (India)

    2016-01-15

    Highlights: • Use of dual drive planetary ball mill for Bench scale (>1 kg) production. • X-ray diffraction and TEM were used to study transformations during sintering. • HIPped and rolled samples with nearly 99% density successfully produced. - Abstract: In fusion and fission reactor material development, ODS alloys are the most suitable candidate materials due to its high temperature creep properties and irradiation resistance properties. This paper describes the preparation of oxide dispersion strengthened alloy powder in large quantity (>1 kg batch) in dual drive planetary ball mill using pre-alloyed ferrtic steel powder with nano sized Y{sub 2}O{sub 3}. The consolidation of the powders was carried out in hot isostatic press (HIP) followed by hot rolling. 99% of the theoretical density was achieved by this method. The vickers hardness values of pressed and rolled samples were in the range of 380 ± 2HV and 719 ± 2HV, respectively. Samples were further investigated using X-ray diffraction particle size analyzer and electron microscope. Initial increase in particle size with milling was observed showing flattening of the particle. It was found that 5 h of milling time is sufficient to reduce the particle size to achieve the desired size. Transmission electron microscopy analysis of milled ODS steel powder revealed a uniform distribution of combustion synthesized nano-Y{sub 2}O{sub 3} in ferritic steel matrix after a milling time of 5 h. Preliminary results demonstrated suitability of dual drive planetary ball mill for mass production of alloy within a short time due to various kinds of forces acting at a time during milling process. Fine monoclinic Y{sub 2}Si{sub 2}O{sub 7} precipitates were also observed in the steel. This study explains the particle characteristics of nano Y{sub 2}O{sub 3} dispersed ODS powder and formation of nano clusters in ODS ferritic alloy.

  14. Revision of hip resurfacing arthroplasty.

    Science.gov (United States)

    Wera, Glenn D; Gillespie, Robert J; Petty, Carter; Petersilge, William J; Kraay, Matthew J; Goldberg, Victor M

    2010-08-01

    Metal-on-metal (MOM) hip resurfacing has become an increasingly popular treatment for young, active patients with degenerative disease of the hip, as bearing surfaces with better wear properties are now available. One proposed advantage of resurfacing is its ability to be successfully revised to total hip arthroplasty (THA). In addition, radiographic parameters that may predict failure in hip resurfacing have yet to be clearly defined. Seven MOM resurfacing arthroplasties were converted to conventional THAs because of aseptic failure. Using Harris Hip Scores (HHS) and Short Form 12 (SF-12) questionnaire scores, we compared the clinical outcomes of these patients with those of patients who underwent uncomplicated MOM hip resurfacing. In addition, all revisions were radiographically evaluated. Mean follow-up periods were 51 months (revision group) and 43 months (control group). There was no significant difference between the 2 groups' HHS or SF-12 scores. There was no dislocation or aseptic loosening after conversion of any resurfacing arthroplasty. Valgus neck-shaft angle (P hip resurfacing. Conversion of aseptic failure of hip resurfacing to conventional THA leads to clinical outcomes similar to those of patients who undergo uncomplicated hip resurfacing. The orientation of the femur and the components placed play a large role in implant survival in hip resurfacing. More work needs to be done to further elucidate these radiographic parameters.

  15. Current status of noncemented hip implants.

    Science.gov (United States)

    Harris, W H

    1987-01-01

    Recently the operative techniques, instrumentation, design, and material properties of bony ingrowth total hip replacement have been greatly improved. I prefer a hemispherical acetabular component fixed with screws going through the metal shell. The titanium mesh allows microinterlock with new bone, and macrointerlock is obtained by adding bone graft into the unused screw holes. The femoral component, made of Tivanium with titanium mesh attached to it by a new process called diffusion bonding, retains superalloy fatigue strength characteristics. An intimate press fit is assured by the specific operative technique, and both the fiber mesh and the collar provide proximal stress transfer. The design affords a nondestructive method for removal if necessary. The short-term clinical results are promising; most patients function as well as with cemented total hip replacement. The incidence of thigh pain has been significantly reduced since prior reports of cementless total hip replacement; however, a few patients still have thigh pain. The results in revision surgery are also promising, but as in cemented total hip replacement, the functional capacity of revision cases is usually lower than primary cases. There is an increased capacity to correct complex and difficult acetabular problems with this acetabular component. Obviously, long-term data are needed to establish the behavior of these implants over the immediate and long term.

  16. Nonarthritic hip joint pain.

    Science.gov (United States)

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

    2014-06-01

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

  17. Comparison of neuromuscular and quadriceps strengthening exercise in the treatment of varus malaligned knees with medial knee osteoarthritis: a randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Bennell Kim L

    2011-12-01

    Full Text Available Abstract Background Osteoarthritis of the knee involving predominantly the medial tibiofemoral compartment is common in older people, giving rise to pain and loss of function. Many people experience progressive worsening of the disease over time, particularly those with varus malalignment and increased medial knee joint load. Therefore, interventions that can reduce excessive medial knee loading may be beneficial in reducing the risk of structural progression. Traditional quadriceps strengthening can improve pain and function in people with knee osteoarthritis but does not appear to reduce medial knee load. A neuromuscular exercise program, emphasising optimal alignment of the trunk and lower limb joints relative to one another, as well as quality of movement performance, while dynamically and functionally strengthening the lower limb muscles, may be able to reduce medial knee load. Such a program may also be superior to traditional quadriceps strengthening with respect to improved pain and physical function because of the functional and dynamic nature. This randomised controlled trial will investigate the effect of a neuromuscular exercise program on medial knee joint loading, pain and function in individuals with medial knee joint osteoarthritis. We hypothesise that the neuromuscular program will reduce medial knee load as well as pain and functional limitations to a greater extent than a traditional quadriceps strengthening program. Methods/Design 100 people with medial knee pain, radiographic medial compartment osteoarthritis and varus malalignment will be recruited and randomly allocated to one of two 12-week exercise programs: quadriceps strengthening or neuromuscular exercise. Each program will involve 14 supervised exercise sessions with a physiotherapist plus four unsupervised sessions per week at home. The primary outcomes are medial knee load during walking (the peak external knee adduction moment from 3D gait analysis, pain, and self

  18. The influence of heterotopic ossification on functional status of hip joint following total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Pohl, F.; Seufert, J.; Flentje, M.; Koelbl, O. [Wuerzburg Univ. (Germany). Dept. of Radiotherapy; Tauscher, A.; Springorum, H.W. [Caritas Krankenhaus Bad Mergentheim (Germany). Orthopedic Clinic; Lehmann, H. [Caritas Krankenhaus Bad Mergentheim (Germany). Inst. of Radiology

    2005-08-01

    Purpose: The functional failure induced by heterotopic ossification (HO) following total hip arthroplasty (THA) was analyzed and correlated to the radiologic failure. Patients and methods: From July 1997 to July 2001, 315 patients (345 hips) received THA indicated by a hypertrophic osteoarthritis of higher degree (Kellgren grade III, IV). All patients were irradiated prophylactically for prevention of HO on the evening before surgery with a 7-Gy single fraction. The patients' median age was 66.3 years. Radiologic failure was assessed by comparison of pre- and postoperative hip X-rays (immediately and 6 months after surgery). Analysis of radiographs was performed according to the Brooker Score. Clinical failure was appraised by measurement of passive range of motion (ROM) of the hip joint with a standard goniometer. The t-test was used for statistical analysis. Results: 281 patients (81.5%) did not develop HO. HO of Brooker grade I or II was found in 58 patients (16.8%). Six patients (1.7%) developed HO Brooker grade III or IV. There was a significant negative correlation between the degree of radiologic and clinical failure. ROM differed significantly between patients with HO Brooker grade 0, I, II and patients with HO Brooker grade III, IV. Comparing the pre- and postoperative ROM, all patients with Brooker grade 0, I and II showed a significant improvement of flexion, internal and external rotation, abduction and adduction movement. Patients with HO Brooker grade III and IV showed no improvement of ROM in the postoperative follow-up. Conclusion: The development of HO following THA influences the physical function of the hip joint dependent on the degree of ossification. HO of lower degree (Brooker I, II) does not influence the clinical outcome, whereas HO of higher degree (Brooker III, IV) reduces the function of hip arthroplasty. Therefore, the purpose of a prophylactic therapy must be to reduce HO of higher degree. (orig.)

  19. EFFECTIVENESS OF STRETCHING AND STRENGTHENING EXERCISES (JANDA’S APPROACH IN SUBJECTS WITH POSTURAL BACKACHE: A RANDOMIZED CONTROLLED TRIAL

    Directory of Open Access Journals (Sweden)

    Vijay Kage

    2015-12-01

    Full Text Available Background: Chronic low back pain is often associated with imbalances in hip muscle length and strength. Low back pain could result from prolonged overstretching of the innervated soft tissues when poor sitting or standing postures were maintained. These changes in muscular tone create a muscle imbalance, which leads to movement dysfunction. Objectives: To investigate the effect of Stretching and Strengthening exercises (Janda’s Approach in subjects with Postural Back Ache. Study D¬esign: Randomized Controlled Trial Intervention: 40 participants were divided into two groups; Group A was the control group and Group B was the Janda’s Approach group. Group A was given Shortwave Diathermy with Core Stability exercises and Group B was given SWD with Core Stability exercises followed by Janda’s Approach Exercises. Outcome Measure: Pain Intensity, Severity of Spinal Malalignment and Muscle Strength and Flexibility were measured using Visual Analogue Scale (VAS, Index of Lumbar Lordosis, Manual Muscle Testing of abdominals and gluteals and Tests for flexibility of iliopsoas, rectus femoris and erector spinae respectively. Results: The results showed a significant difference between both groups in terms of VAS, index of lumbar lordosis, manual muscle testing of abdominals, gluteals and tests for flexibility of iliopsoas, rectus femoris and erector spinae.. Conclusion: The results concluded that stretching and strengthening exercises are beneficial in reducing pain, normalizing the lumbar lordosis curvature, increasing strength of abdominals and gluteals and increasing flexibility of rectus femoris, iliopsoas and erector spinae.

  20. Physical Activity and Hip Fracture Disability: A Review

    Science.gov (United States)

    Marks, Ray

    2011-01-01

    Objective. The present paper examines pertinent literature sources published in the peer-reviewed English language between 1980 and November 1, 2010 concerning hip fractures. The aim was to highlight potential intervention points to offset the risk of incurring a hip fracture and its attendant disability. Methods. An in-depth search of the literature using the key terms: disability, epidemiology, hip fracture, prevention, and risk factors was conducted, along with data from the author's research base detailing the disability associated with selected hip fracture cases. All articles that dealt with these key topics were reviewed, and relevant data were tabulated and analyzed. Results. Hip fractures remain an important but potentially preventable public health problem. Among the many related remediable risk factors, low physical activity levels are especially important. Related determinants of suboptimal neuromuscular function also contribute significantly to hip fracture disability. Conclusion. Physical activity participation can help to reduce the prevalence and excess disability of hip fractures and should be encouraged. PMID:21584248

  1. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    OpenAIRE

    Sporer, Scott M.; Bernard R. Bach, Jr

    2009-01-01

    DESCRIPTION A user friendly reference for decision making in hip arthroplasty designed in a question formed clinical problem scenarios and answers format .The articles composed of the answers, containing current concepts and preferences of experts in primary and revision hip surgery are enhanced by several images, diagrams and references and written in the form of a curbside consultation by Scott M. Sporer, MD. and his collaborators. PURPOSE By this practical reference of hip arthroplasty, Sc...

  2. Nursing Experience of Perioperative Nursing for Patients with Artificial Hip Replacement%人工髋关节置换术患者围手术期的护理体会

    Institute of Scientific and Technical Information of China (English)

    冷观琴

    2015-01-01

    目的探讨人工髋关节置换术患者的围手术期护理。方法回顾性分析40例人工髋关节置换术手术后患者的护理资料。结果39例平稳渡过围手术期安全出院,只有1例患者出现深静脉血栓并发症。结论人工髋关节置换术手术风险较高,加强围手术期护理能有效降低手术风险,提高手术成功率。%Objective To investigate the peri operation period nursing of the patients with artificial hip joint replacement. Methods The nursing data of 40 patients after artificial hip joint replacement were reviewed retrospectively. Results 39 cases which smoothly passed through the operation were safely discharged, only 1 patients with deep venous thrombosis complications. Conclusion Artificial hip joint replacement operation with high risk, Because the artificial hip joint replacement operation risk is higher, to strengthen peri operation period nursing can ef ectively reduce the operation risk, improve the success rate of operation.

  3. Hip resurfacing: history, current status, and future.

    Science.gov (United States)

    Amstutz, Harlan C; Le Duff, Michel J

    2015-01-01

    Hip resurfacing arthroplasty (HRA) presents several advantages over conventional total hip arthroplasty (THA), including conservation and preservation of bone, reduced risk of dislocation, easy replication of hip biomechanics and easy revision if needed. It is a particularly appealing procedure for young patients. HRA has been performed for over 40 years following the same technological advances as THA. The bearing material used by most designs is metal-on-metal (MoM), which has the best compromise between strength and wear properties. However, MoM HRA has a specific set of possible complications. Aseptic femoral failures were initially the most prevalent cause for revision but progress in patient selection and surgical technique seem to have resolved this problem. Wear-related failures (high metal ion levels and adverse local tissue reactions) are now the main concern, and are essentially associated with poor acetabular component design and orientation, to which MoM is more sensitive than other bearing materials. The concept of functional coverage is key to understanding how MoM bearings are affected by edge wear. Only a 3-D assessment of cup position (e.g., the contact patch to rim distance) provides the necessary information to determine the role of cup positioning in relationship with abnormal bearing wear.The concept of hip resurfacing is more valid today than ever as the age of the patients in need of hip arthroplasty keeps getting lower. The recent publication of several excellent long-term survivorship results suggests that selection of a well-designed resurfacing system and accuracy in the placement of the cup can achieve long-term durability.

  4. Hip Dysplasia in Children With Osteogenesis Imperfecta: Association With Collagen Type I C-Propeptide Mutations.

    Science.gov (United States)

    Kishta, Waleed; Abduljabbar, Fahad H; Gdalevitch, Marie; Rauch, Frank; Hamdy, Reggie; Fassier, François

    Osteogenesis imperfecta (OI) is a heritable skeletal disorder characterized by bone fragility and short stature that is usually due to mutations in 1 of the 2 genes that code for collagen type I α-chains. The association between hip dysplasia and OI has not been systematically investigated. In this single-center study, we retrospectively reviewed all cases of OI associated with hip dysplasia to describe clinical characteristics and the effect of therapy. We reviewed the charts of 687 patients with OI who were seen at the Shriners Hospital for Children in Montreal between 1999 and 2013 to identify patients with a diagnosis of hip dysplasia. Clinical characteristics and the course after therapeutic interventions were extracted from the charts. Hip dysplasia was diagnosed in 8 hips of 5 patients (4 boys, 1 girl; age at diagnosis ranged between 3 wk and 27 mo old). The prevalence of hip dysplasia and OI was therefore 0.87% (per patient). In 4 of the 5 patients (80%), OI was caused by mutations affecting the C-propeptide of collagen type I, which is otherwise rare in OI. Among the 26 patients with C-propeptide mutations followed at our institution, 4 (15%) had hip dysplasia. Pavlik harness treatment was attempted in 2 patients (3 hips) but was not effective in either case and resulted in avascular necrosis of 1 hip. Femoral varus derotational shortening osteotomies using a telescopic rod were performed in all 8 hips along with a closed reduction in 4 hips and an open reduction in 4 hips. Concomitant pelvic osteotomies were performed in 2 hips (1 patient). Surgery resulted in redislocation of 1 hip; all other surgically treated hips remained reduced. Clinical screening for hip dysplasia is difficult in OI owing to the bowing of the proximal femur and the risk of causing fractures. OI patients with positive C-propeptide mutation should therefore be screened for hip dysplasia by use of ultrasound. Presence of a C-propeptide mutation appears to be a risk factor for hip

  5. Canine hip and elbow dysplasia in UK Labrador retrievers.

    Science.gov (United States)

    Woolliams, J A; Lewis, T W; Blott, S C

    2011-08-01

    This paper examines the outcomes from recent genetic analyses of hip and elbow scores from British Veterinary Association (BVA)/UK Kennel Club (KC) screening programmes targeted at reducing the prevalence of hip dysplasia (HD) and elbow dysplasia in UK Labrador retrievers. The analyses made use of 25,243 hip scores and 3613 elbow scores. Heritabilities (± standard error) for hip score, analysed on a log scale, and for elbow score were 0.35±0.02 and 0.19±0.04, respectively, with a genetic correlation of 0.41±0.09. For both hip and elbow scores, there was a near perfect genetic correlation between the left and right joint; analysis of hip score showed a predictive benefit of using the total of left and right scores rather than worst score and the benefit of using all component scores rather than their aggregate score. Downward genetic trends were observed in both hip and elbow scores, although the latter was consistent with it being correlated to response to genetic change in hip score. Estimated breeding values (EBVs) offered substantial benefits in accuracy and hence genetic progress when compared to the use of phenotypes for both hip and elbow scores. There are major opportunities for improving selection against elbow dysplasia through the use of bivariate evaluations, although progress against dysplasia would be improved by more widespread elbow scoring. The studies highlighted a number of ways in which data recording for addressing complex traits may be improved in the future. Ongoing advances in genomic technology may be utilised for increasing the rate of genetic progress in selection against HD and for complex diseases in general, through the use of genomic evaluations. Copyright © 2011. Published by Elsevier Ltd.

  6. Hip Hip Hurrah! Hip size inversely related to heart disease and total mortality

    DEFF Research Database (Denmark)

    Heitmann, B L; Lissner, L

    2011-01-01

    obesity and/or waist circumference. These studies have been remarkable in terms of their consistency, and in the unexpected finding of an adverse effect of small hip size, after statistically correcting for differences in general and abdominal size. The hazard related to a small hip size may be stronger......During the past decade a series of published reports have examined the value of studying the relation between hip circumferences and cardiovascular end points. Specifically, in a series of recent studies the independent effects of hip circumference have been studied after adjustment for general...

  7. Trochanteric osteotomy in total hip replacement for congenital hip disease.

    Science.gov (United States)

    Hartofilakidis, G; Babis, G C; Georgiades, G; Kourlaba, G

    2011-05-01

    We studied the effect of trochanteric osteotomy in 192 total hip replacements in 140 patients with congenital hip disease. There was bony union in 158 hips (82%), fibrous union in 29 (15%) and nonunion in five (3%). The rate of union had a statistically significant relationship with the position of reattachment of the trochanter, which depended greatly on the pre-operative diagnosis. The pre-operative Trendelenburg gait substantially improved in all three disease types (dysplasia, low and high dislocation) and all four categories of reattachment position. A persistent Trendelenburg gait post-operatively was noticed mostly in patients with defective union (fibrous or nonunion). Acetabular and femoral loosening had a statistically significant relationship with defective union and the position of reattachment of the trochanter. These results suggest that the complications of trochanteric osteotomy in total hip replacement for patients with congenital hip disease are less important than the benefits of this surgical approach.

  8. Functional activity in patients after total hip replacement.

    Science.gov (United States)

    Pogorzała, Adam M; Stryła, Wanda; Nowakowski, Andrzej

    2012-11-08

    Osteoarthritis of hip joints is one of the most common diseases limiting social functioning of patients. Pain and mobility disorders are major problems associated with the disease. The goal of the study was to compare the efficacy of surgical treatment in a selected group of patients using a modified Harris Hip Score questionnaire including questions regarding the pain, the type of gait disorders and the functional activity. Surgical treatment helped to reduce the pain and improve the gait quality and parameters as well as functional activities associated with putting on socks and shoes, climbing stairs, sitting and using public transportation. Following conclusions were drawn after the study: Surgical treatment leads to significant reduction in hip pain. Mobility improvement was observed in most analyzed patients in early post-operative period as a consequence of hip contracture and pain being eliminated. The walking speed and distance improved significantly during the first 3 months after the surgery. All patients were satisfied with the treatment.

  9. Developmental dysplasia of the hip in neonates: evolution of acetabular dysplasia after hip stabilization by brief Pavlik harness treatment.

    Science.gov (United States)

    Bin, K; Laville, J-M; Salmeron, F

    2014-06-01

    The recommended treatment duration in neonates with developmental dysplasia of the hip (DDH) varies depending on whether prolonged Pavlik harness therapy is believed to favourably affect the course of the acetabular dysplasia. According to one theory, several months of additional Pavlik harness therapy after achieving hip reduction contributes to correct the acetabular dysplasia. Another theory holds that hip dislocation induces the acetabular dysplasia, which corrects spontaneously once the femoral head is properly seated in the acetabulum. Here, we evaluated this second theory by studying outcomes after early brief Pavlik harness therapy. Acetabular dysplasia associated with neonatal hip instability undergoes self-correction provided stable hip reduction is achieved very early after birth. Therefore, the duration of Pavlik harness therapy can be substantially shortened. We defined hip instability as either reducible hip dislocation or a very easily dislocatable hip with a soft clunk precluding determination of spontaneous hip position as dislocated or reduced. Static and dynamic ultrasound scans were obtained. Patients with ultrasonographic instability (pubo-femoral distance>5mm with less than 50% of coverage) underwent a second physical examination and received treatment. We re-evaluated 42 abnormal hips in 30 patients after a mean follow-up of 6.7 years (range, 5-14 years). Mean age at treatment initiation was 5 days (range, 1-15 days) and mean treatment duration was 34 days (range, 15-75 days). Mean acetabular angle was 20° (range, 12°-30°) and mean Wiberg's lateral centre-edge angle was 30° (range, 22°-35°). Blunting of the lateral angle of the bony roof was noted in 8 hips at last follow-up. In 1 patient whose hip was stable clinically but unstable by ultrasonography at 21 days of age, recurrent dislocation occurred at 5 months of age. The Severin class was 1a in all patients. Despite continuing controversy about whether hip dislocation induces

  10. Danish Hip Arthroscopy Registry

    DEFF Research Database (Denmark)

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

    2016-01-01

    and Pincer resection in 93.5% of the cases. Labral refixation or repair was done in 70.3% of the cases. The most common type of acetabular chondral damage was grade II lesions (36.6%). Grade III and IV changes were seen in 36.1% of the cases. The preoperative iHOT12 was 45 (mean) based on all 12 items. EQ-5D....... The problems with development and maintaining a large clinical registry are described and further studies are needed to validate data completeness. We consider the development of a national clinical registry for hip arthroscopy as a successful way of developing and maintaining a valuable clinical...

  11. Microstructure Refinement and Strengthening Mechanisms of a 9Cr Oxide Dispersion Strengthened Steel by Zirconium Addition

    Directory of Open Access Journals (Sweden)

    Haijian Xu

    2017-02-01

    Full Text Available To study the effects of zirconium (Zr addition on the microstructure, hardness and the tensile properties of oxide dispersion strengthened (ODS ferritic–martensitic steels, two kinds of 9Cr-ODS ferritic–martensitic steels with nominal compositions (wt.% of Fe-9Cr-2W-0.3Y2O3 and Fe-9Cr-2W-0.3Zr-0.3Y2O3 were fabricated by the mechanical alloying (MA of premixed powders and then consolidated by hot isostatic pressing (HIP techniques. The experimental results showed that the average grain size decreases with Zr addition. The trigonal δ-phase Y4Zr3O12 oxides and body-centered cubic Y2O3 oxides are formed in the 9Cr-Zr-ODS steel and 9Cr non-Zr ODS steel, respectively, and the average size of Y4Zr3O12 particles is much smaller than that of Y2O3. The dispersion morphology of the oxide particles in 9Cr-Zr-ODS steel is significantly improved and the number density is 1.1×1023/m3 with Zr addition. The 9Cr-Zr-ODS steel shows much higher tensile ductility, ultimate tensile strength and Vickers hardness at the same time.

  12. Effects of cryomilling on the microstructures and high temperature mechanical properties of oxide dispersion strengthened steel

    Science.gov (United States)

    Gwon, Jin-Han; Kim, Jeoung-Han; Lee, Kee-Ahn

    2015-04-01

    The effects of cryomilling on the microstructures and high temperature mechanical properties of oxide dispersion-strengthened (ODS) steel were examined. Cryomilling was newly tried on this ODS steel to control oxides, grains, and dislocation microstructures. Fe-14Cr-3W-0.4Ti (wt.%) alloy powder and 0.3 wt.%Y2O3 powder were mixed and were mechanically alloyed (MA) through ball milling at each of room temperature (RT) and -150 °C and then hot isostatic pressing (HIP), hot rolling, and annealing processes were implemented to manufacture two types of ODS ferritic steel, K1 (RT) and K4 (-150 °C). Oxide particles were shown to be finer and more uniformly distributed in K4 (5-10 nm size distribution) than in K1 (average size 30 nm). The two alloys were subjected to high temperature compression (RT ∼ 900 °C) tests. K4 represented higher yield strength under all temperature conditions. However, K4 showed rapid strength decreases at high temperatures exceeding 700 °C and showed similar levels of strengths to K1 at 900 °C. This is considered attributable to the fact that although cryomilling increased the number density of oxide particles, it simultaneously reduced grain sizes too much, so that grain boundary weakening at high temperatures could not be sufficiently prevented.

  13. Social inequality and hip fracture

    DEFF Research Database (Denmark)

    Harvey, N. C.; Hansen, L.; Judge, A.

    2015-01-01

    Social inequality appears to be increasing in many countries. We explored whether risk of hip fracture was associated with markers of inequality and whether these relationships changed with time, using data from Danish Health Registries. Methods: All patients 60 years or older with a primary hip...

  14. Hip and Lumbar Spine Physical Examination Findings in People Presenting With Low Back Pain, With or Without Lower Extremity Pain.

    Science.gov (United States)

    Prather, Heidi; Cheng, Abby; Steger-May, Karen; Maheshwari, Vaibhav; Van Dillen, Linda

    2017-03-01

    Study Design Prospective cohort study, cross-sectional design. Background The hip-spine syndrome is described in patients with known arthritis of the hip. This study describes the hip examination findings of people presenting with low back pain (LBP). Objectives To (1) report examination findings of the hip in patients with LBP and (2) compare pain and function in patients with positive hip examination findings to those in patients without positive hip examination findings. Methods An examination and validated questionnaires of spine and hip pain and function were completed. Pain and function scores were compared between patients with and without positive hip findings. Results Consecutive patients (68 women, 33 men) with a mean age of 47.6 years (range, 18.4-79.8 years) participated. On physical examination, 81 (80%) had reduced hip flexion; 76 (75%) had reduced hip internal rotation; and 25 (25%) had 1, 32 (32%) had 2, and 23 (23%) had 3 positive provocative hip tests. Patients with reduced hip flexion had worse LBP-related (mean modified Oswestry Disability Index, 35.3 versus 25.6; P = .04) and hip-related function (mean modified Harris Hip Score, 66.0 versus 82.0; P = .03). Patients with reduced hip internal rotation had worse LBP-related function (mean Roland-Morris questionnaire, 12.4 versus 8.2; P = .003). A positive provocative hip test was coupled with more intense pain (median, 9 versus 7; P = .05) and worse LBP-related (mean Roland-Morris questionnaire, 12.1 versus 8.5; P = .02) and hip-related function (mean modified Harris Hip Score, 65.8 versus 89.7; P = .005). Conclusion Physical examination findings indicating hip dysfunction are common in patients presenting with LBP. Patients with LBP and positive hip examination findings have more pain and worse function compared to patients with LBP but without positive hip examination findings. Level of Evidence Symptom prevalence, level 1b. J Orthop Sports Phys Ther 2017;47(3):163-172. Epub 3 Feb 2017. doi:10

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

    Science.gov (United States)

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

    2012-02-01

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

  16. Initial Semantics for Strengthened Signatures

    Directory of Open Access Journals (Sweden)

    André Hirschowitz

    2012-02-01

    Full Text Available We give a new general definition of arity, yielding the companion notions of signature and associated syntax. This setting is modular in the sense requested by Ghani and Uustalu: merging two extensions of syntax corresponds to building an amalgamated sum. These signatures are too general in the sense that we are not able to prove the existence of an associated syntax in this general context. So we have to select arities and signatures for which there exists the desired initial monad. For this, we follow a track opened by Matthes and Uustalu: we introduce a notion of strengthened arity and prove that the corresponding signatures have initial semantics (i.e. associated syntax. Our strengthened arities admit colimits, which allows the treatment of the λ-calculus with explicit substitution.

  17. Initial Semantics for Strengthened Signatures

    CERN Document Server

    Hirschowitz, André; 10.4204/EPTCS.77.5

    2012-01-01

    We give a new general definition of arity, yielding the companion notions of signature and associated syntax. This setting is modular in the sense requested by Ghani and Uustalu: merging two extensions of syntax corresponds to building an amalgamated sum. These signatures are too general in the sense that we are not able to prove the existence of an associated syntax in this general context. So we have to select arities and signatures for which there exists the desired initial monad. For this, we follow a track opened by Matthes and Uustalu: we introduce a notion of strengthened arity and prove that the corresponding signatures have initial semantics (i.e. associated syntax). Our strengthened arities admit colimits, which allows the treatment of the \\lambda-calculus with explicit substitution.

  18. Strength deficit of knee flexors is dependent on hip position in adults with chronic hemiparesis

    Directory of Open Access Journals (Sweden)

    Stella M. Michaelsen

    2013-02-01

    Full Text Available BACKGROUND: The extent to which muscle length affects force production in paretic lower limb muscles after stroke in comparison to controls has not been established. OBJECTIVES: To investigate knee flexor strength deficits dependent on hip joint position in adults with hemiparesis and compare with healthy controls. METHOD: a cross-sectional study with ten subjects with chronic (63±40 months hemiparesis with mild to moderate lower limb paresis (Fugl-Meyer score 26±3 and 10 neurologically healthy controls. Isometric knee flexion strength with the hip positioned at 90° and 0° of flexion was assessed randomly on the paretic and non-paretic side of hemiparetic subjects and healthy controls. Subjects were asked to perform a maximal isometric contraction sustained for four seconds and measured by a dynamometer. The ratio of knee flexor strength between these two hip positions was calculated: Hip 0°/Hip 90°. Also, locomotor capacity was evaluated by the timed up and go test and by walking velocity over 10 meters. RESULTS: In subjects with hemiparesis, absolute knee flexion torque decreased (p<0.001 with the hip in extension (at 0°. The ratio of knee flexor torque Hip 0°/Hip 90° on the paretic side in hemiparetics was lower than in controls (p=0.02. CONCLUSIONS: Weakness dependent on joint position is more significant in the paretic lower limb of adults with hemiparesis when compared to controls. More attention should be given to lower limb muscle strengthening exercises in individuals with stroke, with emphasis on the strengthening exercises in positions in which the muscle is shortened.

  19. Strengthening of metallic iron rust in reduced ilmenite%还原钛铁矿中金属铁锈蚀反应速率过程的强化

    Institute of Scientific and Technical Information of China (English)

    郭宇峰; 刘霞; 邱冠周; 姜涛

    2012-01-01

    Using Panzhihua reduced ilmenite as material, the effects of hydrochloric acid and oxygen gas on rust course of metallic iron and Ti-Fe separation in reduced ilmenite in NH4CI aqueous solution were studied. The results show that when hydrochloric acid is added in the solution, metallic iron in reduced ilmenite is leached instead of being rusted. When oxygen gas is introduced into the reaction system, the rust reaction mechanism of metallic iron is not changed, and rust rate is increased remarkably, and the Ti-Fe separation effect is greatly enhanced. Rust of metallic iron in reduced ihnenite is controlled by internal diffusions. After oxygen gas is introduced, the apparent activation energy of rust reaction is decreased to 8.12 kJ/mol from 13.28 kJ/mol in air atmosphere. Oxygen gas improves the internal diffusions and cathodic reaction of rust of metallic iron. Consequently, rust rate of metallic iron is increased.%以攀枝花还原钛铁矿为原料,研究在NH4Cl溶液体系下盐酸和氧气对还原钛铁矿中金属铁锈蚀反应过程及钛铁分离效果的影响.研究结果表明:添加盐酸后,还原钛铁矿中金属铁的锈蚀反应有转变为浸出反应的倾向;通入氧气后,还原钛铁矿中金属铁的锈蚀反应历程没有发生变化,锈蚀反应速度显著加快,钛铁分离效果明显改善;还原钛铁矿中金属铁的锈蚀反应过程受内扩散控制,通入氧气后锈蚀反应的表观活化能由通入空气时的13.28kJ/mol降低至8.12 kJ/mol,氧气加快内扩散过程,促进还原钛铁矿中金属铁锈蚀过程的阴极反应,从而加快金属铁的锈蚀反应速率.

  20. Physical activity and osteoporosis hip fracture in postmenopausal women EJERCICIO FÍSICO Y RIESGO DE FRACTURA OSTEOPORÓTICA DE CADERA EN MUJERES POSTMENOPAUSICAS.

    OpenAIRE

    L.P. Rodrí­guez; Pascual, F.; Álvarez, A.; Ponce, J.

    2010-01-01

    Studies from 1968 on postmenopausal osteoporosis, osteoporotic hip fracture, and fundamentally the association betwen physical activity and hip fractures in postmenopausal women are reviewed. Physical activity has been related to enhanced bone mass and improved physical functioning and thus may reduce the risk for osteoporotic hip fracture. All the studies suggest a protectiv effect of physical activity with regard to hip fractures reducing the risk o...

  1. Test-retest reliability of innovated strength tests for hip muscles.

    Directory of Open Access Journals (Sweden)

    Christophe Meyer

    Full Text Available The burden of hip muscles weakness and its relation to other impairments has been well documented. It is therefore a pre-requisite to have a reliable method for clinical assessment of hip muscles function allowing the design and implementation of a proper strengthening program. Motor-driven dynamometry has been widely accepted as the gold-standard for lower limb muscle strength assessment but is mainly related to the knee joint. Studies focusing on the hip joint are less exhaustive and somewhat discrepant with regard to optimal participants position, consequently influencing outcome measures. Thus, we aimed to develop a standardized test setup for the assessment of hip muscles strength, i.e. flexors/extensors and abductors/adductors, with improved participant stability and to define its psychometric characteristics. Eighteen participants performed unilateral isokinetic and isometric contractions of the hip muscles in the sagittal and coronal plane at two separate occasions. Peak torque and normalized peak torque were measured for each contraction. Relative and absolute measures of reliability were calculated using the intraclass correlation coefficient and standard error of measurement, respectively. Results from this study revealed higher levels of between-day reliability of isokinetic/isometric hip abduction/flexion peak torque compared to existing literature. The least reliable measures were found for hip extension and adduction, which could be explained by a less efficient stabilization technique. Our study additionally provided a first set of reference normalized data which can be used in future research.

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

    Directory of Open Access Journals (Sweden)

    Saroj Kumar Suwal

    2016-06-01

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

  3. Strengthening Mechanisms in Microtruss Metals

    Science.gov (United States)

    Ng, Evelyn K.

    Microtrusses are hybrid materials composed of a three-dimensional array of struts capable of efficiently transmitting an externally applied load. The strut connectivity of microtrusses enables them to behave in a stretch-dominated fashion, allowing higher specific strength and stiffness values to be reached than conventional metal foams. While much attention has been given to the optimization of microtruss architectures, little attention has been given to the strengthening mechanisms inside the materials that make up this architecture. This thesis examines strengthening mechanisms in aluminum alloy and copper alloy microtruss systems with and without a reinforcing structural coating. C11000 microtrusses were stretch-bend fabricated for the first time; varying internal truss angles were selected in order to study the accumulating effects of plastic deformation and it was found that the mechanical performance was significantly enhanced in the presence of work hardening with the peak strength increasing by a factor of three. The C11000 microtrusses could also be significantly reinforced with sleeves of electrodeposited nanocrystalline Ni-53wt%Fe. It was found that the strength increase from work hardening and electrodeposition were additive over the range of structures considered. The AA2024 system allowed the contribution of work hardening, precipitation hardening, and hard anodizing to be considered as interacting strengthening mechanisms. Because of the lower formability of AA2024 compared to C11000, several different perforation geometries in the starting sheet were considered in order to more effectively distribute the plastic strain during stretch-bend fabrication. A T8 condition was selected over a T6 condition because it was shown that the plastic deformation induced during the final step was sufficient to enhance precipitation kinetics allowing higher strengths to be reached, while at the same time eliminating one annealing treatment. When hard anodizing

  4. Postoperative pain treatment after total hip arthroplasty

    DEFF Research Database (Denmark)

    Højer Karlsen, Anders Peder; Geisler, Anja; Petersen, Pernille Lykke

    2015-01-01

    of this systematic review was to document the procedure-specific evidence for analgesic interventions after total hip arthroplasty (THA). This PRISMA-compliant and PROSPERO-registered review includes randomized placebo-controlled trials (RCTs) of medication-based analgesic interventions after THA. Endpoints were......, and lumbar plexus block reduced nausea and pruritus. The GRADE-rated quality of evidence ranged from low to very low throughout the analyses. This review demonstrated, that some analgesic interventions may have the capacity to reduce mean opioid requirements and/or mean pain intensity compared with controls...

  5. Total hip arthroplasty following failed fixation of proximal hip fractures

    Directory of Open Access Journals (Sweden)

    Srivastav Shekhar

    2008-01-01

    Full Text Available Background: Most proximal femoral fractures are successfully treated with internal fixation but a failed surgery can be very distressing for the patient due to pain and disability. For the treating surgeon it can be a challenge to perform salvage operations. The purpose of this study was to evaluate the short-term functional outcome and complications of total hip arthroplasty (THA following failed fixation of proximal hip fracture. Materials and Methods: In a retrospective study, 21 hips in 20 patients (13 females and seven males with complications of operated hip fractures as indicated by either established nonunion or fracture collapse with hardware failure were analysed. Mean age of the patients was 62 years (range 38 years to 85 years. Nine patients were treated for femoral neck fracture, 10 for intertrochanteric (I/T fracture and two for subtrochanteric (S/T fracture of the hip. Uncemented THA was done in 11 cases, cemented THA in eight hip joints and hybrid THA in two patients. Results: The average duration of follow-up was four years (2-13 years. The mean duration of surgery was 125 min and blood loss was 1300 ml. There were three dislocations postoperatively. Two were managed conservatively and one was operated. There was one superficial infection and one deep infection. Only one patient required a walker while four required walking stick for ambulation. The mean Harris Hip score increased from 32 preoperatively to 79 postoperatively at one year interval. Conclusion: Total hip arthroplasty is an effective salvage procedure after failed osteosynthesis of hip fractures. Most patients have good pain relief and functional improvements inspite of technical difficulties and high complication rates than primary arthroplasty.

  6. Traumatic hip dislocation at a regional trauma centre in Nigeria.

    Science.gov (United States)

    Onyemaechi, N O C; Eyichukwu, G O

    2011-01-01

    (4%). Forty-seven hips (94%) were treated by primary closed reduction, two hips (4%) were treated with open reduction and one patient (2%) had Girdlestone excision arthroplasty. Thirty-six hips (73.5%) were reduced with 12 hours of the injury. Concomitant injuries were found in 37 patients (77%). The follow up period ranged from 10 months to 36 months with a mean follow up period of 15 months. Post-traumatic osteoarthritis occurred in 2 hips (4%) avascular necrosis of the femoral head was seen in 2 hips (4%). Five patients had sciatic nerve paresis while there was recurrence in one hip. No mortality was recorded. Traumatic dislocations and fracture-dislocations of the hip are severe injuries caused mostly by high-speed motor-vehicular accidents. Young adult males are most commonly affected, and there is a high rate of concomitant injuries. Excellent results can be achieved by early and stable closed reduction of these injuries with immobilization of the affected hips.

  7. [Value of preoperative planning in total hip arthroplasty].

    Science.gov (United States)

    De Thomasson, E; Mazel, C; Guingand, O; Terracher, R

    2002-05-01

    Preoperative planning enables an assessment of the size of the implants needed before total hip replacement. Eggli and Müller demonstrated the reproduciblity of preoperative planning but did not evaluate its contribution to reducing limb length discrepancy. As femur lateralization and the position of the prosthetic center of rotation affect joint mechanics, it would be useful to assess their contribution to the efficacy of preoperative planning. We reviewed the files of 57 patients who underwent total hip arthroplasty for primary joint degeneration or necrosis limited to one hip. The healthy hip served as a control. The surgical plan was elaborated from the preoperative pelvis x-rays (AP and lateral views) and anatomic measurements on films obtained three months postoperatively. In 49 cases, preoperative planning predicted a restoration of the normal anatomy of the operated hip (center of rotation, femur lateralization, length of the operated limb). This objective was achieved in only 22.5% of the cases. Femur lateralization was the most difficult objective to achieve (59.2%). Equal limb length and good position of the center of rotation was achieved in 70% of the cases. For eight patients (14%) preoperative planning was not satisfactory, the implant offset not being adapted to the patient's anatomy. There are limits to preoperative planning, particularly for restitution of adequate femur lateralization. This difficulty appears to be related to three factors: inadequate adaptation of the implant to hip anatomy (14% of the cases in our experience), stiff rotation in degenerative hips inhibiting proper assessment of the length of the femoral neck, and relative imprecision of operative evaluation of femoral anteversion affecting femur lateralization and the level of the femoral cut. Although imperfect, preoperative planning is, in our opinion, essential before total hip arthroplasty in order to avoid major positioning errors and operative difficulties.

  8. 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.

  9. Developmental Dislocation (Dysplasia) of the Hip (DDH)

    Science.gov (United States)

    .org Developmental Dislocation (Dysplasia) of the Hip (DDH) Page ( 1 ) The hip is a “ball-and-socket” joint. In a normal hip, the ball at the ... American Academy of Orthopaedic Surgeons. .org Developmental Dislocation (Dysplasia) of the Hip cont. • Family history of DDH (parents or siblings) • ...

  10. Strength deficit of knee flexors is dependent on hip position in adults with chronic hemiparesis.

    Science.gov (United States)

    Michaelsen, Stella M; Ovando, Angélica C; Bortolotti, Adriano; Bandini, Bruno

    2013-01-01

    The extent to which muscle length affects force production in paretic lower limb muscles after stroke in comparison to controls has not been established. To investigate knee flexor strength deficits dependent on hip joint position in adults with hemiparesis and compare with healthy controls. a cross-sectional study with ten subjects with chronic (63±40 months) hemiparesis with mild to moderate lower limb paresis (Fugl-Meyer score 26±3) and 10 neurologically healthy controls. Isometric knee flexion strength with the hip positioned at 90° and 0° of flexion was assessed randomly on the paretic and non-paretic side of hemiparetic subjects and healthy controls. Subjects were asked to perform a maximal isometric contraction sustained for four seconds and measured by a dynamometer. The ratio of knee flexor strength between these two hip positions was calculated: Hip 0°/Hip 90°. Also, locomotor capacity was evaluated by the timed up and go test and by walking velocity over 10 meters. In subjects with hemiparesis, absolute knee flexion torque decreased (phemiparesis when compared to controls. More attention should be given to lower limb muscle strengthening exercises in individuals with stroke, with emphasis on the strengthening exercises in positions in which the muscle is shortened.

  11. 27 CFR 24.153 - Strengthening bonds.

    Science.gov (United States)

    2010-04-01

    ... Strengthening bonds. In any instance where the penal sum of the bond on file becomes insufficient, the principal shall either give a strengthening bond with the same surety to attain a sufficient penal sum or give a... limiting the amount of either bond to less than its full penal sum. Strengthening bonds will show...

  12. 27 CFR 26.69 - Strengthening bonds.

    Science.gov (United States)

    2010-04-01

    ... Liquors and Articles in Puerto Rico Bonds § 26.69 Strengthening bonds. In all cases where the penal sum of... surety to attain a sufficient penal sum, or give a new bond to cover the entire liability. Strengthening... penal sum. Strengthening bonds shall show the current date of execution and the effective date....

  13. 27 CFR 19.246 - Strengthening bonds.

    Science.gov (United States)

    2010-04-01

    ... Strengthening bonds. In all cases when the penal sum of any bond becomes insufficient, the principal shall either give a strengthening bond with the same surety to attain a sufficient penal sum, or give a new... amount of any bond to less than its full penal sum. Strengthening bonds shall show the current date...

  14. Congenital dislocation of the hip. A review.

    Science.gov (United States)

    Sherk, H H; Pasquariello, P S; Watters, W C

    1981-08-01

    Congenital dislocation of the hip usually results from capsular stretching caused by fetal malposition and crouching late in the third trimester. Early recognition of hip dislocation or instability soon after birth permits prompt treatment. Ortolani's and Barlow's maneuvers, respectively, reduce into and displace from the acetabulum a femoral head that is insecurely contained therein. The diagnosis of CDH in the first month of life usually depends on these clinical components of the physical examination of the newborn, because similar device, in this age group can usually maintain the displaced hip in sufficient flexion and abduction to permit reduction and normal development. By 3 months of age, the nuclei of the pelvis and upper femur have ossified enough to permit radiologic diagnosis of CDH. Problems related to treatment increase as the child grows older. In infants up to 6 months of age, closed methods with a harness usually succeed. Beyond 6 months, the soft tissues shorten and prevent easy reduction. These patients almost always require pre-reduction traction. An adductor tenotomy also facilitates reduction and apparently lessens compressive forces on the femoral head, an important consideration in preventing avascular necrosis of the head. Children over 1 year old develop bony changes, such as excessive femoral valgus and anteversion and deformity of the acetabulum. Treatment in these patients requires realignment of bony deformities with femoral or pelvic osteotomies in addition to the measures noted previously. The gentleness and high success rate of early treatment make early diagnosis of CDH an important consideration in infants and newborns.

  15. Glass strengthening and patterning methods

    Science.gov (United States)

    Harper, David C; Wereszczak, Andrew A; Duty, Chad E

    2015-01-27

    High intensity plasma-arc heat sources, such as a plasma-arc lamp, are used to irradiate glass, glass ceramics and/or ceramic materials to strengthen the glass. The same high intensity plasma-arc heat source may also be used to form a permanent pattern on the glass surface--the pattern being raised above the glass surface and integral with the glass (formed of the same material) by use of, for example, a screen-printed ink composition having been irradiated by the heat source.

  16. Time Strengthening of Crystal Nanocontacts

    Science.gov (United States)

    Mazo, Juan J.; Dietzel, Dirk; Schirmeisen, Andre; Vilhena, J. G.; Gnecco, Enrico

    2017-06-01

    We demonstrate how an exponentially saturating increase of the contact area between a nanoasperity and a crystal surface, occurring on time scales governed by the Arrhenius equation, is consistent with measurements of the static friction and lateral contact stiffness on a model alkali-halide surface at different temperatures in ultrahigh vacuum. The "contact ageing" effect is attributed to atomic attrition and is eventually broken by thermally activated slip of the nanoasperity on the surface. The combination of the two effects also leads to regions of strengthening and weakening in the velocity dependence of the friction, which are well-reproduced by an extended version of the Prandtl-Tomlinson model.

  17. Canine Hip Dysplasia: Diagnostic Imaging.

    Science.gov (United States)

    Butler, J Ryan; Gambino, Jennifer

    2017-07-01

    Diagnostic imaging is the principal method used to screen for and diagnose hip dysplasia in the canine patient. Multiple techniques are available, each having advantages, disadvantages, and limitations. Hip-extended radiography is the most used method and is best used as a screening tool and for assessment for osteoarthritis. Distraction radiographic methods such as the PennHip method allow for improved detection of laxity and improved ability to predict future osteoarthritis development. More advanced techniques such as MRI, although expensive and not widely available, may improve patient screening and allow for improved assessment of cartilage health. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Traumatic injuries of the hip.

    LENUS (Irish Health Repository)

    Marshall, Nina

    2009-11-01

    Traumatic lesions of the hip in athletes may be clinically challenging because of the overlap in clinical presentation due to differing pathologies and the presence of multiple injuries. Imaging of the hip in the athlete has undergone a recent resurgence of interest and understanding related to the increasing accessibility and use of hip arthroscopy, which expands the treatment options available for intra-articular pathology. MR imaging and MR arthrography have a unique role in diagnosis of these pathologies, guiding the surgeon, arthroscopist, and referring clinician in their management of bony and soft tissue injury.

  19. Hip fracture epidemiological trends, outcomes, and risk factors, 1970–2009

    Directory of Open Access Journals (Sweden)

    Ray Marks

    2009-12-01

    Full Text Available Ray MarksCity University of New York and Columbia University, New York, NY, USAAbstract: Hip fractures – which commonly lead to premature death, high rates of morbidity, or reduced life quality – have been the target of a voluminous amount of research for many years. But has the lifetime risk of incurring a hip fracture decreased sufficiently over the last decade or are high numbers of incident cases continuing to prevail, despite a large body of knowledge and a variety of contemporary preventive and refined surgical approaches? This review examines the extensive hip fracture literature published in the English language between 1980 and 2009 concerning hip fracture prevalence trends, and injury mechanisms. It also highlights the contemporary data concerning the personal and economic impact of the injury, plus potentially remediable risk factors underpinning the injury and ensuing disability. The goal was to examine if there is a continuing need to elucidate upon intervention points that might minimize the risk of incurring a hip fracture and its attendant consequences. Based on this information, it appears hip fractures remain a serious global health issue, despite some declines in the incidence rate of hip fractures among some women. Research also shows widespread regional, ethnic and diagnostic variations in hip fracture incidence trends. Key determinants of hip fractures include age, osteoporosis, and falls, but some determinants such as socioeconomic status, have not been well explored. It is concluded that while more research is needed, well-designed primary, secondary, and tertiary preventive efforts applied in both affluent as well as developing countries are desirable to reduce the present and future burden associated with hip fracture injuries. In this context, and in recognition of the considerable variation in manifestation and distribution, as well as risk factors underpinning hip fractures, well-crafted comprehensive, rather

  20. Martial arts fall training to prevent hip fractures in the elderly.

    NARCIS (Netherlands)

    Groen, B.E.; Smulders, E.; Kam, D. de; Duysens, J.E.J.; Weerdesteijn, V.G.M.

    2010-01-01

    Hip fractures are a common and serious consequence of falls. Training of proper fall techniques may be useful to prevent hip fractures in the elderly. The results suggested that martial arts fall techniques may be trainable in older individuals. Better performance resulted in a reduced impact force.

  1. High reliability of an algorithm for choice of implants in hip fracture patients

    DEFF Research Database (Denmark)

    Palm, Henrik; Posner, Eva; Ahler-Toftehøj, Hans-Ulrik;

    2013-01-01

    Hip fracture treatment is controversial, with high complication rates. An algorithm for hip fracture surgery has shown reduced reoperation rates, but choice of implant is based on the commonly used fracture classifications, which were previously evaluated to be unreliable. The purpose of this study...... was to investigate the reliability of the algorithm....

  2. Martial arts fall training to prevent hip fractures in the elderly.

    NARCIS (Netherlands)

    Groen, B.E.; Smulders, E.; Kam, D. de; Duysens, J.E.J.; Weerdesteijn, V.G.M.

    2010-01-01

    Hip fractures are a common and serious consequence of falls. Training of proper fall techniques may be useful to prevent hip fractures in the elderly. The results suggested that martial arts fall techniques may be trainable in older individuals. Better performance resulted in a reduced impact force.

  3. Monoarticular Hip Involvement in Pseudogout

    Directory of Open Access Journals (Sweden)

    Figen Kocyigit

    2015-01-01

    Full Text Available Pseudogout is the acutest form of arthritis in the elderly. Although clinical manifestations vary widely, polyarticular involvement is typical mimicking osteoarthritis or rheumatoid arthritis. Monoarticular involvement is relatively rare and is generally provoked by another medical condition. There are reported cases of hip involvement by pseudogout in monoarticular form. However, all of the cases were presented as septic arthritis. In this report, we present a case of monoarticular hip involvement mimicking soft tissue abscess. We confirmed the pseudogout diagnosis after ultrasonographic evaluation of the involved hip joint and pathological and biochemical analysis of synovial fluid analysis. Diagnosis is important to avoid unnecessary medical and surgical treatment in cases of the bizarre involvement of hip in pseudogout.

  4. Abstract: Lightweight Authentication for HIP

    Science.gov (United States)

    Heer, Tobias

    In recent years numerous solutions for overcoming the architectural constraints of the Internet have emerged. One of the most promising among them is the Host Identity Protocol (HIP) [2], which was recently approved as an experimental standard by the IETF. HIP adds an additional protocol layer between TCP and IP to implement the Identifier/Locator split. Apart from mobility and multihoming, HIP supports host authentication, payload encryption, and a cryptographic namespace without requiring changes to the network infrastructure or network applications. However, especially mobile devices with tightly limited CPU resources are slowed down by HIP. Its poor performance on these mobile devices is a result of the extensive use of public-key (PK) cryptography for securing the main protocol functions.

  5. Relationships between core endurance, hip strength, and balance in collegiate female athletes.

    Science.gov (United States)

    Ambegaonkar, Jatin P; Mettinger, Lindsey M; Caswell, Shane V; Burtt, Andrea; Cortes, Nelson

    2014-10-01

    anterior and posterolateral SEBT scores. Having females participate in hip muscle strengthening programs may help improve their SEBT balance scores, as a measure of their neuromuscular control and influence their ACL and lower extremity injury risk. 2b.

  6. Current possibilities for hip arthroplasty,

    Directory of Open Access Journals (Sweden)

    Giancarlo Cavalli Polesello

    2014-04-01

    Full Text Available Hip arthroscopy has been popularized over the last decade and, with technical advances regarding imaging diagnostics, understanding of the physiopathology or surgical techniques, several applications have been described. Both arthroscopy for intra-articular conditions and endoscopy for extra-articular procedures can be used in diagnosing or treating different conditions. This updated article has the objective of presenting the various current possibilities for hip arthroscopy.

  7. Hip: Anatomy and US technique

    OpenAIRE

    2011-01-01

    Ultrasound (US) has always had a relatively limited role in the evaluation of the hip due to the deep location of this joint. However, many hip diseases are well detectable at US, but before approaching such a study it is necessary to be thoroughly familiar with the normal anatomy and related US images. The study technique is particularly important as optimization of various parameters is required, such as probe frequency, focalization, positioning of the probe, etc. Also the patient’s positi...

  8. Conversion of hip arthrodesis to total hip arthroplasty.

    Science.gov (United States)

    Panagiotopoulos, K P; Robbins, G M; Masri, B A; Duncan, C P

    2001-01-01

    With the predictably good outcome now found with THA, hip arthrodesis has limited indications today. The procedure still has a role in the case of the young, heavy demand male with an isolated arthritic hip condition, and developments such as the Cobra head plate have considerably improved success rates. However, a long-term hip arthrodesis can have profound effects on a patient's daily function and activities of daily living. In addition, gait pattern is considerably affected as well as other joints such as the lower back, ipsilateral knee, and contralateral hip. Many patients with a hip arthrodesis will eventually require a takedown of the fused hip and conversion to a THA. The primary indications include fusion in malposition, pseudarthrosis, or severe pain in other joints. The surgeon undertaking such a task must be familiar with the arthrodesis techniques that have been used in the past as well as the equipment that may be required to extract the fixation hardware. Clinical assessment with particular attention to leg-length discrepancy, position of the arthrodesis, and function of the abductors is of paramount importance. The surgeon must carefully review preoperative radiographs to plan the procedure. The surgeon must also be aware of the presence of pathology in other joints. After takedown of a hip arthrodesis and conversion to a THA, patients cannot expect the result to equal the success rates of primary THA. Patients generally can expect an improvement in function and mobility. Back pain and ipsilateral knee pain are usually improved postoperatively, but the effect on contralateral hip pain is less predictable. Many patients will continue to show a positive Trendelenburg sign, but further improvement in strength of the hip abductors can be expected with time. Leg-length discrepancy is generally improved substantially after THA. However, a substantial number of patients will require a walking aid postoperatively. Overall, the risk of complications and the

  9. 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...

  10. Missile Defense: Opportunity Exists to Strengthen Acquisitions by Reducing Concurrency

    Science.gov (United States)

    2012-04-01

    order to model interceptor performance and thereby assess end- game performance and probability of success. 4 With HWIL models, closed loop...flight test FTM-16 E1 in March 2011, delivered the SM-3 Block IB pathfinder round to hold FTM-16 E2, and gained sufficient data in FTM-16 E2 in September

  11. Regional Cooperation to Strengthen Safeguards

    Energy Technology Data Exchange (ETDEWEB)

    Minnini, Margot; Elkhamri, Oksana O.

    2016-06-06

    President Obama’s decision over four years ago to ”pivot” toward Asia represented an important strategic shift in American foreign policy and a rebalancing of U.S. economic and security engagement in the Asia-Pacific countries. The United States has since supported a variety of regional initiatives aimed at promoting nuclear security and safeguards. When a new regional organization, the Asia-Pacific Safeguards Network (APSN) was established in 2010, DOE/NNSA became an early member and enthusiastic advocate. Launched on the initiative of Australia, Japan, Republic of Korea, and Indonesia, the APSN aims to strengthen the quality and effectiveness of safeguards implementation in the Asia-Pacific region.

  12. STRENGTHENING BIOTECHNOLOGY RESEARCH IN INDONESIA

    Directory of Open Access Journals (Sweden)

    S. Sastrapradja

    2012-09-01

    Full Text Available The wave of biotechnology promises has struck not only the developed countries but the developing countries as well. The scientific community in Indonesia is aware of the opportunities and is eager to take an active part in this particular endeavour. Meanwhile resources are required to welcoming the biotech­nology era. The need of trained manpower, appropriate infrastructure and equipment, operational and maintenance costs requires serious consideration if a unit or a laboratory is expected to be functional in biotechnology. There is a good opportunity of applying biotechnology in the field of agriculture and industry considering the availability of biological resources in Indonesia. This paper outlines what have been done so far, the difficulties encountered and the efforts made to strengthening biotechnology research in Indonesia.

  13. 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

  14. A comparison of hip fracture incidence rates among elderly in Sweden by latitude and sunlight exposure.

    Science.gov (United States)

    Nilson, Finn; Moniruzzaman, Syed; Andersson, Ragnar

    2014-03-01

    Research has shown that hip fracture risk increases with latitude; hypothetically due to reduced sunlight exposure and its effect on bone quality. Sweden, with large differences in latitude and UV radiation, is ideal to study in order to analyse the association between latitude and UV radiation on age- and sex-specific hip fracture rates among elderly. Aggregated (2006-2008) age- and sex-specific hip fracture data was obtained for each Swedish municipality as well as the municipality's latitudinal coordinates and aggregated (2006-2008) UV radiation levels. Pearson correlations were calculated between hip fracture incidence rates, latitude and UV radiation. Independent t tests were calculated on tertile-categorized latitudinal data in order to investigate the difference in hip fracture risk between these categories. Statistically significant correlations were seen in all groups between hip fracture incidence rates and latitude as well as UV radiation. The independent t tests showed that this correlation was mainly due to high incidence rates in high latitude municipalities. Statistically significant correlations are seen between hip fracture incidence rates and latitude as well as UV radiation in Sweden and the northern parts of Sweden have an increased risk of hip fractures compared to the middle and southern parts. To our knowledge this is the first study using a national discharge register that shows this relationship and provides a starting point for further research to investigate why populations in northern Sweden have a higher risk of hip fractures compared to other Swedish regions.

  15. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Scott M. Sporer

    2009-03-01

    Full Text Available DESCRIPTION A user friendly reference for decision making in hip arthroplasty designed in a question formed clinical problem scenarios and answers format .The articles composed of the answers, containing current concepts and preferences of experts in primary and revision hip surgery are enhanced by several images, diagrams and references and written in the form of a curbside consultation by Scott M. Sporer, MD. and his collaborators. PURPOSE By this practical reference of hip arthroplasty, Scott M. Sporer, MD. and the contributors have aimed providing the reader practical and clinically relevant information, evidence-based advices, their preferences and opinions containing current concepts for difficult and controversial clinical situations in total hip replacement surgery which are often not addressed clearly in traditional references. FEATURES The book is composed of 9 sections and 49 articles each written by a different expert designed in a question and answers format including several images and diagrams and also essential references at the end of each article. In the first section preoperative questions is subjected. Second section is about preoperative acetabulum questions. Third section is about preoperative femur questions. Fourth section is about intraoperative questions. Intraoperative acetabulum question is subjected in the fifth section and the intraoperative femur questions in the sixth section. The seventh section is about postoperative questions. Eighth and ninth sections are about general questions about failure and failure of acetabulum in turn. AUDIENCE Mainly practicing orthopedic surgeons, fellows and residents who are interested in hip arthroplasty have been targeted but several carefully designed scenarios of controversial and difficult situations surrounding total hip replacement surgery and the current information will also be welcomed by experienced clinicians practicing in hip arthroplasty. ASSESSMENT Scott M. Sporer

  16. Frontal plane hip and ankle sensorimotor function, not age, predicts unipedal stance time

    Science.gov (United States)

    Allet, Lara; Kim, Hogene; Ashton-Miller, James; De Mott, Trina; Richardson, James K.

    2011-01-01

    Introduction Changes occur in muscles and nerves with aging. This study aimed to explore the relationship between unipedal stance time (UST) and frontal plane hip and ankle sensorimotor function in subjects with diabetic neuropathy. Methods UST, quantitative measures of frontal plane ankle proprioceptive thresholds, and ankle and hip motor function were tested in forty-one persons with a spectrum of lower limb sensorimotor function, ranging from healthy to moderately severe diabetic neuropathy. Results Frontal plane hip and ankle sensorimotor function demonstrated significant relationships with UST. Multivariate analysis identified only composite hip strength, composite ankle proprioceptive threshold, and age to be significant predictors of UST (R2=0.73); they explained 46%, 24% and 3% of the variance, respectively. Discussion/Conclusions Frontal plane hip strength was the single best predictor of UST and appeared to compensate for less precise ankle proprioceptive thresholds. This finding is clinically relevant given the possibility of strengthening the hip, even in patients with significant PN. . PMID:22431092

  17. 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...... 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....

  18. Hip fracture epidemiological trends, outcomes, and risk factors, 1970–2009

    Science.gov (United States)

    Marks, Ray

    2010-01-01

    Hip fractures – which commonly lead to premature death, high rates of morbidity, or reduced life quality – have been the target of a voluminous amount of research for many years. But has the lifetime risk of incurring a hip fracture decreased sufficiently over the last decade or are high numbers of incident cases continuing to prevail, despite a large body of knowledge and a variety of contemporary preventive and refined surgical approaches? This review examines the extensive hip fracture literature published in the English language between 1980 and 2009 concerning hip fracture prevalence trends, and injury mechanisms. It also highlights the contemporary data concerning the personal and economic impact of the injury, plus potentially remediable risk factors underpinning the injury and ensuing disability. The goal was to examine if there is a continuing need to elucidate upon intervention points that might minimize the risk of incurring a hip fracture and its attendant consequences. Based on this information, it appears hip fractures remain a serious global health issue, despite some declines in the incidence rate of hip fractures among some women. Research also shows widespread regional, ethnic and diagnostic variations in hip fracture incidence trends. Key determinants of hip fractures include age, osteoporosis, and falls, but some determinants such as socioeconomic status, have not been well explored. It is concluded that while more research is needed, well-designed primary, secondary, and tertiary preventive efforts applied in both affluent as well as developing countries are desirable to reduce the present and future burden associated with hip fracture injuries. In this context, and in recognition of the considerable variation in manifestation and distribution, as well as risk factors underpinning hip fractures, well-crafted comprehensive, rather than single solutions, are strongly indicated in early rather than late adulthood. PMID:20463818

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

    Energy Technology Data Exchange (ETDEWEB)

    Cerezal, Luis, E-mail: lcerezal@gmail.com [Diagnóstico Médico Cantabria, C/Castilla 6, 39002 Santander (Spain); Arnaiz, Javier; Canga, Ana; Piedra, Tatiana [Valdecilla University Hospital, 39011 Santander (Spain); Altónaga, José R. [Leon University, 24071 Leon (Spain); Munafo, Ricardo [CETEA, Buenos Aires (Argentina); Pérez-Carro, Luis [Valdecilla University Hospital, 39011 Santander (Spain)

    2012-12-15

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

  20. Do Twin Boundaries Always Strengthen Metal Nanowires?

    OpenAIRE

    Zhang Yongfeng; Huang Hanchen

    2008-01-01

    Abstract It has been widely reported that twin boundaries strengthen nanowires regardless of their morphology—that is, the strength of nanowires goes up as twin spacing goes down. This article shows that twin boundaries do not always strengthen nanowires. Using classical molecular dynamics simulations, the authors show that whether twin boundaries strengthen nanowires depends on the necessary stress for dislocation nucleation, which in turn depends on surface morphologies. When nanowire...

  1. The effect of posterior capsule repair upon post-operative hip dislocation following primary total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Wang Chen-Ti

    2008-02-01

    Full Text Available Abstract Background Herein, we evaluated, retrospectively, the effect of posterior capsular repair upon postoperative hip dislocation subsequent to total hip arthroplasty (THA incorporating a posterolateral approach. Methods A total of 181 patients undergoing 204 primary non-complicated THA surgical procedures in the period from January 2000 to October 2005 inclusively were included in this study. The patients were separated into two groups by whether the posterior capsular repair had been incorporated in the surgical procedure. For the surgeon did not commence repairing the posterior capsule until July, 2003, all members in the group that did not undergo posterior capsular repair (142 hips from 131 patients were collected since January, 2000 to July, 2003, while the members in the group that underwent posterior capsular repair (62 hips from 52 patients were followed since July, 2003, to October, 2005. With a minimum follow-up period of 12 months, we evaluated the early post-operative dislocation rate. Results The early postoperative hip-dislocation rate for the group who did not undergo posterior capsular repair appeared to be substantially greater (6.38% versus 0% than the corresponding figure for the group the members of which underwent posterior capsular repair. In addition, patient demographics and the orientation of acetabular components for the replaced hip joints, as presented in postoperative radiographs, did not differ between the two groups. Conclusion Thus, surgeons should include posterior capsular repair as an important step in the surgical procedures of posterolateral approach for all THA in order to reduce the likelihood of early hip dislocation subsequent to THA.

  2. Study of a reinforced concrete beam strengthened using a combination of SMA wire and CFRP plate

    Science.gov (United States)

    Liu, Zhi-qiang; Li, Hui

    2006-03-01

    Traditional methods used for strengthening of reinforced concrete (RC) structures, such as bonding of steel plates, suffer from inherent disadvantages. In recent years, strengthening of RC structures using carbon fiber reinforced polymer (CFRP) plates has attracted considerable attentions around the world. Most existing research on CFRP plate bonding for flexural strengthening of RC beams has been carried out for the strength enhancement. However, little research is focused on effect of residual deformations on the strengthening. The residual deformations have an important effect on the strengthening by CFRP plates. There exists a very significant challenge how the residual deformations are reduced. Shape memory alloy (SMA) has showed outstanding functional properties as an actuator. It is a possibility that SMA can be used to reduce the residual deformation and make cracks of concrete close by imposing the recovery forces on the concrete in the tensile zone. It is only an emergency damage repair since the SMA wires need to be heated continuously. So, an innovative method of a RC beam strengthened by CFRP plates in combination with SMA wires was first investigated experimentally in this paper. In addition, the nonlinear finite element software of ABAQUS was employed to further simulate the behavior of RC beams strengthened through the new strengthening method. It can be found that this is an excellent and effective strengthening method.

  3. Developmental dysplasia of the hip

    Directory of Open Access Journals (Sweden)

    Shahryar Noordin

    2010-10-01

    Full Text Available Developmental dysplasia of the hip (DDH is a spectrum of anatomical abnormalities of the hip joint in which the femoral head has an abnormal relationship with the acetabulum. Most studies report an incidence of 1 to 34 cases per 1,000 live births and differences could be due to different diagnostic methods and timing of evaluation. Risk factors include first born status, female sex, positive family history, breech presentation and oligohydramnios. Clinical presentations of DDH depend on the age of the child. Newborns present with hip instability, infants have limited hip abduction on examination, and older children and adolescents present with limping, joint pain, and/or osteoarthritis. Repeated, careful examination of all infants from birth and throughout the first year of life until the child begins walking is important to prevent late cases. Provocative testing includes the Barlow and Ortolani maneuvers. Other signs, such as shorting of the femur with hips and knees flexed (Galeazzi sign, asymmetry of the thigh or gluteal folds, and discrepancy of leg lengths are potential clues. Treatment depends on age at presentation and outcomes are much better when the child is treated early, particularly during the first six months of life.

  4. Pelvic congestion syndrome masquerading as osteoarthritis of the hip

    Directory of Open Access Journals (Sweden)

    Scott J Dos Santos

    2016-12-01

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

  5. A RARE CASE OF IPSILATERAL HIP AND KNEE DISLOCATION

    Directory of Open Access Journals (Sweden)

    Deepak

    2015-06-01

    Full Text Available High velocity road traffic accidents leads to complicated lower limb injuries. Such injuries demand highly experienced surgeon and are associated with high morbidity and mortality. Hip or knee dislocations are two different orthopaedic emergencies. Concomitant fracture dislocation of the hip and knee is rare and very few cases have been reported in the literature. A 45 year old man with history of fall from motorcycle came to the casualty. He had ipsilateral hip and knee dislocation. Immediately patient was shifted to operation theatre and closed reduction was performed under general anaesthesia. Reduction was confirmed under fluoroscopy and post-operative x-rays were taken. The functional results were excellent. After 2 months patient made an uncomplicated recovery and had satisfactory functional outcome with right hip having 110⁰ flexion and right knee flexes to 120⁰.There was no neurological deficit. The urgency, that the treating surgeon shows in managing these injuries, significantly affects the prognosis and outcome finally achieved by these patients (golden period in reducing the hip joint has been described to be 6 hours.

  6. Traumatic Posterior Dislocation of Hip in Child: A Case Report

    Directory of Open Access Journals (Sweden)

    Dinesh Dhar

    2017-07-01

    Full Text Available Traumatic hip dislocation in children is uncommon, but like in adults, it is an orthopedic emergency. We report a rare case of traumatic posterior dislocation left hip in a 9 year old boy following a motor vehicle accident. The dislocation was promptly reduced by closed manipulation in Accident and Emergency Department with the application of above knee skin traction which was maintained for 3 weeks  followed by non-weight bearing crutch walking for another 6 weeks. On follow up, the patient had a good outcome without any evidence of avascular necrosis (AVN. In this rare case report a literature review of pediatric hip dislocation with treatment recommendations have been highlighted.

  7. The Effectiveness of a Hip Abduction Orthosis for Perthes Disease

    Directory of Open Access Journals (Sweden)

    Mohanty RK

    2016-05-01

    Full Text Available Perthes disease is a rare childhood disorder of femoral head affecting 5-10 per 100,000 children. Prognostic factors remain uncertain after age five which requires careful evaluation of subject, planning for treatment always associated with a slow recovery. Orthoses are provided as a conservative treatment to reduce weight bearing stress across hip joint, maintenance of joint congruity, allowing safe and pain free ambulation for school growing children by keeping the limb in abduction and internal rotation. Though there are different number of orthoses used earlier, the present literature does not provide sufficient evidence to support its use in Perthes disease. We report a case of 8 years old active school going subject with Perthes disease of right hip who was fitted with an ambulatory trilateral hip abduction orthosis and assessed by radiographic examination with satisfactory result

  8. Competing indentation deformation mechanisms in glass using different strengthening methods

    Science.gov (United States)

    Luo, Jian; Lezzi, Peter; Vargheese, K. Deenamma; Tandia, Adama; Harris, Jason; Mauro, John

    2016-11-01

    Chemical strengthening via ion exchange, thermal tempering, and lamination are proven techniques for strengthening of oxide glasses. For each of these techniques, the strengthening mechanism is conventionally ascribed to the linear superposition of the compressive stress profile on the glass surface. However, in this work we use molecular dynamics simulations to reveal the underlying indentation deformation mechanism beyond the simple linear superposition of compressive and indentation stresses. In particular, the plastic zone can be dramatically different from the commonly assumed hemispherical shape, which leads to a completely different stress field and resulting crack system. We show that the indentation-induced fracture is controlled by two competing mechanisms: the compressive stress itself and a potential reduction in free volume that can increase the driving force for crack formation. Chemical strengthening via ion exchange tends to escalate the competition between these two effects, while thermal tempering tends to reduce it. Lamination of glasses with differential thermal expansion falls in between. The crack system also depends on the indenter geometry and the loading stage, i.e., loading vs. after unloading. It is observed that combining thermal tempering or high free volume content with ion exchange or lamination can impart a relatively high compressive stress and reduce the driving force for crack formation. Therefore, such a combined approach might offer the best overall crack resistance for oxide glasses.

  9. Competing indentation deformation mechanisms in glass using different strengthening methods

    Directory of Open Access Journals (Sweden)

    Jian Luo

    2016-11-01

    Full Text Available Chemical strengthening via ion exchange, thermal tempering, and lamination are proven techniques for strengthening of oxide glasses. For each of these techniques, the strengthening mechanism is conventionally ascribed to the linear superposition of the compressive stress profile on the glass surface. However, in this work we use molecular dynamics simulations to reveal the underlying indentation deformation mechanism beyond the simple linear superposition of compressive and indentation stresses. In particular, the plastic zone can be dramatically different from the commonly assumed hemispherical shape, which leads to a completely different stress field and resulting crack system. We show that the indentation-induced fracture is controlled by two competing mechanisms: the compressive stress itself and a potential reduction in free volume that can increase the driving force for crack formation. Chemical strengthening via ion exchange tends to escalate the competition between these two effects, while thermal tempering tends to reduce it. Lamination of glasses with differential thermal expansion falls in between. The crack system also depends on the indenter geometry and the loading stage, i.e., loading vs. after unloading. It is observed that combining thermal tempering or high free volume content with ion exchange or lamination can impart a relatively high compressive stress and reduce the driving force for crack formation. Therefore, such a combined approach might offer the best overall crack resistance for oxide glasses.

  10. A Review on Strengthening Steel Beams Using FRP under Fatigue

    Directory of Open Access Journals (Sweden)

    Mohamed Kamruzzaman

    2014-01-01

    Full Text Available In recent decades, the application of fibre-reinforced polymer (FRP composites for strengthening structural elements has become an efficient option to meet the increased cyclic loads or repair due to corrosion or fatigue cracking. Hence, the objective of this study is to explore the existing FRP reinforcing techniques to care for fatigue damaged structural steel elements. This study covers the surface treatment techniques, adhesive curing, and support conditions under cyclic loading including fatigue performance, crack propagation, and failure modes with finite element (FE simulation of the steel bridge girders and structural elements. FRP strengthening composites delay initial cracking, reduce the crack growth rate, extend the fatigue life, and decrease the stiffness decay with residual deflection. Prestressed carbon fibre-reinforced polymer (CFRP is the best strengthening option. End anchorage prevents debonding of the CRRP strips at the beam ends by reducing the local interfacial shear and peel stresses. Hybrid-joint, nanoadhesive, and carbon-flex can also be attractive for strengthening systems.

  11. Cementless total hip arthroplasty for patients with Crowe type III or IV developmental dysplasia of the hip: two-stage total hip arthroplasty following skeletal traction after soft tissue release for irreducible hips.

    Science.gov (United States)

    Yoon, Pil Whan; Kim, Jung Il; Kim, Dong Ok; Yu, Cheol Hwan; Yoo, Jeong Joon; Kim, Hee Joong; Yoon, Kang Sup

    2013-09-01

    Total hip arthroplasty (THA) for severe developmental dysplasia of the hip (DDH) is a technically demanding procedure for arthroplasty surgeons, and it is often difficult to reduce the hip joint without soft tissue release due to severe flexion contracture. We performed two-stage THAs in irreducible hips with expected lengthening of the affected limb after THA of over 2.5 cm or with flexion contractures of greater than 30 degrees in order to place the acetabular cup in the true acetabulum and to prevent neurologic deficits associated with acute elongation of the limb. The purpose of this study is to evaluate the outcomes of cementless THA in patients with severe DDH with a special focus on the results of two-stage THA. Retrospective clinical and radiological evaluations were done on 17 patients with Crowe type III or IV developmental DDH treated by THA. There were 14 women and 3 men with a mean age of 52.3 years. Follow-ups averaged 52 months. Six cases were treated with two-stage THA followed by surgical hip liberalization and skeletal traction for 2 weeks. The mean Harris hip score improved from 40.9 to 89.1, and mean leg length discrepancy (LLD) in 13 unilateral cases was reduced from 2.95 to 0.8 cm. In the patients who underwent two-stage surgery, no nerve palsy was observed, and the single one-stage patient with incomplete peroneal nerve palsy recovered fully 4 weeks postoperatively. The short-term clinical and radiographic outcomes of primary cementless THA for patients with Crowe type III or IV DDH were encouraging. Two-stage THA followed by skeletal traction after soft tissue release could provide alternative solutions to the minimization of limb shortenings or LLD without neurologic deficits in highly selected patients.

  12. [Uncemented arthroplasty of the hip].

    Science.gov (United States)

    von Schulze Pellengahr, C; Fottner, A; Utzschneider, S; Schmitt-Sody, M; Teske, W; Lichtinger, T; Esenwein, S A

    2009-05-01

    Prognosis of cemented total hip replacement seems to be excellent for elderly patients. In younger age the outcome is less favourable and early revision is more common. Thus, different concepts with better prognosis and preservation of bone stock for possible revisions were needed. After more than 30 years of application with excellent short-term and long-term results, uncemented total hip arthroplasty is nowadays generally regarded as the standard procedure for younger patients. New bone-preserving implants, such as surface replacement or short-stemmed femoral shaft prostheses, have been introduced especially for younger patients. Some of these new procedures are still under development, and the long-term results of new implant concepts have to be evaluated over the next decades. Regarding recently published scientific studies an overview about non-cemented total hip arthroplasty is given and current concepts and developments are presented.

  13. Cementless Hydroxyapatite Coated Hip Prostheses

    Directory of Open Access Journals (Sweden)

    Antonio Herrera

    2015-01-01

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

  14. Radiology of the resurfaced hip

    Energy Technology Data Exchange (ETDEWEB)

    Rahman, Luthfur [The London Hip Unit, London (United Kingdom); Hall-Craggs, Margaret [University College London Hospital, London (United Kingdom); Muirhead-Allwood, Sarah K. [The London Hip Unit, London (United Kingdom); The Royal National Orthopaedic Hospital, Middlesex (United Kingdom)

    2011-07-15

    Hip resurfacing arthroplasty is an increasingly common procedure for osteoarthritis. Conventional radiographs are used routinely for follow-up assessment, however they only provide limited information on the radiological outcome. Various complications have been reported in the scientific literature although not all are fully understood. In an effort to investigate problematic or failing hip resurfacings, various radiological methods have been utilized. These methods can be used to help make a diagnosis and guide management. This paper aims to review and illustrate the radiographic findings in the form of radiography, computerized tomography (CT), magnetic resonance imaging (MRI), and ultrasound of both normal and abnormal findings in hip resurfacing arthroplasty. However, imaging around a metal prosthesis with CT and MRI is particularly challenging and therefore the potential techniques used to overcome this are discussed. (orig.)

  15. Developmental hip dysplasia in adolescence

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2009-01-01

    Full Text Available The authors define adolescence and developmental dysplasia of the hip (DDH. Special attention is paid to pathological findings characteristic of DDH in adolescence (unrecognized and untreated DDH; treated DDH, but non-terminated treatment; DDH diagnosed with delay, inadequately treated, with complications. The authors emphasise that DDH treatment has to be successfully terminated well before the adolescence; possibilities are explained on management modes at the time of adolescence, and possible persons guilty for the persistence of later hip problems are indicated. Based on the authors' experience and having in mind all surgical possibilities for the treatment (pelvic osteotomies, femoral osteotomies, trochanteroplasties, leg length equalization procedures the authors propose treatment protocols. The intention is to provide better treatment results and to prevent secondary hip arthrosis. Furthermore, how to improve the struggle against DDH is suggested.

  16. Hip dysplasia in the skeletally mature patient

    National Research Council Canada - National Science Library

    Goldstein, Rachel Y; Kaye, Ian David; Slover, James; Feldman, David

    2014-01-01

    .... These characteristic changes result in intraarticular pathology leading to hip arthritis. A variety of treatment options exist based on the degree of dysplasia and the amount of concomitant hip arthritis...

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

    DEFF Research Database (Denmark)

    Svege, Ida; Nordsletten, Lars; Fernandes, Linda

    2015-01-01

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

  18. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Science.gov (United States)

    2010-04-01

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

  19. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

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

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

    Science.gov (United States)

    2010-04-01

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

  1. Infection in periprosthetic hip fractures.

    Science.gov (United States)

    Cabral, Rui

    2012-01-01

    Fracture around the acetabulum and femur in total hip arthroplasty is a possible complication, sometimes with difficult surgical solution, namely when a sepsis is present. Periprosthetic hip fractures were classified according to a modified Vancouver classification. We treated 112 patients (67 men and 45 women) with periprosthetic hip fractures: 105 femoral fractures (94%) and seven acetabular fractures (6%). Mean follow-up was 10.6 years. For Type A (seven cases - 7%), B1 (10 cases - 10%) or C (13 cases - 12%) fractures around well fixed femoral stems we only fixed the fractures. For Type B2 (17 cases - 16%), B3 (46 cases - 44%) and D (12 cases - 11%, with associated fractures, not contemplated in the Vancouver classification) we used an uncemented long femoral stem, fixation with metallic cables and cancellous bone allografts to fill the femoral bone loss. We observed a deep infection in three patients (2.7%), three early hip dislocations treated by closed reductions, two cases with asymptomatic trochanteric non-union and one femoral refracture. In the three infection cases we performed two-stage revision with cementless hip prosthesis, using an antibiotic-loaded cement hip spacer (three to eight months), a six weeks period of parenteral antibiotics and we performed articular aspiration before revision surgery. Until now, we did not observe any re-infection. It is very important to make an early diagnosis, isolate micro-organisms and ensure their antibiotic susceptibility. The surgery solution depends on the well fixed implants and periprosthetic osteolysis and articular instability.

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

    OpenAIRE

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

    2010-01-01

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

  3. Focal osteoporosis defects play a key role in hip fracture.

    Science.gov (United States)

    Poole, Kenneth E S; Skingle, Linda; Gee, Andrew H; Turmezei, Thomas D; Johannesdottir, Fjola; Blesic, Karen; Rose, Collette; Vindlacheruvu, Madhavi; Donell, Simon; Vaculik, Jan; Dungl, Pavel; Horak, Martin; Stepan, Jan J; Reeve, Jonathan; Treece, Graham M

    2017-01-01

    BMD parameters. CBM measures however improved only minimally on aBMD for predicting any hip fracture and depended on the inclusion of trabecular bone measures alongside cortical regions. Focal osteoporosis was confirmed on biopsy as reduced sub-cortical trabecular bone volume. Using 3D imaging methods and targeted bone biopsy, we discovered focal osteoporosis affecting trabecular and cortical bone of the proximal femur, among men and women with hip fracture. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Transient osteoporosis of the hip.

    Science.gov (United States)

    Mirza, Rabeea; Ishaq, Saliha; Amjad, Hira

    2012-02-01

    Transient Osteoporosis of Hip (TOH) is an uncommon disorder of idiopathic nature, particularly in the Asian population. It has been described to mostly occur in middle aged men and women in their third trimester of pregnancy. A distinctive hallmark of this condition is that it is self limiting and resolves in a few months. The patient presents to the physician with pain on movement and impaired mobility of the affected joint, developing without any history of trauma. MRI is the main diagnostic tool. We report herein a case of a forty five year old male, who developed transient osteoporosis of the hip, and was managed conservatively.

  5. [Tendinitis of the hip region].

    Science.gov (United States)

    Samson, M; Lequesne, M

    1991-06-21

    Tendinitis and bursitis are less common around the hip than around the shoulder. Nevertheless, they must be recognized to avoid unnecessary and costly diagnostic errors. Their various clinical forms are studied in detail. Tendino-bursitis of the gluteus medius muscle is the most frequent in its subacute form, but it is rare in its acute, pseudo-gouty form. Calcification of the reflected tendon of the rectus femoris muscle often closely resembles arthritis of the hip. Synovial cysts of the psoas bursa and rupture of the gluteus medius tendon are rare but must be known. Local injections of corticosteroids play an important part in the treatment of these diseases.

  6. Hip-Hop发烧友

    Institute of Scientific and Technical Information of China (English)

    文泉; 张鹏

    2005-01-01

    我出生在布朗克斯。我只有三十岁。我一直是争论的焦点。我一年可以赚数十亿美元,而且非常非常红。你知道我是谁吗?我是Hip-Hop。三十年前“hip hop”这个词儿还不存在,如今它已经成为一种几乎难以定义的包罗万象的生活方式。

  7. Computed tomography in abnormalities of the hip

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-06-26

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

  8. Ultrasonography of the hip and lower extremity.

    Science.gov (United States)

    Malanga, Gerard A; Dentico, Richard; Halperin, Jonathan S

    2010-08-01

    Musculoskeletal ultrasonographic evaluation of the proximal lower limb includes the evaluation of the soft tissue structures, including tendons, ligaments, or muscles, and the bony structures of this region, include the hip, pubic symphysis, and sacroiliac joints. The evaluation of the hip or proximal lower limb region can be performed in an efficient and systematic manner. Ultrasonography of the lateral hip, intra-articular hip, medial thigh, and posterior thigh are discussed in the article. Copyright 2010 Elsevier Inc. All rights reserved.

  9. CUSTOMIZED ACETABULAR COMPONENTS IN REVISION HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    G. M. Kavalersky

    2016-01-01

    Full Text Available In recent years, there is a trend of increasing demand for revision hip arthroplasty. Among these patients there are many with complex acetabular defects, including patients with pelvic discontinuity. To ensure stability for revised acetabular components in such cases becomes a challenging or unachievable task. Such defects give indications for printing customized tri-flange acetabular component. The authors analysed own experience of creating and applying custom made acetabular components in 3 patients with complex acetabular defects. Material and methods. Among the patients there were 2 women and 1 man. Average age was 60,3±19,4 years (38 to 78 years. Two patients had III B defects with pelvic discontinuity and one patient had III A defect by Paprosky classification. As the first step, the authors in collaboration with engineers printed a plaster full size pelvic 3D model, as the second step a customized tri-flange acetabular component was designed and printed. Harris Hip Score was evaluated preoperatively and 3 months postoperatively. Results. Average follow-up period was 5,3±2,5 months (3 to 8 months. The authors observed no cases of implant loosening, dislocation or deep periprosthetic infection. Average Harris Hip Score before surgery was 27,13 and after surgery – 74,1 indicating a significant improvement in 3 months postoperatively. Conclusion. Indications for use of individual acetabular components in reported patients correspond to indications formulated by Berasi et al. The authors obtained encouraging early follow-up outcomes that correspond to data of other authors. In one patient certain difficulties were reported due to insufficient pelvic distraction. Component’s flanges prevented achieving adequate pelvic distraction. Nevertheless, good primary stability was achieved. Modern software and 3D metal printers can significantly reduce the production cost of customized acetabular components. Application of this technology can be

  10. On HIP-HOP%HIP-HOP运动论

    Institute of Scientific and Technical Information of China (English)

    王丽娜; 兰健

    2009-01-01

    运用文献资料等方法,从文化社会学的角度对传入我国的HIP-HOP运动的文化背景及其文化表现进行分析.认为:HIP-HOP运动主要包括:街舞、街头篮球、滑板等运动.HIP-HOP运动以其流行的社会文化要素和独特魅力吸引亿万青少年,使其狂热地投入到这股新兴的运动时尚潮流中,影响和改变着青少年的现代生活.HIP-HOP运动创造了一种非冲突性的、娱乐休闲的,以及有理想化价值的身体娱乐体系,有着独有的体育文化功能.

  11. Superior austempered ductile iron (ADI) properties achieved by prior hot isostatic pressing (HIP)

    Energy Technology Data Exchange (ETDEWEB)

    LaGoy, J.L.; Widmer, R.; Zick, D.H. [Industrial Materials Technology Inc., Andover, MA (United States)

    1996-12-31

    Ductile iron obtained from different foundries and cast by dissimilar methods has been successfully hot isostatically pressed (HIPed) before austempering to achieve substantially higher ductilities, without significant detriment to other properties, than those reached by austempering along. HIP was attempted to solve different mechanical deficiencies in austempered ductile iron (ADI) such as the lack of ductility in higher strength grades, inconsistent mechanical properties, and service life limitations. A variety of HIP temperatures were analyzed from near the austenitizing region up to within 56 C (100 F) of the melting point of ductile iron. Microporosity was eliminated by HIP at all temperatures, and subsequent austempering revealed a uniform ADI microstructure. HIP proved successful with both unencapsulated castings and those enclosed within steel canisters. Additional benefits caused by HIP processing of ductile iron castings without the austempering treatment include a significant decrease in mechanical property data scatter, high hardness at reasonable ductility levels, and a substantially reduced scrap rate.

  12. 27 CFR 28.66 - Strengthening bonds.

    Science.gov (United States)

    2010-04-01

    ... bonds. In all cases where the penal sum of any bond becomes insufficient, the principal shall either give a strengthening bond with the same surety to attain a sufficient penal sum, or give a new bond to... of any bond to less than its full penal sum. Strengthening bonds shall show the current date...

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

    Science.gov (United States)

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

    2009-06-19

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

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

    OpenAIRE

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

    2015-01-01

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

  15. Total Hip Arthroplasty in Failed Hip Fractures: A Case Series

    Directory of Open Access Journals (Sweden)

    Syed Shahid Noor

    2015-01-01

    Full Text Available Osteoporosis is epidemic in Asian countries. It is a major cause of fractures that orthopaedic surgeons deal in Pakistan, though proper epidemiological data is not available. Habiba U et al found that 75.3% of post menopausal women of Pakistan were predisposed to Osteoporosis; whereas Baig L has described an average T - score of -1.833±0.65 on bone mineral density calculation of post menopausal females of Pakistan. Osteoporotic hip fractures constitute a major cause of elderly mortality worldwide and recent figures supporting the idea that these patients have survival rates comparable to breast and thyroid cancer patients. Pakistan is a developing country with large burden of hip fractures. Patients living in remote areas are the ones which suffer more because of inadequate awareness, fear of surgical treatment and lack of availability of standard treatment. These patients are dealt by surgeons of various expertise and levels of experience. Lack of facilities in hospitals is well known and usage of sub-standard implant is a major cause of failure. Therefore these patients either because of their bone fragility or mal-treatment suffer frequently from failure of hip fracture surgeries. Being in a tertiary care centre we come across these types of cases very frequently. Six to eight such cases present to outpatient department of Liaquat National Hospital every month being referred from every part of the country. These patients may have been operated once, twice or even multiple times. Special attention is required to acquire an informative history from these cases and perform a comprehensive examination. Moreover previous records and radiographs provide invaluable information regarding cause of failure and deciding course of further treatment. We herein discuss few of the cases of failure of hip fractures which were treated by hip arthroplasty.

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

    Science.gov (United States)

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

    2015-10-01

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

  17. THERAPEUTIC STRATEGY IN THE REHABILITATION OF THE DYSPLASTIC HIP THROUGH ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Liliana SAVIN

    2012-07-01

    Full Text Available Total hip arthroplasty in degenerative pathology secondary to congenital dysplasia differentiates itself amongtotal arthroplasties by the frequent technical difficulties it poses and the site where it is performed. The existence of aform of congenital dysplasia that remained untreated or insufficiently treated in childhood leads to irreversibledeformities in adulthood. Partial or total loss of joint congruence causes, in time, degenerative changes with theimpairment of hip mobility and is associated with a number of progressive deformations (limb length discrepancy,abnormal rotation, asymmetric lesions, periarticular muscle failure, which gradually reduce the quality of the patient’slife. This study aims at investigating the incidence of prosthetic hip arthroplasty for osteoarthritis secondary todysplastic hip in the total number of arthroplasties, the age when surgery is performed, the type of deformity andprosthetic components used, and the postoperative and long-term functional results. The study was conducted on 110patients who received total hip arthroplasty due to osteoarthritis secondary to hip dysplasia, between 1994 and 2011, inthe Orthopaedics Trauma Department of the Rehabilitation Hospital of Iasi, the incidence being of 3.34% of the totalnumber of arthroplasties, with a prevalence of 65% under the age of 50 years. The functional results were assessed,according to the Harris-hip-score parameters, as good or very good in proportion of 82%. The complexity of the areawhere the total hip arthroplasty is performed requires a good management consisting of thorough preoperativeplanning, determining the operatory indication, and specialized and individualized medical recovery.

  18. Planetary Suit Hip Bearing Model for Predicting Design vs. Performance

    Science.gov (United States)

    Cowley, Matthew S.; Margerum, Sarah; Harvil, Lauren; Rajulu, Sudhakar

    2011-01-01

    Designing a planetary suit is very complex and often requires difficult trade-offs between performance, cost, mass, and system complexity. In order to verifying that new suit designs meet requirements, full prototypes must eventually be built and tested with human subjects. Using computer models early in the design phase of new hardware development can be advantageous, allowing virtual prototyping to take place. Having easily modifiable models of the suit hard sections may reduce the time it takes to make changes to the hardware designs and then to understand their impact on suit and human performance. A virtual design environment gives designers the ability to think outside the box and exhaust design possibilities before building and testing physical prototypes with human subjects. Reductions in prototyping and testing may eventually reduce development costs. This study is an attempt to develop computer models of the hard components of the suit with known physical characteristics, supplemented with human subject performance data. Objectives: The primary objective was to develop an articulating solid model of the Mark III hip bearings to be used for evaluating suit design performance of the hip joint. Methods: Solid models of a planetary prototype (Mark III) suit s hip bearings and brief section were reverse-engineered from the prototype. The performance of the models was then compared by evaluating the mobility performance differences between the nominal hardware configuration and hardware modifications. This was accomplished by gathering data from specific suited tasks. Subjects performed maximum flexion and abduction tasks while in a nominal suit bearing configuration and in three off-nominal configurations. Performance data for the hip were recorded using state-of-the-art motion capture technology. Results: The results demonstrate that solid models of planetary suit hard segments for use as a performance design tool is feasible. From a general trend perspective

  19. Readmissions after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B

    2010-01-01

    With the implementation of fast-track surgery with optimization of both logistical and clinical features, the postoperative convalescence has been reduced as functional milestones have been achieved earlier and consequently length of stay (LOS) in hospital has been reduced. However, it has been s...... speculated that a decrease in LOS may be associated with an increase in readmissions in general, including risk of dislocation after total hip arthroplasty (THA) or manipulation after total knee arthroplasty (TKA)....

  20. Glycine reduces tissue lipid peroxidation in hypoxia-reoxygenation-induced necrotizing enterocolitis in rats Glicina reduz a peroxidação lipídica tecidual em enterocolite necrosante induzida por hipóxia-reoxigenação em ratos

    Directory of Open Access Journals (Sweden)

    Karine Furtado Meyer

    2006-06-01

    Full Text Available PURPOSE: To assess the protective effect of glycine in an experimental model of Neonatal Necrotizing Enterocolitis (NEC. METHODS: Fifty (50 neonatal Wistar rats, from a litter of six female rats and weighing 4 to 6 grams, were used. Five animals were cannibalized and the 45 remaining were distributed into three groups: the G1 normal control group (n=12; the G2 Group (n=16, of animals that underwent hypoxia-reoxygenation (HR; the G3 Group of animals (n=17 that underwent HR following a 5% intraperitoneal glycine infusion. The animals underwent hypoxia in a CO2 chamber receiving an air flow of 100% CO2 for 5 minutes and reoxygenation receiving an O2 flow at 100% for 5 minutes. One centimeter long small bowel and colon segments were prepared for histological analysis. The rest of the bowel was removed in a block and frozen at minus 80°C for homogenization and determination of tissue malondialdehyde (MDA. Tissue lesions were classified as Grade 0 to Grade 5, according to the level of damaged mucosa. RESULTS: The animals in Group G1 had levels of small bowel and colon lesion significantly smaller as compared to the animals in Groups G2 and G3. The G2 group had mean MDA values significantly higher than the animals in the G1 (p = .015 and G3 (p=0.021 groups. MDA values did not differ significantly (p = 0.992 for the animals in groups G1 and G3. CONCLUSION: Glycine reduces tissue MDA levels (a measurement of lipid peroxidation following HR in neonatal rats.OBJETIVO: Avaliar o efeito protetor da glicina, num modelo experimental de ECN. MÉTODOS: Foram utilizados 50 ratos Wistar recém-nascidos, com peso variando de 4 a 6 gramas, provenientes da ninhada de seis ratas. Cinco animais foram canibalizados e, os 45 restantes, foram distribuídos em três grupos: controle G1(n=12; G2(n=16, animais que foram submetidos à hipóxia-reoxigenação; G3(n=17, animais submetidos à hipóxia-reoxigenação após uma infusão intraperitoneal de glicina 5%. Os animais

  1. Studies on the Performance of RC Beam-Column Joints Strengthened Using Different Composite Materials

    Science.gov (United States)

    Sheela, S.; Anu Geetha, B.

    2012-02-01

    Many reinforced concrete structures in our country are in a deteriorated or distressed state. Hence strengthening such structures or reducing the load limit on them is becoming necessary to extend their service life. Beam-column joint is the crucial zone in a reinforced concrete moment resisting frame since it is subjected to large forces during severe ground shaking. In the present study, an attempt has been made to determine the cost-effective composite material and optimum number of layers of composite material for strengthening beam-column joints. Specimens were strengthened using ferrocement, glass fibre reinforced polymer (GFRP) and carbon fibre reinforced polymer (CFRP) and studied their behaviour under static as well as cyclic loading. It was found that the rotation at ultimate moment of all the strengthened beam-column joints were greater than that of the control specimens. The specimens strengthened with more number of layers of strengthening material showed better moment-rotation characteristics. The joints strengthened using GFRP showed better performance in terms of ultimate load, moment rotation characteristics, ductility, energy absorption capacity and strength-to-cost ratio, when compared to that of the specimens strengthened with other composite materials. However, CFRP strengthened specimens showed good ductility and better cracking characteristics and prevented the failure at the joint.

  2. SU-E-J-230: Effect of Metal Hip Prosthesis On the Accuracy of Electromagnetic Localization and Tracking

    Energy Technology Data Exchange (ETDEWEB)

    Butler, W; Merrick, G; Kurko, B [Wheeling Hospital, Wheeling, WV (United States); Bittner, N [Tacoma\\Valley Radiation Oncology, Tacoma, WA (United States)

    2014-06-01

    Purpose: To quantify the effect of metal hip prosthesis on the ability to track and localize electromagnetic transponders. Methods: Three Calypso transponders were implanted into two prostate phantoms. The geometric center of the transponders were identified on computed tomography and set as the isocenter. With the phantom stationary on the treatment table and the tracking array 14-cm above the isocenter, data was acquired by the Calypso system at 10 Hz to establish the uncertainty in measurements. Transponder positional data was acquired with unilateral hip prostheses of different metallic compositions and then with bilateral hips placed at variable separation from the phantom. Results: Regardless of hip prosthesis composition, the average vector displacement in the presence of a unilateral prosthesis was < 0.5 mm. The greatest contribution to overall vector displacement occurred in the lateral dimension. With bilateral hip prosthesis, the average vector displacement was 0.3 mm. The displacement in the lateral dimension was markedly reduced compared with a unilateral hip, suggesting that there was a countervailing effect with bilateral hip prosthesis. The greatest average vector displacement was 0.6 mm and occurred when bilateral hip prostheses were placed within 4 cm of the detector array. Conclusion: Unilateral and bilateral hip prostheses did not have any meaningful effect on the ability to accurately track electromagnetic transponders implanted in a prostate phantom. At clinically realistic distances between the hip and detection array, the average tracking error is negligible.

  3. The Bernese periacetabular osteotomy: clinical, radiographic and mechanical 7-15-year follow-up of 26 hips.

    Science.gov (United States)

    Kralj, Marko; Mavcic, Blaz; Antolic, Vane; Iglic, Ales; Kralj-Iglic, Veronika

    2005-12-01

    The Bernese periacetabular osteotomy is used in dysplastic hips to increase the load-bearing area of the hip and to prevent osteoarthritis. The aim of our work was to determine the contact hip stress before and after the osteotomy and to compare the relief of stress with the long-term radiographic and clinical outcome. We followed 26 dysplastic hips (26 patients) for 7-15 years after the index operation. Clinical evaluation was based on the WOMAC score, osteoarthrosis was evaluated with the Tönnis classification, the angles of lateral (CE) and anterior (VCA) femoral coverage were measured, and biomechanical parameters were studied. Periacetabular osteotomy increased the mean CE from 15 degrees to 37 degrees , and the mean VCA from 22 degrees to 38 degrees . The mean normalized peak contact stress was reduced from 5.2 to 3.0 kPa/N. Four hips required total hip arthroplasty after an average of 4.5 years, 8 hips showed considerable arthrosis progression, and 14 hips had no or mild arthrosis at follow-up. Preoperative WOMAC score, preoperative Tönnis grade and postoperative normalized peak contact stress were the most important predictors of outcome. The Bernese periacetabular osteotomy improves the mechanical status of the hip. Long-term success depends on the grade of arthrosis preoperatively and on the magnitude of operative correction of the contact hip stress.

  4. Improving hip surgery patients’ outcomes:

    DEFF Research Database (Denmark)

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

    2013-01-01

    This presentation focuses upon the improvement of hip surgery patients’ outcomes with respect to health promotion and rehabilitation. The overall aims of the EU financed orthopedic nursing project will be introduced. Speakers highlight the project’s contribution to: -the development of nurse...

  5. Hip-Hop Pop Art

    Science.gov (United States)

    Talley, Clarence, Sr.

    2011-01-01

    Art has a way of helping students better understand and appreciate the world around them, particularly the things that are most important to them. Hip hop is one of those generational genres that capture the attention of young students like few other things do. Drawing on this genre to get students to create art is an excellent way to demonstrate…

  6. Hip-Hop Pop Art

    Science.gov (United States)

    Talley, Clarence, Sr.

    2011-01-01

    Art has a way of helping students better understand and appreciate the world around them, particularly the things that are most important to them. Hip hop is one of those generational genres that capture the attention of young students like few other things do. Drawing on this genre to get students to create art is an excellent way to demonstrate…

  7. Excess mortality following hip fracture

    DEFF Research Database (Denmark)

    Abrahamsen, B; van Staa, T; Ariely, R;

    2009-01-01

    Summary This systematic literature review has shown that patients experiencing hip fracture after low-impact trauma are at considerable excess risk for death compared with nonhip fracture/community control populations. The increased mortality risk may persist for several years thereafter, highlig...

  8. Hominin Hip Biomechanics: Changing Perspectives.

    Science.gov (United States)

    Warrener, Anna G

    2017-05-01

    The shape of the human pelvis reflects the unique demands placed on the hip abductor muscles (gluteus medius and gluteus minimus), which stabilize the body in the frontal plane during bipedal locomotion. This morphological shift occurred early in hominin evolution, yet important shape differences between hominin species have led to significant disagreement about abductor function and locomotor capability in these extinct taxa. A static biomechanical model that relies on a close association between skeletal measurements of the pelvis and femur has traditionally been used to reconstruct hip biomechanics in these species. However, experimental biomechanical approaches have highlighted the dynamic nature of mediolateral balance in walking and running, challenging the assumptions of the static hip model. This article reviews traditional approaches for understanding hip abductor function, shows how they have been applied to the fossil hominin record, and discusses new techniques that integrate the dynamic nature of mediolateral balance during human locomotion. Anat Rec, 300:932-945, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  9. Peripheral nerve blocks for hip fractures.

    Science.gov (United States)

    Guay, Joanne; Parker, Martyn J; Griffiths, Richard; Kopp, Sandra

    2017-05-11

    Various nerve blocks with local anaesthetic agents have been used to reduce pain after hip fracture and subsequent surgery. This review was published originally in 1999 and was updated in 2001, 2002, 2009 and 2017. This review focuses on the use of peripheral nerves blocks as preoperative analgesia, as postoperative analgesia or as a supplement to general anaesthesia for hip fracture surgery. We undertook the update to look for new studies and to update the methods to reflect Cochrane standards. For the updated review, we searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 8), MEDLINE (Ovid SP, 1966 to August week 1 2016), Embase (Ovid SP, 1988 to 2016 August week 1) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO, 1982 to August week 1 2016), as well as trial registers and reference lists of relevant articles. We included randomized controlled trials (RCTs) involving use of nerve blocks as part of the care provided for adults aged 16 years and older with hip fracture. Two review authors independently assessed new trials for inclusion, determined trial quality using the Cochrane tool and extracted data. When appropriate, we pooled results of outcome measures. We rated the quality of evidence according to the GRADE Working Group approach. We included 31 trials (1760 participants; 897 randomized to peripheral nerve blocks and 863 to no regional blockade). Results of eight trials with 373 participants show that peripheral nerve blocks reduced pain on movement within 30 minutes of block placement (standardized mean difference (SMD) -1.41, 95% confidence interval (CI) -2.14 to -0.67; equivalent to -3.4 on a scale from 0 to 10; I(2) = 90%; high quality of evidence). Effect size was proportionate to the concentration of local anaesthetic used (P mobilization after surgery (mean difference -11.25 hours, 95% CI -14.34 to -8.15 hours; I(2) = 52%; moderate quality of evidence). One trial

  10. FRP Composites Strengthening of Concrete Columns under Various Loading Conditions

    Directory of Open Access Journals (Sweden)

    Azadeh Parvin

    2014-04-01

    Full Text Available This paper provides a review of some of the progress in the area of fiber reinforced polymers (FRP-strengthening of columns for several loading scenarios including impact load. The addition of FRP materials to upgrade deficiencies or to strengthen structural components can save lives by preventing collapse, reduce the damage to infrastructure, and the need for their costly replacement. The retrofit with FRP materials with desirable properties provides an excellent replacement for traditional materials, such as steel jacket, to strengthen the reinforced concrete structural members. Existing studies have shown that the use of FRP materials restore or improve the column original design strength for possible axial, shear, or flexure and in some cases allow the structure to carry more load than it was designed for. The paper further concludes that there is a need for additional research for the columns under impact loading senarios. The compiled information prepares the ground work for further evaluation of FRP-strengthening of columns that are deficient in design or are in serious need for repair due to additional load or deterioration.

  11. Tape blisters after hip surgery: can they be eliminated completely?

    Science.gov (United States)

    Koval, Kenneth J; Egol, Kenneth A; Hiebert, Rudi; Spratt, Kevin F

    2007-05-01

    It was recently reported that use of a perforated, stretchable cloth tape instead of silk tape reduced the incidenc of postoperative blisters around the hip from 41% to 10%. The present prospective randomized study was conducted to determine whether use of spica bandage (vs the cloth tape) could further reduce or eliminate the incidence of these blisters. Patients were randomized to 2 treatmen groups: perforated, stretchable cloth tape (Hypafix; Smit & Nephew, Memphis, Tenn) and elastic spica bandage tha was started at the lower thigh and was extended aroun the hip and abdomen. After surgery, cloth tape or spic bandage was applied over the postoperative dressing, with care taken not to produce skin tension. At the first dressing change, presence or absence of blisters was recorded, along with their number, size, location, and type. All subsequent dressing changes were done much as they wer at surgery, using the assigned type of dressing. Presence or absence of blisters was recorded at each subsequent dressing change. Two hundred ninety-four patients (300 hips) were enrolled. Twenty-two (7.33%) of the 300 hips developed a blister. Risk for developing a blister was 10% with the cloth tape versus 4.67% with the elastic spica bandage (P blister formation than dressing type.

  12. [Atraumatic hip pain in young adults].

    Science.gov (United States)

    González Murillo, M; Turcu, V; De Nicolás Navas, M B; Yeguas Bermejo, A

    2016-01-01

    Hip pain in the young adult is a disabling pathophysiological process may be related to multiple etiologies. The process must be determined in order to make a diagnosis and follow-up treatment. The case is presented of a 29 year old woman with anemia, atraumatic hip pain on the right side, and a limp of one month onset. The differential diagnosis includes infectious, rheumatological, tumor, avascular necrosis of hip, hip impingement, hip dysplasia, osteoarthritis and other syndromes. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  13. [Congenital hip dysplasia, screening and therapy].

    Science.gov (United States)

    Kolb, A; Windhager, R; Chiari, C

    2015-11-01

    Congenital hip dysplasia and hip dislocation are relatively common pathological conditions of the musculoskeletal system in infants. An early and certain diagnosis can now be achieved by sonographic hip screening within the framework of screening examination programs. This early diagnostic procedure in infants is essential particularly for a conservative treatment strategy. Therefore, apart from possessing in-depth knowledge, training of the examiner in specialist courses is of central importance. This article presents an overview of the entity of congenital hip dysplasia and hip dislocation, the diagnostics and treatment with special emphasis on recent developments.

  14. Hip arthroscopy in the setting of hip dysplasia: A systematic review.

    Science.gov (United States)

    Yeung, M; Kowalczuk, M; Simunovic, N; Ayeni, O R

    2016-06-01

    Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to July 2015. Study parameters including sample size, definition of dysplasia, outcomes measures, and re-operation rates were obtained. Furthermore, the levels of evidence of studies were collected and quality assessment was performed. The systematic review identified 18 studies investigating hip arthroscopy in the setting of hip dysplasia, with 889 included patients. Criteria used by the studies to diagnose hip dysplasia and borderline hip dysplasia included centre edge angle in 72% of studies but the range of angles were quite variable. Although 89% of studies reported improved post-operative outcome scores in the setting of hip dysplasia, revision rates were considerable (14.1%), with 9.6% requiring conversion to total hip arthroplasty. The available orthopaedic literature suggests that although improved outcomes are seen in hip arthroscopy in the setting of hip dysplasia, there is a high rate of re-operation and conversion to total hip arthroplasty. Furthermore, the criteria used to define hip dysplasia vary considerably among published studies.Cite this article: M. Yeung, M. Kowalczuk, N. Simunovic, O. R. Ayeni. Hip arthroscopy in the setting of hip dysplasia: A systematic review. Bone Joint Res 2016;5:225-231. DOI: 10.1302/2046-3758.56.2000533. © 2016 Ayeni et al.

  15. Hip range of motion and scapula position in youth baseball pitching pre and post simulated game.

    Science.gov (United States)

    Oliver, Gretchen Dawn; Weimar, Wendi

    2015-01-01

    Lower to upper extremity sequencing of energy and force is linked by virtue of the scapula. It was the purpose of this study to examine the relationship between passive hip rotational range of motion and scapular kinematics during baseball pitching. Nineteen youth baseball players (11.3 ± 0.6 years; 151.8 ± 8.8 cm; 45.9 ± 10.9 kg) with no history of injury participated. Bilateral hip passive rotational range of motion was measured pre and post pitching a simulated game. Scapular kinematics at the position of shoulder maximum external rotation during the pitching cycle were recorded in the first and last innings of the simulated game. Post simulated game, stance leg hip passive internal rotation revealed significant correlations (r = -0.57, P = 0.01) with scapula anterior/posterior tilt at the pitching event of maximum humeral external rotation. The current study reveals that pitching a simulated game results in alterations throughout the kinetic chain. Specifically, this study strengthens the notion that lumbopelvic-hip complex parameters play a significant role in shoulder motion. With this link identified, it is suggested that clinical focus be directed musculature about the lumbopelvic-hip complex as well as muscles that work to stabilise the scapula during dynamic movement.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

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

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

    Science.gov (United States)

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

    2012-03-01

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

  18. Techniques and results for open hip preservation

    Directory of Open Access Journals (Sweden)

    David eLevy

    2015-12-01

    Full Text Available While hip arthroscopy grows in popularity, there are still many circumstances under which open hip preservation is most appropriately indicated. This article specifically reviews open hip preservation procedures for a variety of hip conditions. Femoral acetabular impingement may be corrected using an open surgical hip dislocation. Acetabular dysplasia may be corrected using a periacetabular osteotomy. Acetabular protrusio may require surgical hip dislocation with rim trimming and a possible valgus intertrochanteric osteotomy. Legg-Calve ́-Perthes disease produces complex deformities that may be better served with osteotomies of the proximal femur and/ or acetabulum. Chronic slipped capital femoral epiphysis (SCFE may also benefit from a surgical hip dislocation and/or proximal femoral osteotomy.

  19. Hip Imaging in Athletes: Sports Imaging Series.

    Science.gov (United States)

    Agten, Christoph A; Sutter, Reto; Buck, Florian M; Pfirrmann, Christian W A

    2016-08-01

    Hip or groin pain in athletes is common and clinical presentation is often nonspecific. Imaging is a very important diagnostic step in the work-up of athletes with hip pain. This review article provides an overview on hip biomechanics and discusses strategies for hip imaging modalities such as radiography, ultrasonography, computed tomography, and magnetic resonance (MR) imaging (MR arthrography and traction MR arthrography). The authors explain current concepts of femoroacetabular impingement and the problem of high prevalence of cam- and pincer-type morphology in asymptomatic persons. With the main focus on MR imaging, the authors present abnormalities of the hip joint and the surrounding soft tissues that can occur in athletes: intraarticular and extraarticular hip impingement syndromes, labral and cartilage disease, microinstability of the hip, myotendinous injuries, and athletic pubalgia. (©) RSNA, 2016.

  20. Timber Elements: Traditional and Modern Strengthening Techniques

    Directory of Open Access Journals (Sweden)

    Raluca Hohan

    2010-01-01

    Full Text Available The main idea of this paper is to analyse the means for the rehabilitation of our cultural heritage timber structures. Several methods together with their application techniques are described, and also, the reasons for what these strengthening operations become imminent at a point. First of all, the necessity of the timber structural elements strengthening is explained through a short presentation of the factors which are degrading the material. Then, certain precautions and strengthening procedures are presented, all involving the usage of traditional materials like wood, metal, or concrete, and of modern materials like fiber reinforced polymeric composite.

  1. Comparison and analysis of reoperations in two different treatment protocols for trochanteric hip fractures - postoperative technical complications with dynamic hip screw, intramedullary nail and Medoff sliding plate.

    Science.gov (United States)

    Paulsson, Johnny; Stig, Josefine Corin; Olsson, Ola

    2017-08-24

    treatment protocol based on use of biaxial Medoff sliding plate for unstable pertrochanteric and uniaxial Medoff sliding plate for subtrochanteric fractures reduced the risk of severe technical complications compared to using the treatment protocol based on dynamic hip screw and intramedullary nail.

  2. Influence of Power Delivery Timing on the Energetics and Biomechanics of Humans Wearing a Hip Exoskeleton.

    Science.gov (United States)

    Young, Aaron J; Foss, Jessica; Gannon, Hannah; Ferris, Daniel P

    2017-01-01

    A broad goal in the field of powered lower limb exoskeletons is to reduce the metabolic cost of walking. Ankle exoskeletons have successfully achieved this goal by correctly timing a plantarflexor torque during late stance phase. Hip exoskeletons have the potential to assist with both flexion and extension during walking gait, but the optimal timing for maximally reducing metabolic cost is unknown. The focus of our study was to determine the best assistance timing for applying hip assistance through a pneumatic exoskeleton on human subjects. Ten non-impaired subjects walked with a powered hip exoskeleton, and both hip flexion and extension assistance were separately provided at different actuation timings using a simple burst controller. The largest average across-subject reduction in metabolic cost for hip extension was at 90% of the gait cycle (just prior to heel contact) and for hip flexion was at 50% of the gait cycle; this resulted in an 8.4 and 6.1% metabolic reduction, respectively, compared to walking with the unpowered exoskeleton. However, the ideal timing for both flexion and extension assistance varied across subjects. When selecting the assistance timing that maximally reduced metabolic cost for each subject, average metabolic cost for hip extension was 10.3% lower and hip flexion was 9.7% lower than the unpowered condition. When taking into account user preference, we found that subject preference did not correlate with metabolic cost. This indicated that user feedback was a poor method of determining the most metabolically efficient assistance power timing. The findings of this study are relevant to developers of exoskeletons that have a powered hip component to assist during human walking gait.

  3. Influence of Power Delivery Timing on the Energetics and Biomechanics of Humans Wearing a Hip Exoskeleton

    Science.gov (United States)

    Young, Aaron J.; Foss, Jessica; Gannon, Hannah; Ferris, Daniel P.

    2017-01-01

    A broad goal in the field of powered lower limb exoskeletons is to reduce the metabolic cost of walking. Ankle exoskeletons have successfully achieved this goal by correctly timing a plantarflexor torque during late stance phase. Hip exoskeletons have the potential to assist with both flexion and extension during walking gait, but the optimal timing for maximally reducing metabolic cost is unknown. The focus of our study was to determine the best assistance timing for applying hip assistance through a pneumatic exoskeleton on human subjects. Ten non-impaired subjects walked with a powered hip exoskeleton, and both hip flexion and extension assistance were separately provided at different actuation timings using a simple burst controller. The largest average across-subject reduction in metabolic cost for hip extension was at 90% of the gait cycle (just prior to heel contact) and for hip flexion was at 50% of the gait cycle; this resulted in an 8.4 and 6.1% metabolic reduction, respectively, compared to walking with the unpowered exoskeleton. However, the ideal timing for both flexion and extension assistance varied across subjects. When selecting the assistance timing that maximally reduced metabolic cost for each subject, average metabolic cost for hip extension was 10.3% lower and hip flexion was 9.7% lower than the unpowered condition. When taking into account user preference, we found that subject preference did not correlate with metabolic cost. This indicated that user feedback was a poor method of determining the most metabolically efficient assistance power timing. The findings of this study are relevant to developers of exoskeletons that have a powered hip component to assist during human walking gait. PMID:28337434

  4. Retrieval analysis of 240 metal-on-metal hip components, comparing modular total hip replacement with hip resurfacing.

    Science.gov (United States)

    Matthies, A; Underwood, R; Cann, P; Ilo, K; Nawaz, Z; Skinner, J; Hart, A J

    2011-03-01

    This study compared component wear rates and pre-revision blood metal ions levels in two groups of failed metal-on-metal hip arthroplasties: hip resurfacing and modular total hip replacement (THR). There was no significant difference in the median rate of linear wear between the groups for both acetabular (p = 0.4633) and femoral (p = 0.0872) components. There was also no significant difference in the median linear wear rates when failed hip resurfacing and modular THR hips of the same type (ASR and Birmingham hip resurfacing (BHR)) were compared. Unlike other studies of well-functioning hips, there was no significant difference in pre-revision blood metal ion levels between hip resurfacing and modular THR. Edge loading was common in both groups, but more common in the resurfacing group (67%) than in the modular group (57%). However, this was not significant (p = 0.3479). We attribute this difference to retention of the neck in resurfacing of the hip, leading to impingement-type edge loading. This was supported by visual evidence of impingement on the femur. These findings show that failed metal-on-metal hip resurfacing and modular THRs have similar component wear rates and are both associated with raised pre-revision blood levels of metal ions.

  5. Meta-analysis of the effect of strengthening interventions in individuals with cerebral palsy.

    Science.gov (United States)

    Park, Eun-Young; Kim, Won-Ho

    2014-02-01

    This study aimed to investigate the evidence that strengthening interventions can improve muscle strength and activity in individuals with cerebral palsy. The search focused on studies that employed strength training for children with cerebral palsy for which six electronic databases were used to extract literature published from 2001 to 2012. The key terms used in these searches were combined strength training, strengthening, weight training, weight lifting, resistance, and cerebral palsy. The quality of each study was assessed using the PEDro (Physiotherapy Evidence Database) scale. Thirteen randomized controlled trial studies were selected and divided into categories according to program type, mode, and outcome measures. The overall effect sizes of each study and types of strengthening were large. Strengthening exercise improved muscle strength to a greater degree, when practiced 3 times per week in 40-50 min sessions than in other categories of session length, and greater improvement was observed in younger children than in older. The effect size of the activities and variables related to gait, except for gait endurance, were medium to large. The effect size of individual muscles was large, but the effect sizes for ankle plantar flexor, hip abductor/adductor, and extensor were insignificant. Strengthening interventions are useful for increasing muscle strength in individuals with cerebral palsy, specifically in youth and children, and optimal exercise consisted of 40- to 50-min sessions performed 3 times per week. Although strengthening interventions may improve activities, including gait, more studies that are rigorous are needed to determine the contributions to gross motor function. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Ultrasound screening for developmental dysplasia of the hip and its socioeconomic impact: Experience of tertiary care health level

    Directory of Open Access Journals (Sweden)

    Khaled Aly Matrawy

    2014-03-01

    Conclusion: Screening ultrasound is a useful tool for detection of hip dislocation and dysplasia especially among the population of infants at increased risk of developmental dysplasia of the hip. Limitation of screening ultrasound programs for those at risk only reduces the financial burden with better outcome in choosing candidates for further workup especially surgical intervention.

  7. Use of postoperative irradiation for the prevention of heterotopic bone formation after total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Sylvester, J.E.; Greenberg, P.; Selch, M.T.; Thomas, B.J.; Amstutz, H.

    1988-03-01

    Formation of heterotopic bone (HTB) following total hip replacement may partially or completely ankylose the joint space, causing pain and/or limiting the range of motion. Patients at high risk for formation of HTB postoperatively include those with previous HTB formation, heterotopic osteoarthritis, and active rheumatoid spondylitis. Patients in these high risk groups have a 63-69% incidence of post-operative HTB formation, usually seen radiographically by 2 months post-operation. From 1980-1986 twenty-nine hips in 28 consecutively treated patients were irradiated post-operatively at the UCLA Center for the Health Sciences. The indication for irradiation was documented HTB formation previously in 26 of the 27 hips presented below. From 1980-1982 patients received 20 Gray (Gy) in 2 Gy fractions; from 1982-1986 the dose was reduced to 10 Gy in 2 Gy fractions. Twenty-seven hips in 26 patients completed therapy and were available for evaluation, with a minimum of 2 month follow-up, and a median follow-up of 12 months. Three of 27 hips developed significant HTB (Brooker grade III or IV) post-operatively, whereas 5 of 27 hips developed minor, nonsymptomatic HTB (Brooker grade I). When irradiation was begun by postoperative day 4, 0 of 17 hips formed significant HTB. If irradiation began after post-operative day 4, 3 of 10 hips formed significant HTB (Brooker grade III or IV). These 3 hips received doses of 10 Gy in one hip and 20 Gy in the other 2 hips. There were no differences in the incidence or severity of side effects in the 10 Gy vs. the 20 Gy treatment groups. Eighteen hips received 10 Gy, 8 hips 20 Gy and, 1 hip 12 Gy. In conclusion, 10 Gy in 5 fractions appears as effective as 20 Gy in 10 fractions at preventing post-operative formation of HTB. For optimal results, treatment should begin as early as possible prior to post-operative day 4.

  8. Low-trauma fractures indicate increased risk of hip fracture in frail older people.

    Science.gov (United States)

    Chen, Jian Sheng; Cameron, Ian D; Simpson, Judy M; Seibel, Markus J; March, Lyn M; Cumming, Robert G; Lord, Stephen R; Sambrook, Philip N

    2011-02-01

    This study aims to investigate the risk of subsequent fractures after low-trauma fracture in frail older people. A total of 1412 elderly residents (mean age 86.2 years, SD 7.0 years, female 77%) were recruited from aged care facilities in Australia. Residents were assessed and then followed for any fracture for 2 years and hip fractures for at least 5 years. Residents with and without a newly acquired fracture in the first 2 years were compared for risk of subsequent hip fracture. Residents with a nonhip fracture in the first 2 years had an increased risk of subsequent hip fracture for about 2.5 years, whereas those with a hip fracture had a similar risk over the whole period compared with those with no fracture. During these 2.5 years, 60, 28, and 6 subsequent hip fractures occurred in the nonfracture group (n = 953), the nonhip fracture group (n = 194), and the hip fracture group (n = 101), respectively, resulting in the probability of subsequent hip fracture of 8.0%, 19.9%, and 10.4%, respectively. Compared with the nonfracture group, the hazard ratio (HR) was 2.82 [95% confidence interval (CI) 1.73-4.59; p < .001] for the nonhip fracture group and 1.48 (95% CI 0.63-3.49, p = .37) for the hip fracture group after adjusting for age, sex, residence type, calcaneal broadband ultrasound attenuation, fracture history, weight, lower leg length, immobility, cognitive function, and medications. Frail institutionalized older people with newly acquired fractures are at increased risk of subsequent hip fracture for the next few years. Accordingly, despite their advanced age, they are a high-priority target group to investigate interventions that might reduce the risk of hip fracture.

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

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig

    2005-01-01

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

  10. BILATERAL ASYMMETRIC TRAUMATIC HIP DISLOCATION IN AN ADULT - A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Venkateswarlu

    2015-11-01

    Full Text Available Bilateral asymmetric traumatic hip dislocation without an associated fracture of the pelvis or femur occurring in an young adult with no previous history of hip abnormality or ligamentous laxity is a rarity. There were only 58 such cases reported in literature till date. Here is a 28 year old male patient presented to our Department of Orthopaedics and Traumatology, Rangaraya Medical College, Kakinada, Andhrapradesh, India with a history of fall from mango tree with bilateral asymmetric traumatic hip dislocation. The mode if injury is fall from a height. The dislocations were promptly reduced by closed method. Serial follow-up revealed no complications.

  11. Leveraging gait dynamics to improve efficiency and performance of powered hip exoskeletons.

    Science.gov (United States)

    Ryder, Matthew C; Sup, Frank

    2013-06-01

    This paper presents a new mechanical design for efficient exoskeleton actuation to power the sagittal plane motion in the human hip. The device uses a DC motor to drive a Scotch-Yoke mechanism and series elasticity to take advantage of the cyclic nature of human gait and to reduce power and control requirements of the exoskeleton. The mechanism creates a transmission that varies between 4:1 and infinity and does not require the motor to reverse direction when the hip joint reverses direction. This paper provides a detailed analysis of how the dynamic nature of human walking can be leveraged with this hip exoskeleton design.

  12. Do Twin Boundaries Always Strengthen Metal Nanowires?

    Science.gov (United States)

    Zhang, Yongfeng; Huang, Hanchen

    2009-01-01

    It has been widely reported that twin boundaries strengthen nanowires regardless of their morphology-that is, the strength of nanowires goes up as twin spacing goes down. This article shows that twin boundaries do not always strengthen nanowires. Using classical molecular dynamics simulations, the authors show that whether twin boundaries strengthen nanowires depends on the necessary stress for dislocation nucleation, which in turn depends on surface morphologies. When nanowires are circular cylindrical, the necessary stress of dislocation nucleation is high and the presence of twin boundaries lowers this stress; twin boundaries soften nanowires. In contrast, when nanowires are square cylindrical, the necessary stress of dislocation nucleation is low, and a higher stress is required for dislocations to penetrate twin boundaries; they strengthen nanowires.

  13. Do Twin Boundaries Always Strengthen Metal Nanowires?

    Directory of Open Access Journals (Sweden)

    Zhang Yongfeng

    2008-01-01

    Full Text Available Abstract It has been widely reported that twin boundaries strengthen nanowires regardless of their morphology—that is, the strength of nanowires goes up as twin spacing goes down. This article shows that twin boundaries do not always strengthen nanowires. Using classical molecular dynamics simulations, the authors show that whether twin boundaries strengthen nanowires depends on the necessary stress for dislocation nucleation, which in turn depends on surface morphologies. When nanowires are circular cylindrical, the necessary stress of dislocation nucleation is high and the presence of twin boundaries lowers this stress; twin boundaries soften nanowires. In contrast, when nanowires are square cylindrical, the necessary stress of dislocation nucleation is low, and a higher stress is required for dislocations to penetrate twin boundaries; they strengthen nanowires.

  14. Strengthening entrepreneurship through coaching and developing competencies

    NARCIS (Netherlands)

    Beldman, A.C.G.

    2011-01-01

    Strengthening entrepreneurship is an important strategy for stimulating the transition to sustainable agriculture. But how is that done? One example is the Interactive Strategic Management method, which supports entrepreneurs in the creation and execution of future-focused strategies.

  15. Numerical Modelling Of The Strengthening Process Of Steel-Concrete Composite Beams

    Directory of Open Access Journals (Sweden)

    Szewczyk Piotr

    2015-12-01

    Full Text Available This paper presents the numerical modelling of strengthening a steel-concrete composite beam. The main assumption is that the strengthening is not the effect of the state of a failure of a structure, but it resulted from the need to increase the load-bearing capacity and stiffness of the structure (for example: due to a change in the use of the object. The expected solution is strengthening without the necessity to completely unload the structures (to reduce the scope of works, the cost of modernization and to shorten the time. The problem is presented on the example of a composite beam which was strengthened through welding a steel plate to the lower flange of the steel beam. The paper describes how energy parameters are used to evaluate the efficiency of structures’ strengthening and proposes an appropriate solution.

  16. [Retrospective analysis on total hip arthroplasty for the treatment of developmental dysplasia of the hip in 29 adults].

    Science.gov (United States)

    Cao, Yin-Sheng; Lu, Min; Yao, Gong-He; Li, Wei-Ning; Zhu, Fu-Ping; Zhang, Bo

    2013-11-01

    To study the results of the total hip arthroplasty (THA) in the treatment of developmental dysplasia of the hip (DDH) with severe osteoarthritis in adults. From March 2004 to February 2011, 29 patients (32 hips) with DDH were treated by THA with an cementless cup. There were 11 males and 18 females,with an average age of 52.6 years (ranging from 37 to 73 years). Unilateral DDH occurred in 26 patients and bilateral DDH occurred in 3 patients. Based on the Crowe classification, there were 18 hips in 17 patients of type I ,7 hips in 6 patients of type II, 4 hips in 3 patients of type III, 3 hips in 3 patients of type IV. Except for 3 patients with bilateral DDH, the other patients' ill lower limbs were 1 to 6 cm shorter than the healthy lower ones. All the patients were followed up,and the duration ranged from 8 months to 5.3 years(averaged 3.7 years) without infection, dislocation, and sciatic nerves injury after the operation. One patient with proximal femoral fracture, intraoperation used wire binding, after 4 years of follow-up, fracture healed without evidence of prosthesis loosening. All grafts and subtrochanteric osteotomy healing were achieved. In 21 patients, the pain was completely relieved and the function of the hip joints was good. Five patients still had mild limping, but reduced significantly than preoperation. In 3 patients, the ill lower limbs were more than 1 cm shorter than the healthy lower ones and the other patients' ill lower limbs were less than 1 cm shorter than the healthy lower ones. Two patients' lower limbs were lengthened 4 to 5 cm. The Harris scores were 43.6 +/- 7.1 preoperatively and 86.7 +/- 5.3 postoperatively (P < 0.05). THA with deepening the medial wall of the acetabulum at the true acetabulum, according to different characteristics of Crowe classification, using different operation program, cementless cup in adult could obtain favorable results.

  17. Risk Factors for Hip Fracture in Older Home Care Clients

    Science.gov (United States)

    Poss, Jeff; Cook, Richard J.; Byrne, Kerry; Hirdes, John P.

    2009-01-01

    Background Little information is available on hip fracture risks among community-dwelling persons receiving home care. Our aim was to identify risk factors for hip fracture from health information routinely collected for older home care clients. Methods This was a cohort study involving secondary analysis of data on 40,279 long-stay (>60 days) home care clients aged 65 and older in Ontario, Canada; occurrence of hip fracture as well as potential risk factor information were measured using the Resident Assessment Instrument (RAI)/Minimum Data Set–Home Care assessment instrument. Results In all, 1,003 clients (2.5%) had hip fracture on follow-up assessment. Older (85+ vs 65–74, relative risk [95% confidence interval]: 0.52 [0.43–0.64]) clients are at increased risk; males are at reduced risk [0.60 (0.51–0.70)]. Other risk factors include osteoporosis (1.19 [1.03–1.36]), falls (1.31 [1.15–1.49]), unsteady gait (1.18 [1.03–1.36]), use of ambulation aide (1.39 [1.21–1.59]), tobacco use (1.42, [1.13–1.80]), severe malnutrition (2.61 [1.67–4.08]), and cognitive impairment (1.30 [1.12–1.51]). Arthritis (0.86 [0.76–0.98]) and morbid obesity (0.34 [0.16–0.72]) were associated with reduced risk. Males and females demonstrated different risk profiles. Conclusions Important risk factors for hip fracture can be identified from routinely collected data; these could be used to identify at-risk clients for further investigation and prevention strategies [22]. PMID:19196903

  18. Genetic evaluation of the total hip score of four populous breeds of dog, as recorded by the New Zealand Veterinary Association Hip Dysplasia Scheme (1991-2011).

    Science.gov (United States)

    Soo, M; Sneddon, N W; Lopez-Villalobos, N; Worth, A J

    2015-03-01

    To use estimated breeding value (EBV) analysis to investigate the genetic trend of the total hip score (to assess canine hip dysplasia) in four populous breeds of dogs using the records from the New Zealand Veterinary Association (NZVA) Canine Hip Dysplasia Scheme database (1991 to 2011). Estimates of heritability and EBV for the NZVA total hip score of individual dogs from the German Shepherd, Labrador Retriever, Golden Retriever and Rottweiler breeds were obtained using restricted maximum likelihood procedures with a within-breed linear animal model. The model included the fixed effects of gender, birth year, birth season, age at scoring and the random effect of animal. The pedigree file included animals recorded between 1990 and 2011. A total of 2,983 NZVA hip score records, from a pedigree of 3,172 animals, were available for genetic evaluation. Genetic trends of the NZVA total hip score were calculated as the regression coefficient of the EBV (weighted by reliabilities) on year of birth. The estimates of heritability for hip score were 0.32 (SE 0.08) in German Shepherd, 0.37 (SE 0.08) in Labrador Retriever, 0.29 (SE 0.08) in Golden Retriever and 0.52 (SE 0.18) in Rottweiler breeds. Genetic trend analysis revealed that only the German Shepherd breed exhibited a genetic trend towards better hip conformation over time, with a decline of 0.13 (SE 0.04) NZVA total hip score units per year (phip score for the remaining three breeds were not significantly different from zero (p>0.1). Despite moderate heritability of the NZVA total hip score, there has not been substantial improvement of this trait for the four breeds analysed in the study period. Greater improvement in reducing the prevalence of canine hip dysplasia may be possible if screening were to be compulsory as a requirement for registration of pedigree breeding stock, greater selection pressure were to be applied and selection of breeding stock made on the basis on an individual's EBV rather than the NZVA

  19. Association between timing of zoledronic acid infusion and hip fracture healing

    DEFF Research Database (Denmark)

    Colón-Emeric, C; Nordsletten, L; Olson, S

    2010-01-01

    Patients in the Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly (HORIZON) Recurrent Fracture Trial were assessed for evidence of delayed hip fracture healing. No association was observed between zoledronic acid (ZOL) and delayed healing. We conclude that ZOL has no clinically...... evident effect on fracture healing, even when the drug is infused in the immediate postoperative period. INTRODUCTION: Intravenous zoledronic acid 5 mg (ZOL) given after a hip fracture reduces secondary fracture rates and mortality. It has been postulated that bisphosphonates may affect healing if given...... soon after a fracture. We sought to determine whether the timing of ZOL infusion affected the risk of delayed hip fracture healing. METHODS: In the HORIZON Recurrent Fracture Trial, patients were randomized within 90 days of a low-trauma hip fracture to receive either once-yearly ZOL (n¿=¿1...

  20. Symptoms of Nerve Dysfunction After Hip Arthroscopy

    DEFF Research Database (Denmark)

    Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto

    2014-01-01

    PURPOSE: The primary purpose of this study was to analyze the rate, pattern, and severity of symptoms of nerve dysfunction after hip arthroscopy (HA) by reviewing prospectively collected data. The secondary purpose was to study whether symptoms of nerve dysfunction were related to traction time...... year after HA concerning symptoms of nerve dysfunction, possible localization, and erectile dysfunction. Fifty patients participated and returned fully completed questionnaires. Patients reporting symptoms of nerve dysfunction 1 year after HA were re-examined. RESULTS: Twenty-three of 50 patients (46......%) reported symptoms of nerve dysfunction during the first week after HA; this was reduced to 14 patients (28%) after 6 weeks, 11 patients (22%) after 26 weeks, and 9 patients (18%) after 1 year. One patient experienced temporary erectile dysfunction. No difference in traction time between patients...

  1. Safety Issue of Hip Resurfacing

    Directory of Open Access Journals (Sweden)

    Timothy McTighe

    2015-10-01

    Full Text Available Hip Resurfacing (HR development of the 1970s was an attempt to address the failures of conventional cemented stems. Those early HR designs failed because problems with maintaining bone under the resurfaced femoral head, and loosening of the socket with substantial acetabular bone loss. However technology, knowledge and surgical techniques have evolved over the past 45 years. The more recent designs like the Birmingham Hip Resurfacing (BHR focused on metal to metal bearing surfaces. These devices are under attack and maybe they should be. However, lets not ignore the significant amount of information and potential improvements in both design technology and surgical techniques that have come about over the past few years.

  2. 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.

  3. Erythrocyte Antioxidant Protection of Rose Hips (Rosa spp.

    Directory of Open Access Journals (Sweden)

    C. Widén

    2012-01-01

    Full Text Available Rose hips are popular in health promoting products as the fruits contain high content of bioactive compounds. The aim of this study was to investigate whether health benefits are attributable to ascorbic acid, phenols, or other rose-hip-derived compounds. Freeze-dried powder of rose hips was preextracted with metaphosphoric acid and the sample was then sequentially eluted on a C18 column. The degree of amelioration of oxidative damage was determined in an erythrocyte in vitro bioassay by comparing the effects of a reducing agent on erythrocytes alone or on erythrocytes pretreated with berry extracts. The maximum protection against oxidative stress, 59.4±4.0% (mean ± standard deviation, was achieved when incubating the cells with the first eluted meta-phosphoric extract. Removal of ascorbic acid from this extract increased the protection against oxidative stress to 67.9±1.9%. The protection from the 20% and 100% methanol extracts was 20.8±8.2% and 5.0±3.2%, respectively. Antioxidant uptake was confirmed by measurement of catechin by HPLC-ESI-MS in the 20% methanol extract. The fact that all sequentially eluted extracts studied contributed to protective effects on the erythrocytes indicates that rose hips contain a promising level of clinically relevant antioxidant protection.

  4. Total bilateral hip arthroplasty in one surgical procedure

    Directory of Open Access Journals (Sweden)

    Popović Zoran

    2007-01-01

    Full Text Available Background/Aim. Primary coxarthrosis occurs often in older population. There is possibility of implanting both endoprothesis simultaneously in bilateral coxarthrosis which decreases hospitalization and reduces the expenses and possibility of complication that can occur during general anesthesia. The most serious indications for bilateral total hip arthroplasty in one procedure are younger patients with serious bilateral osteoarthrosis of the hips, without added diseases. Absolute contraindication is found in patients with persistent ductus arteriosus and septal defect. The aim of this study was to point out the possibility and advantages of a single-staged bilateral hip arthroplasty and introducing it in our orthopedic practice. Methods. The procedure was accomplished in 19 patients. The standard total hip arthroplasty surgical technique was performed, followed by the usual antibiotic and anticoagulant therapy. Results. Only one complication - acetabular part instability we recorded, followed by luxation that was surgically managed. Conclusion. This procedure can be performed routinely in selected population and should be reserved for major medical centers capable to provide adequate postoperative care.

  5. Bosworth hip shelf arthroplasty in adult dysplastic hips: ten to twenty three year results.

    Science.gov (United States)

    Bartoníček, Jan; Vávra, Jaroslav; Chochola, Antonín

    2012-12-01

    Hip shelf arthroplasty is currently considered to be a salvage procedure. The aim of the study is to present outcomes of Bosworth hip shelf arthroplasty in adolescent dysplastic hips with a minimum ten-year follow-up. The basic group comprised 25 hips in 18 patients with the mean age of 31 years (range, 16-52) at the time of operation. Subgroup A included 20 hips that were evaluated prior to operation as spherical, centric hips without osteoarthritic changes (acetabular dysplasia). The heterogeneous subgroup B comprised five hips. Of these, three hips were evaluated as aspheric, without osteoarthritic changes, and two hips as aspheric, with osteoarthritic changes of grade 2 according to Tönnis. In addition, two hips in subgroup B were evaluated as decentred (subluxated), one hip without and one hip with osteoarthritic changes. The mean follow-up was 15 years (range, ten-23). In subgroup A, the positive effect of operation had lasted at the time of the final follow-up for ten to 22 years postoperatively (average follow-up 14 years) in 19 hips. Only one female patient, 46 years old at the time of operation, developed hip osteoarthritis within ten years, that was treated by THA. In subgroup B, a lasting positive effect of operation was recorded in two cases at the time of the final follow-up (12 and 15 years). The third female patient with an aspheric and decentred hip developed severe hip osteoarthritis 21 years after shelf procedure that was treated by THA. In two patients who had hip osteoarthritis already before the operation, the positive effect of the shelf procedure survived over 13 and 20 years. Although hip osteoarthritis progressed, THA was performed as late as 15 and 23 years after the shelf procedure. The mean Harris hip score in 21 hips with a still functional hip shelf was 68 (range, 56-82) before and 90 (range, 76-100) after the surgery. The best outcomes of Bosworth hip shelf arthroplasty may be expected in a dysplastic spherical centred hip

  6. Strengthening of Unreinforced Masonry Walls with Composite Materials

    Directory of Open Access Journals (Sweden)

    Ioana-Sorina Enţuc

    2004-01-01

    Full Text Available Unreinforced masonry (URM is considered one of the oldest construction materials being until the end of XIXth century, the basic material for: foundations, walls, columns, volts, staircases, floor joints, roofs, retaining walls, drainage channels, barrages, etc. Construction with URM elements posses a series of advantages such as: fire resistance, thermal an acoustic insulations between interior and outside spaces, humidity resistance. However the URM elements have some significant inconveniences such as: large self weight (heaviness causes cracks in the other elements of structures, reduced mechanical strengths in comparison with other traditional materials (steel and concrete, low tenacity, great manual labor consumptions, and vulnerability to earthquakes. Various factors cause deteriorations which must be overcome by strengthening solutions. Some strengthening solutions based on fiber reinforced polymers (FRP products applied directly on URM brick walls are presented in the paper.

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

    DEFF Research Database (Denmark)

    Rosenlund, Signe; Broeng, Leif; Jensen, Carsten

    2014-01-01

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

  8. Total hip replacement in dancers.

    Science.gov (United States)

    Buyls, Inge R A E; Rietveld, A B M Boni; Ourila, Tiia; Emerton, Mark E; Bird, H A

    2013-04-01

    A case report of a professional contemporary dancer who successfully returned to the stage after bilateral total hip replacements (THR) for osteoarthritis is presented, together with her own commentary and a retrospective cohort study of total hip replacements in dancers. In the presented cohort, there were no post-operative dislocations or infections, the original pain had been relieved, rehabilitation was objectively normal and all resumed their dance (teaching) activities. Nevertheless, they were disappointed about the prolonged rehabilitation. Due to their high demands as professional dancers, post-operative expectations were too optimistic in view of the usual quick and favourable results of THR in the older and less physically active, general population. In all dancers with unilateral osteoarthritis, the left hip was involved, which may reflect the tendency to use the left leg as standing leg and be suggestive that strenuous physical activity may lead to osteoarthritis. Better rehabilitation guidelines are needed for dancer patients undergoing THR, especially drawing their attention to realistic post-operative expectations.

  9. The use of electromyogram biofeedback to reduce Trendelenburg gait.

    Science.gov (United States)

    Petrofsky, J S

    2001-09-01

    Ten subjects suffering from incomplete spinal cord injuries, clinically diagnosed as walking with Trendelenburg gait, underwent a 2 month therapy program to strengthen their muscles and reduce their gait abnormalities. Therapy involved muscle strengthening and gait training for 2 h a day, 5 days a week in a clinic. Biofeedback was also accomplished for 30 min each training day on all subjects. In addition, five of the subjects wore a two-channel electromyogram (EMG) biofeedback training device at home to see if neuromuscular re-education outside of the clinical setting could speed their recovery. The difference for these five subjects was that they would have continuous biofeedback therapy every time they walked and not biofeedback limited to only 30 min a day. Since weakness of the gluteus medius muscles is the prime contributor to Trendelenburg gait, the device provided warning tones giving feedback of improper gait through bilateral assessment of the use of the gluteus medius muscles. If too little gluteus medius activity was seen on the affected side or the step was too short in duration, the microprocessor provided an audio cue to the subjects alerting them to correct the deficit. Subjects only undergoing clinical therapy showed about a 50% reduction in hip drop due to therapy. However, the group that used the home training device showed almost normal gait after the 2 month period.

  10. 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.

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

    Institute of Scientific and Technical Information of China (English)

    DAI Min; NIE Tao

    2010-01-01

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

  12. Feasibility of Early-Initiated Progressive Resistance Training after Total Hip Replacement

    DEFF Research Database (Denmark)

    Mikkelsen, Lone Ramer; Mechlenburg, Inger; Petersen, Annemette Krintel

    Background: Muscle atrophy, reduced hip muscle strength and function are documented within the first weeks after Total Hip Replacement (THR). Purpose / Aim of Study: The purpose of this study was to evaluate the feasibility of early-initiated progressive resistance training (PRT) after THR...... extension, mean (sd): 28.9 (8.5), 36.3 (7.5), 39.4 (8.4), kg, p=0.02. Hip flexion, mean (sd): 32.4 (9.7), 43.8 (11.5), 53.6 (12.9), kg, p=0.001. Isometric strength in Nm/kg: Preoperative, 4 weeks postoperative, p- value (diff): Hip abduction, mean (sd): 0.86 (0.28), 0.85 (0.16) Nm/kg, p=0.94. Hip flexion......, mean (sd): 0.98 (0.26), 1.03 (0.29) Nm/kg, p=0.52. Conclusions: It seems feasible to commence PRT within the first week after THR, as hip pain remained the same or decreased, while the training load increased progressively. The included patients reached their preoperative hip-strength levels after 4...

  13. Effect of CFRP strengthening on the response of RC slabs to hard projectile impact

    Energy Technology Data Exchange (ETDEWEB)

    Almusallam, Tarek; Al-Salloum, Yousef; Alsayed, Saleh; Iqbal, Rizwan; Abbas, Husain, E-mail: abbas_husain@hotmail.com

    2015-05-15

    Highlights: • Studied response of CFRP-strengthened RC slabs under the impact load. • Slabs were tested under the strike of hemispherical steel projectiles at varying impact. • The slabs were analyzed numerically using LS-DYNA. • Strengthening increased the ballistic limit velocity by 18% and perforation energy by 56.7%. • CFRP sheet reduced the crater damage and contained the flying concrete fragments. - Abstract: In this paper impact response of CFRP-strengthened RC panels under the impact of non-deformable projectiles has been presented. The control and CFRP-strengthened RC slab panels were tested under the strike of hemispherical nosed steel projectiles at varying impact velocities. The response of these panels was investigated experimentally as well as numerically. The damage of the slab panels was measured in terms of the penetration depth, formation of cracks, spalling and scabbing areas and fracture of CFRP sheet. This study presents a practical and efficient numerical method for analyzing the impact response of CFRP-strengthened RC structures using LS-DYNA. The CFRP strengthening was found to increase the ballistic limit velocity by 18%, perforation energy of RC slabs by 56.7%, reduce the front crater damage and contains the flying of concrete fragments from the rear face. The maximum impact force occurs at almost same penetration depth for the control and CFRP-strengthened slabs but the restraint provided by CFRP increased the penetration depth by about 1/19.3 of the thickness of slab.

  14. Preoperative Patient Education for Hip and Knee Arthroplasty: Financial Benefit?

    Science.gov (United States)

    Tait, Mark A; Dredge, Carter; Barnes, C Lowry

    2015-01-01

    Of 904 patients who underwent primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) at the same hospital, 802 participated in a preoperative education day called "Joint Academy" (JA). The length of stay of JA participants was 2.12 days (49.5%) less than patients who did not attend a JA (p education program may significantly reduce overall costs for primary TKA and THA procedures.

  15. Wear debris in cemented total hip arthroplasty.

    Science.gov (United States)

    Huo, M H; Salvati, E A; Buly, R L

    1991-03-01

    One of the most prevalent clinical problems in long-term follow up of total hip arthroplasty patients is loosening of prosthetic fixation. Factors contributing to mechanical failure of total hip reconstruction are complex and multiple. It has become increasingly apparent that wear debris from the prosthetic components may contribute significantly to this process. The authors summarize some of the current concepts concerning the detrimental effects of metallic debris in total hip arthroplasty.

  16. [Treatment of infected total hip endoprostheses].

    Science.gov (United States)

    Zilkens, K W; Forst, R; Casser, H R

    1989-07-01

    In total hip arthroplasty the most serious complication besides aseptic loosening is infection. The results observed in 42 cases of infected hip arthroplasties are presented. In contrast to early superficial infection, deep infection following total hip replacement is difficult to treat. Depending on the general condition of the patient, a well-defined, adequate treatment is required. In patients at vital risk the provocation of a permanent fistula can be recommended as an alternative method in preference to revision arthroplasty.

  17. Hip and Spine in Cerebral Palsy

    OpenAIRE

    Persson-Bunke, Måns

    2015-01-01

    Abstract Background: Children with cerebral palsy (CP) have an increased risk of scoliosis, contractures including windswept hip deformity (WS), and hip dislocation. In 1994, a follow-up program and registry for children and adolescents with CP (CPUP) was initiated in Sweden to allow the early detection and prevention of hip dislocations and other musculoskeletal deformities. Purpose: To analyze the prevalence of scoliosis and WS in children with CP and to study the effect of CPUP. To e...

  18. Pelvic Incidence in Patients with Hip Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Ibrahim Raphael

    2016-04-01

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

  19. HIP RESURFACING - FIRST IMPRESSIONS AND NEW OPPORTUNITIES

    Directory of Open Access Journals (Sweden)

    G. V. Kuropatkin

    2010-01-01

    Full Text Available Midi-time follow-up results of hip resurfacing were retrospectively analyzed. 117 operations in 109 patients with average age 36,2 years were performed. From one to four years follow-up results showed good clinical and functional result with proximal hip bone stock preservation. In spite of technical difficulties of resurfacing, complication level was not more, than in standard total hip arthroplasty. This surgical procedure may be recommends for young, active patients.

  20. Secondary capsular laxity of the hip.

    Science.gov (United States)

    Blakey, Caroline M; Field, Michael H; Singh, Parminder J; Tayar, Rene; Field, Richard E

    2010-01-01

    We describe a hip condition with a recognisable pattern of clinical signs and radiological findings thought to result from chronic capsular injury. Between June 2006 and October 2009, ten patients (11 hips), four men and six women, were identified with an abnormality of external rotation at the hip joint. A detailed history and clinical examination was undertaken for each patient. Dynamic magnetic resonance imaging of symptomatic and control hips were evaluated for bony and soft tissue appearances. The relative positions of the femoral head and the acetabulum were assessed through a range of hip rotation. In affected hips, a loss of normal log roll recoil was observed. Three distortions of the iliofemoral ligament were identified on axial MR images; thinning at the lateral insertion of the ligament, attenuation of the iliofemoral ligament most noticeably on maximum external rotation (60º) and the appearance of laxity despite full external rotation. Stability of the hip is dependent on the interaction of bony and soft tissue structures. Hip instability is recognised in dysplasia and is known to lead to premature degeneration of the joint. Chronic capsular injury may destabilise previously asymptomatic hips with subsequent development of pain in young, active patients.

  1. Life Estimation of Hip Joint Prosthesis

    Science.gov (United States)

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

    2014-11-01

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

  2. COMPLEX FUNCTIONAL ASSESSMENT OF THE HIP JOINT.

    Directory of Open Access Journals (Sweden)

    Maya S. Krastanova

    2015-09-01

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

  3. Management of hip involvement in ankylosing spondylitis.

    Science.gov (United States)

    Guan, Mingqiang; Wang, Jian; Zhao, Liang; Xiao, Jun; Li, Zhihan; Shi, Zhanjun

    2013-08-01

    Ankylosing spondylitis (AS) is an inflammatory rheumatologic disease characterized by inflammation and progressive structural damage of the affected joints. Hip involvement often results in severe deformities and significant impairment on function. Although, tremendous progress has been made in conservative management for AS, effective prevention strategies for hip involvement and long-term need for total hip arthroplasty (THA) remain indefinite. When hip involvement has progressed to intractable pain and disability, THA is still the most effective treatment strategy to relieve pain and restore function. However, certain AS-specific problems regarding "preoperative preparation," "intraoperative difficulties," "perioperative pharmacological management," "postoperative physiotherapy," "operation benefits," and "operation complications" need more concern and further discussion.

  4. RECENT DEVELOPMENTS IN FRP STRENGTHENING TECHNIQUES

    Institute of Scientific and Technical Information of China (English)

    Zhishen WU(吴智深); Hedong Niu

    2004-01-01

    This paper mainly gives a State-of-the-Art report of recent development in FRP strengthening techniques for structural rehabilitation by starting with a brief review on some achievements in clarifying bonding/debonding mechanisms and developing evaluation/design methodology for predicting debonding failure caused by intermedioate flexural cracks of con crete.Due to some drawbacks of current FRP bonding technique,two effective FRP strengthening methods,i.e.FRP prestressing and hybrid strengthening techniques,are investigated in detail to make full advantage of FRP composite materials.Combining with the newly develiped PBO fiber sheets,a more effective prestressing method is established as compared with carbon fiber sheets,a more effective prestressing method is established as compared with carbon fiber sheets,where several anchorage treatments are also established to prevent anchorage bond failure due to high shear stress concentration after release of prestressed FRP ends.In addition,the fatigue performance of RC beams externally strenghened with prestressed PBO fiber sheets is experimentally studied.For the developments of hybrid composites and their strengthening methods,both experimental and analytical studies are performed to clarify the hybrid strengthening behavior in structures.

  5. Smart Textiles for Strengthening of Structures

    Science.gov (United States)

    Górski, Marcin; Krzywoń, Rafał; Dawczyński, Szymon; Szojda, Leszek; Salvado, Rita; Lopes, Catarina; Araujo, Pedro; Velez, Fernando Jose; Castro-Gomes, Joao

    2016-11-01

    This paper presents results of mechanical tests on a prototype of an innovative structural strengthening in form of self-monitoring fabric. Smart textile employs carbon fibers conductivity for measuring strains while monitoring changes of electric resistance under increasing load. A general solution was tested in a series of calibrating tests on strengthening of small size concrete slabs. Promising results of simple specimen, has encouraged the research team to perform the next tests using mastered carbon fibre reinforced fabric. Main tests were performed on natural scale RC beam. Smart textile proved its efficiency in both: strengthening and monitoring of strains during load increase. New strengthening proposal was given 10% increase of loading capacity and the readings of strain changes were similar to those obtained in classical methods. In order to calibrate the prototype and to define range limits of solution usability, textile sensor was tested in areas of large deformations (timber beam) and aswell as very small strains (bridge bearing block). In both cases, the prototype demonstrated excellent performance in the range of importance for structural engineering. This paper also presents an example of use of the smart strengthening in situ, in a real life conditions.

  6. Telerehabilitation Versus Traditional Care Following Total Hip Replacement: A Randomized Controlled Trial Protocol

    Science.gov (United States)

    Bourke, Michael; Crossley, Kay; Russell, Trevor

    2017-01-01

    Background Total hip replacement (THR) is the gold standard treatment for severe hip osteoarthritis. Effectiveness of physical rehabilitation for THR patients following discharge from hospital is supported by evidence; however, barriers such as geographical location and transport can limit access to appropriate health care. One solution to this issue is using an alternative model of care using telerehabilitation technology to deliver rehabilitation programs directly into patients’ homes. A telerehabilitation model may also have potential health care cost savings for health care providers. Objective This study aims to determine if a telerehabilitation model of care delivered remotely is as effective as face-to-face rehabilitation in the THR population and cost effective for health care providers and patients. Methods A total of 70 people undergoing THR will be recruited to participate in a randomized, single-blind, controlled noninferiority clinical trial. The trial will compare a technology-based THR rehabilitation program to in-person care. On discharge from hospital, participants randomized to the in-person group will receive usual care, defined as a paper home exercise program (HEP) targeting strengthening exercises for quadriceps, hip abductors, extensors, and flexors; they will be advised to perform their HEP 3 times per day. At 2, 4, and 6 weeks postoperatively, they will receive a 30-minute in-person physiotherapy session with a focus on gait retraining and reviewing and progressing their HEP. The telerehabilitation protocol will involve a program similar in content to the in-person rehabilitation program, except delivery will be directly into the homes of the participants via telerehabilitation technology on an iPad. Outcomes will be evaluated preoperatively, day of discharge from in-patient physiotherapy, 6 weeks and 6 months postoperatively. The primary outcome will be the quality of life subscale of the hip disability and osteoarthritis outcome score

  7. Effect of an eccentrically biased hamstring strengthening home program on knee flexor strength and the length-tension relationship.

    Science.gov (United States)

    Orishimo, Karl F; McHugh, Malachy P

    2015-03-01

    The purposes of this study were to document relative activation intensities of the hamstrings and gluteus maximus during 4 eccentric hamstring strengthening exercises and to assess the effects of a short-term strengthening program comprised of these exercises on knee flexor strength and the length-tension relationship. Twelve healthy subjects participated in this study. Electromyographic (EMG) activities from the biceps femoris, semitendinosus, and gluteus maximus were recorded as subjects performed (a) standing hip extension with elastic resistance, (b) trunk flexion in single limb stance (diver), (c) standing split (glider), and (d) supine sliding bridge (slider). Baseline isometric knee flexor strength was measured at 90, 70, 50, and 30° of flexion at the knee with the subject seated and the hip flexed to 50° from horizontal. After completing the 4-week training program, strength tests were repeated. Repeated-measures analysis of variance were used to compare EMG activity between muscles and to assess angle-specific strength improvements. Hamstring activity exceeded gluteus maximus activity for resisted hip extension, glider, and slider exercises (p Knee flexor strength improved by 9.0% (p = 0.005) but was not angle specific (training by angle p = 0.874). The short-term home training program effectively targeted the hamstrings and resulted in strength gains that were similar at short and long muscle lengths. These data demonstrate that hamstring strength can be improved using eccentrically biased unilateral exercises without the use of weights or other equipments.

  8. 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...

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

    NARCIS (Netherlands)

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

    2004-01-01

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

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

    DEFF Research Database (Denmark)

    Lauritzen, J B

    1997-01-01

    on the hip. Women with hip fractures have a lower body weight compared with controls, and they may also have less soft tissue covering the hip even when adjusted for body mass index, indicating a more android body habitus. Experimental studies show that the passive energy absorption in soft tissue covering...

  11. Arthroplasty in patients with congenital hip dysplasia--early evaluation of a treatment method.

    Science.gov (United States)

    Bożek, Marek; Bielecki, Tomasz; Nowak, Roman; Żelawski, Maciej

    2013-01-01

    Developmental hip dysplasia (DHD) is the most common cause of secondary hip osteoarthritis (OA). It often leads to OA in young, active and working adults. The aim of our study is to evaluate the results of THA in patients with DHD. Total hip arthroplasty was performed in 15 patients with DHD - 13 women (average age - 39) and 2 men (average age - 44) between June 2010 to June 2011. Patient's hips were estimated by Crowe classification to evaluate the severity of degenerative arthritis. Patients we reassessed with Harris Hip Score before and after the surgery. The mean preoperative score was 44.6 points, directly after surgery 62.4 pts., 6 months after 78.6 points. After artrhroplasty, improvement was noted in walking stairs without railing, walking without support, sitting on chair for more than 1 hour. Before the surgery average difference in limbs" length was 4 cm After the treatment it was reduced to 0.5 cm. Mean hip flexion was 40 ° before, 90 ° after the surgery, mean abduction was respectively 0° and 25°. Our study proves that total hip arthroplasty in patients with developmental dysplasia of hip helps to improve stability and mobility of joint and to reduce the pain. 1. In the type 1 and 2 according to Crow's classification, good clinical results may be achieved using standard prosthesis stem sizes and press-fit acebutalar component with possibly the smallest diameter providing stable placing. 2. In the case of ty pe III good results are observed using acetabular press-fit method for fixing, after reconstruction of bone defects with osteogenous bone graft. 3. The usage of big head dimensions gives beneficial effects on the osseointegration of the acetabular component and reduces the risk of dislocation. 4. A short follow-up period of the group of patients presented requires further prospective study to evaluate the long-term results.

  12. Incidence and direct hospitalisation costs of hip fractures in Vilnius, capital of Lithuania, in 2010

    Directory of Open Access Journals (Sweden)

    Tamulaitiene Marija

    2012-07-01

    Full Text Available Abstract Background Few epidemiological data on hip fractures were previously available in Lithuania. The aim of this study was to estimate the incidence and hospital costs of hip fractures in Vilnius in 2010. Methods Data were collected from the medical charts of all patients admitted to hospitals in Vilnius (population, 548,835 due to new low-energy trauma hip fracture, during 2010. The estimated costs included ambulance transportation and continuous hospitalisation immediately after a fracture, which are covered by the Lithuanian healthcare system. Results The incidence of new low-energy trauma hip fractures was 252 (308 women and 160 men per 100,000 inhabitants of Vilnius aged 50-years or more. There was an exponential increase in the incidence with increasing age. The overall estimated cost of hip fractures in Vilnius was 1,114,292 EUR for the year 2010. The greatest part of the expenditure was accounted for by fractures in individuals aged 65-years and over. The mean cost per case was 2,526.74 EUR, and cost varied depending on the treatment type. Hip replacement did not affect the overall mean costs of hip fracture. The majority of costs were incurred for acute (53% and long-term care (35% hospital stays, while medical rehabilitation accounted for only 12% of the overall cost. The costs of hip fracture were somewhat lower than those found in other European countries. Conclusion The data on incidence and costs of hip fractures will help to assess the importance of interventions to reduce the number of fractures and associated costs.

  13. Metal-on-metal hip joint tribology.

    Science.gov (United States)

    Dowson, D; Jin, Z M

    2006-02-01

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

  14. 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.)

  15. 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.

  16. FRP strengthening of RC walls with openings

    DEFF Research Database (Denmark)

    Hansen, Christian Skodborg; Sas, Gabriel; Täljsten, Björn

    2009-01-01

    Strengthening reinforced concrete (RC) walls with openings using fibre reinforced polymers (FRP) has been experimentally proven to be a viable rehabilitation method. However, very few theoretical investigations are reported. In this paper two methods of analysis are presented. Since openings vary...... in size, the analysis of a strengthened wall can be divided into frame idealization method for large openings, and combined disk and frame analysis for smaller openings. The first method provides an easy to use tool in practical engineering, where the latter describes the principles of a ductile...

  17. New concept of critical infrastructure strengthening

    Energy Technology Data Exchange (ETDEWEB)

    Gazizov, Talgat R.; Orlov, Pavel E.; Zabolotsky, Alexander M.; Kuksenko, Sergey P. [Tomsk State University of Control Systems and Radioelectronics, 634050, Lenin Ave., Tomsk (Russian Federation)

    2016-06-08

    Strengthening of critical infrastructure is considered. Modal reservation of electronics is proposed as a new concept of the strengthening. The concept combines a widely used cold backup and a recently proposed modal filtration. It makes electronics reliable as well as protected against electromagnetic interference, especially the ultra-wide band pulses. New printed circuit board structure is suggested for implementation of the proposed concept. Results of simulation in time and frequency domains are presented for the suggested structures. Considerable attenuation of dangerous excitations shows that the new concept and structure are promising.

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

    Directory of Open Access Journals (Sweden)

    Rajesh Kumar Kanojia

    2013-01-01

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

  19. Martial arts fall training to prevent hip fractures in the elderly.

    Science.gov (United States)

    Groen, B E; Smulders, E; de Kam, D; Duysens, J; Weerdesteyn, V

    2010-02-01

    Hip fractures are a common and serious consequence of falls. Training of proper fall techniques may be useful to prevent hip fractures in the elderly. The results suggested that martial arts fall techniques may be trainable in older individuals. Better performance resulted in a reduced impact force. Hip fractures are a common and serious consequence of falls. Fall training may be useful to prevent hip fractures in the elderly. This pilot study determined whether older individuals could learn martial arts (MA) fall techniques and whether this resulted in a reduced hip impact force during a sideways fall. Six male and nineteen female healthy older individuals completed a five-session MA fall training. Before and after training, force and kinematic data were collected during volitional sideways falls from kneeling position. Two MA experts evaluated the fall performance. Fear of falling was measured with a visual analog scale (VAS). After fall training, fall performance from a kneeling position was improved by a mean increase of 1.6 on a ten-point scale (P < 0.001). Hip impact force was reduced by a mean of 8% (0.20 N/N, P = 0.016). Fear of falling was reduced by 0.88 on a VAS scale (P = 0.005). MA techniques may be trainable in older individuals, and a better performance may reduce the hip impact force in a volitional sideways fall from a kneeling position. The additional reduction of fear of falling might result in the prevention of falls and related injuries.

  20. Radiology of total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, H.J.; Lovelock, J.E.; McCollister Evarts, C.; Geyer, D.

    1984-06-01

    The radiology of total hip replacement (THR) and its complications is reviewed in conjunction with a long-term follow-up study on 402 patients with 501 prostheses. The indications, contraindications, biomechanics, and operative management of these patients is discussed. Clinical complications such as deep vein thrombosis, pulmonary embolism, and hemorrhage are mentioned. Postoperative infections including granulomatous pseudotumors, dislocations and fractures, true loosening of the prosthesis, and heterotopic bone formation (HBF) are discussed and illustrated. The importance of differentiating the lucent line from true loosening is stressed. Mechanical and other clinical complications which are largely ignored by radiologists are also discussed. The uses of arthrography and bone scanning are included.

  1. The lubrication performance of the ceramic-on-ceramic hip implant under starved conditions.

    Science.gov (United States)

    Meng, Qingen; Wang, Jing; Yang, Peiran; Jin, Zhongmin; Fisher, John

    2015-10-01

    Lubrication plays an important role in the clinical performance of the ceramic-on-ceramic (CoC) hip implant in terms of reducing wear and avoiding squeaking. All the previous lubrication analyses of CoC hip implants assumed that synovial fluid was sufficiently supplied to the contact area. The aim of this study was to investigate the lubrication performance of the CoC hip implant under starved conditions. A starved lubrication model was presented for the CoC hip implant. The model was solved using multi-grid techniques. Results showed that the fluid film thickness of the CoC hip implant was affected by fluid supply conditions: with the increase in the supplied fluid layer, the lubrication film thickness approached to that of the fully blooded solution; when the available fluid layer reduced to some level, the fluid film thickness considerably decreased with the supplying condition. The above finding provides new insights into the lubrication performance of hip implants.

  2. A multi-component cognitive behavioural intervention for the treatment of fear of falling after hip fracture (FIT-HIP): protocol of a randomised controlled trial.

    Science.gov (United States)

    Scheffers-Barnhoorn, Maaike N; van Haastregt, Jolanda C M; Schols, Jos M G A; Kempen, Gertrudis I J M; van Balen, Romke; Visschedijk, Jan H M; van den Hout, Wilbert B; Dumas, Eve M; Achterberg, Wilco P; van Eijk, Monica

    2017-03-20

    Hip fracture is a common injury in the geriatric population. Despite surgical repair and subsequent rehabilitation programmes, functional recovery is often limited, particularly in individuals with multi-morbidity. This leads to high care dependency and subsequent use of healthcare services. Fear of falling has a negative influence on recovery after hip fracture, due to avoidance of activity and subsequent restriction in mobility. Although fear of falling is highly prevalent after hip fracture, no structured treatment programme is currently available. This trial will evaluate whether targeted treatment of fear of falling in geriatric rehabilitation after hip fracture using a multi-component cognitive behavioural intervention (FIT-HIP), is feasible and (cost) effective in reducing fear of falling and associated activity restriction and thereby improves physical functioning. This multicentre cluster randomised controlled trial will be conducted among older patients with hip fracture and fear of falling who are admitted to a multidisciplinary inpatient geriatric rehabilitation programme in eleven post-acute geriatric rehabilitation units. Fifteen participants will be recruited from each site. Recruitment sites will be allocated by computer randomisation to either the control group, receiving usual care, or to the intervention group receiving the FIT-HIP intervention in addition to usual care. The FIT-HIP intervention is conducted by physiotherapists and will be embedded in usual care. It consists of various elements of cognitive behavioural therapy, including guided exposure to feared activities (that are avoided by the participants). Participants and outcome assessors are blinded to group allocation. Follow-up measurements will be performed at 3 and 6 months after discharge from geriatric rehabilitation. (Cost)-effectiveness and feasibility of the intervention will be evaluated. Primary outcome measures are fear of falling and mobility. Targeted treatment of fear of

  3. Hip Rotations Influence Electromyographic Activity of Gluteus Medius Muscle During Pelvic Drop Exercise.

    Science.gov (United States)

    Monteiro, Renan Lima; Facchini, Joana Hoverter; de Freitas, Diego Galace; Callegaric, Bianca; Amado João, Sílvia Maria

    2016-08-24

    Pelvic drop exercises are often used to strengthen the gluteus medius muscle with the aim of increasing or prioritizing its recruitment. However, the effect of hip rotation on the performance of the action of the gluteus medius is unknown. The aim of the study was to evaluate the effect of hip rotation on the recruitment of the gluteus medius muscle, tensor fasciae latae and quadratus lumborum. Seventeen healthy subjects performed two sets of four repetitions of pelvic drop exercise in random order with lateral (PDLR), medial (PDMR) and neutral (PDN) rotation of the hip. The electromyographic activity of the gluteus medius muscle (GM), tensor fasciae latae (TFL) and quadratus lumborum (QL) were evaluated using surface electromyography (sEMG). The results showed significant increases in activation of the GM with medial and neutral rotation compared with lateral rotation (p = 0.03, p = 0.01, respectively) and there was no difference between medial and neutral rotation (p=1.00). There was no difference in electromyographic activity of the tensor fasciae latae and quadratus lumborum in any of the positions. The GM:TFL ratio was the same in all analyzed positions. Regarding the GM:QL ratio, there was a significant increase with medial rotation compared with lateral rotation (p=0.02). Pelvic drop exercises are more efficient for activating the gluteus medius when the hip is in medial rotation and neutral position.

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

    Directory of Open Access Journals (Sweden)

    Renata Alqualo Costa

    2010-01-01

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

  5. Age-specific incidence of hip fracture in the elderly: a healthy decline.

    LENUS (Irish Health Repository)

    Green, C

    2012-02-01

    Hip fractures in the elderly are an important source of morbidity and mortality. The predicted increase in the number of hip fractures due to the increasing elderly population has not been universally observed. The purpose of this study was to examine the incidence of hip fractures over a twenty year period to determine if this rise is occurring in our region. All hip fractures from the unit over 20 years were identified. Population data for those over 65 in the catchment area of our hospital was acquired. The rate of fractures occurring each year relative to the population was determined. The results were split into age groups. There was a strong correlation between the population rise and number of fractures (p = 0.77). But there was no significant difference in the rate of fracture over time (p = 0.41). However, the average age at which fracture occurred increased by two years. In addition we show the overall trend in the rate of fractures decreases in the younger age groups and increases in the older age groups. Therefore, the predicted rapid increase in rate is not occurring. This probably reflects the strengthening of the economy in Ireland from the 1930\\'s onwards, leading to a healthier population.

  6. Emergency incarcerated obturator hernia repair with biologic mesh in a male patient after ipsilateral hip disarticulation: A case report

    Directory of Open Access Journals (Sweden)

    Rodolfo J. Oviedo, MD, FACS

    2017-01-01

    Conclusion: Being aware of the possibility of obturator foramen herniation and bowel incarceration as part of the differential diagnosis for patients with abdominal pain after a prior hip disarticulation can facilitate prompt diagnosis and reduce morbidity and mortality.

  7. 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.

  8. Eccentric hip abductor weakness in patients with symptomatic external snapping hip

    DEFF Research Database (Denmark)

    Jacobsen, Julie Sandell; Thorborg, Kristian; Søballe, K;

    2012-01-01

    Symptomatic external snapping hip can be a long-standing condition affecting physical function in younger people between 15-40 years. Gluteal weakness has been suggested to be associated with the condition. The aim of this study was to investigate whether eccentric hip abduction strength is decre......Symptomatic external snapping hip can be a long-standing condition affecting physical function in younger people between 15-40 years. Gluteal weakness has been suggested to be associated with the condition. The aim of this study was to investigate whether eccentric hip abduction strength...... is decreased in patients with external snapping hip compared with healthy matched controls, and to examine isometric hip abduction, adduction, extension, flexion, internal rotation, and external rotation in patients with external snapping hip and matched controls. Thirteen patients with external snapping hip....... Eccentric hip abduction strength was 16% lower in patients with external snapping hip compared with healthy matched controls (1.50 ± 0.47 Nm/kg versus 1.82 ± 0.48 Nm/kg, P = 0.01). No other strength differences were measured between patients and controls (P > 0.05). Eccentric hip abductor weakness...

  9. Carryover effect of hip and knee exercises program on functional performance in individuals with patellofemoral pain syndrome.

    Science.gov (United States)

    Ahmed Hamada, Hamada; Hussein Draz, Amira; Koura, Ghada Mohamed; Saab, Ibtissam M

    2017-08-01

    [Purpose] This study was carried out to investigate the carryover effect of hip and knee exercises program on functional performance (single legged hop test as functional performance test and Kujala score for functional activities). [Subjects and Methods] Thirty patients with patellofemoral pain syndrome were randomly assigned into two equal groups. Group (A) consisted of 15 patients undergoing hip strengthening exercises for four weeks then measuring all variables followed by additional four weeks of knee exercises program then measuring all variables again. Group (B): consisted of 15 patients undergoing knee exercises program for four weeks then measuring all variables followed by additional four weeks of hip strengthening exercises then measuring all variables. Functional abilities and knee muscles performance were assessed using Kujala questionnaire and single legged hop test respectively pre and after the completion of the first 4 weeks then after 8 weeks for both groups. [Results] Significantly increase in Kujala questionnaire in group A compared with group B was observed. While, there were significant increase in single legged hop performance test in group B compared with group A. [Conclusion] Starting with hip exercises improve the performance of subjects more than functional activities while starting with knee exercises improve the functional activities of subjects more than performance.

  10. Does Hip Arthroscopy Have a Role in the Treatment of Developmental Hip Dysplasia?

    Science.gov (United States)

    Kirsch, Jacob M; Khan, Moin; Bedi, Asheesh

    2017-09-01

    Indications for hip arthroscopy in mildly dysplastic patients with a symptomatic hip remain controversial. This article provides a concise review of the available literature evaluating the role of hip arthroscopy in treating symptomatic dysplasia. Potential indications for hip arthroscopy in isolation are reviewed. Emerging evidence on the role of hip arthroscopy based on patient-specific pathomorphology is highlighted. Hip arthroscopy in isolation may be helpful for select dysplastic patients with dynamic impingement or microinstability. Isolated arthroscopic treatment of intra-articular pathology resulting from static overload is unlikely to be successful in the long term and may be detrimental. Arthroscopic procedures for individuals with mild dysplasia in the absence of frank instability may be effective; however, great caution should be exercised when approaching dysplastic patients with symptomatic hips. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Conversion of fused hip to total hip arthroplasty with presurgical and postsurgical gait studies.

    Science.gov (United States)

    Bonin, Stephanie J; Eltoukhy, Moataz A; Hodge, W Andrew; Asfour, Shihab S

    2012-03-01

    This case study presents a subject with a fused hip converted to total hip arthroplasty. Kinematic gait analysis was conducted on 3 occasions, presurgery, 4 months postsurgery, and 2.5 years postsurgery. Presurgery data showed decreased cadence and shorter step length; sound limb possessed increased hip, knee range of motion (ROM), and increased knee flexion during stance; the affected limb had minimal hip motion and normal knee ROM with abnormal pattern. At 4 months postsurgery, the sound limb showed decreased step length, whereas the affected limb showed increased knee extension during stance and increased hip ROM. Data obtained at 2.5 years postsurgery indicated decreased cadence and speed and increased ROM in both limbs. The total hip arthroplasty had provided relief of chronic back and affected hip pain and improved mobility. Gait-specific training is recommended. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Microstructure and Mechanical Properties of Ultrafine-Grained Austenitic Oxide Dispersion Strengthened Steel

    Science.gov (United States)

    Mao, Xiaodong; Kang, Suk Hoon; Kim, Tae Kyu; Kim, Seul Cham; Oh, Kyu Hwan; Jang, Jinsung

    2016-11-01

    316L stainless steel based austenitic oxide dispersion strengthened (AODS) steel was fabricated by mechanical alloying (MA) and hot isostatic pressing (HIP). The AODS sample exhibited an ultrafine-grained (UFG) structure with a bimodal grain size distribution (large grains of about 1200 nm and fine grains of about 260 nm). Two groups of oxide particles were observed; fine Y2Ti2O7 of about 7.7 nm and coarse Cr2O3 particles of about 200 nm in diameter. Tensile tests of the hot-rolled AODS steel samples showed yield strength of up to 890 MPa at room temperature, which is nearly four times higher than that of conventional 316L stainless steel. Micro-indentation and hardness tests indicated even higher yield strength of up to 1200 MPa, which shows a good agreement with the calculated value by combining of the grain refinement strengthening by the Hall-Petch relation and the dispersion strengthening by the Orowan mechanism. The lower strength from tensile tests should be attributed to the formation of micro-cracks at the interfaces between coarse Cr2O3 particles and the matrix. Coarse Cr2O3 particles were also frequently observed inside the fracture surface dimples of the creep ruptured sample at 923 K (650 °C) and 140 MPa. It is thus suggested that the yield strength and elongation could be further improved by controlling the coarse Cr2O3 particles.

  13. Hip Arthroscopy: Tales From the Crypt.

    Science.gov (United States)

    Matsuda, Dean K; Philippon, Marc J; Safran, Marc R; Sampson, Thomas G

    2016-01-01

    Complications after hip arthroscopy vary in frequency and severity, even for experienced surgeons. It is important for surgeons to be aware of some of the more dramatic, often unusual, and always memorable (nightmarish) complications of hip arthroscopy and understand how they are caused, how they can be treated, and how they can be prevented.

  14. SOFT TISSUE BALANCING IN TOTAL HIP ARTHROPLASTY.

    Directory of Open Access Journals (Sweden)

    Pencho Kosev

    2015-03-01

    Full Text Available We present our experience with the soft tissue balancing in total hip arthroplasty. Detailed indications, planning and surgical technique are presented. The described procedures are performed on 278 hips for a period of 6 years (2008-2014. We conclude that the outcome of a THA can be improved by balancing the stability, ROM, muscle strength and limb length equality.

  15. TREATMENT OF NEUROLOGICAL CONGENITAL HIP LUXATION

    Directory of Open Access Journals (Sweden)

    Iulian ICLEANU

    2015-11-01

    Full Text Available Congenital hip luxation is a disorder which evolves in time. Teratological hip dislocation is a distinct form of hip luxation, which usually appears with other disorders. These hips are dislocated before birth. In this thesis we will try to elaborate a recovery program, through physical exercises, which will help us realize our treatment objectives: diminishing articular stiffness, increasing articular mobility, increasing muscle strength, recalibration of agonist and antagonist balances and reeducating gait. The specific objectives of the study consist of the particularization of the recovery programs based on age, illness stage (dysplasia or luxation and either surgical or non-surgical intervention. To show the importance of physiotherapy in gait rehabilitation of a child with hip dislocation we started from the hypothesis: using an adequate rehabilitation program after an individualized methodology, optimizes the functional recovery and ensures the gains of hip stability and the formation of an engram of gait as close as it could be to the normal one. We present a case of neurological congenital hip dislocation where the treatment initiated early is showing good results. Results obtained are significantly different and we came to the conclusion that starting an untimely analytical kinetic treatment and globally personalizing it to every patient has better biomechanical results for the hip.

  16. Dilemmas in Uncemented Total Hip Arthroplasty

    NARCIS (Netherlands)

    Goosen, J.H.M.

    2009-01-01

    In this thesis, different aspects that are related to the survivorship and clinical outcome in uncemented total hip arthroplasty are analysed. In Chapter 2, the survival rate, Harris Hip score and radiographic features of a proximally hydroxyapatite coated titanium alloy femoral stem (Bi-Metric, Bio

  17. Pressure ulcer risk in hip fracture patients

    NARCIS (Netherlands)

    Houwing, RH; Rozendaal, M; Wouters-Wesseling, W; Buskens, E; Keller, P; Haalboom, JRE

    2004-01-01

    Hip fracture patients have a high risk of pressure ulcers (PU). We followed 121 hip fracture patients for the development of pressure ulcers and evaluated a risk assessment tool for sensitivity and specificity. More than half of the patients presented with PU, mostly stage I. Risk factors for PU wer

  18. 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

  19. Facts and fiction in hip fracture treatment

    NARCIS (Netherlands)

    Embden, Daphne van

    2016-01-01

    As the number of hip fracture patients has increased dramatically over the years, the need for high quality, multidisciplinary and patient centred fracture treatment continues to grow. The first aim of this thesis is to provide better understanding of fracture patterns and classification in hip

  20. Pressure ulcer risk in hip fracture patients

    NARCIS (Netherlands)

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

    Hip fracture patients have a high risk of pressure ulcers (PU). We followed 121 hip fracture patients for the development of pressure ulcers and evaluated a risk assessment tool for sensitivity and specificity. More than half of the patients presented with PU, mostly stage I. Risk factors for PU

  1. Revision Total Hip Replacement: A Case Report

    Directory of Open Access Journals (Sweden)

    Md Hafizur Rahman

    2013-07-01

    Full Text Available Total hip replacement is a reconstructive procedure that has improved the management of those diseases of the hip joint that have responded poorly to conventional medical therapy. Conventional, primary total hip replacement is a durable operation in the majority of patients. A hip replacement is a mechanical device with parts that are assembled before and during the operation. But the possible complications of total hip arthroplasty, and its clinical performance over time, is a challenging occasion to the surgeons, and such a challenge we faced with our presenting patient. A 68 year old lady with history of cemented bipolar hemiarthroplasty done in a tertiary care hospital, due to fracture neck of the left femur having the history of diabetes, chronic kidney disease, heart disease, anaemia, and mental disorders presented with loosened prosthesis, thinning of medial proximal cortex of the femur which had broken within few months after surgery. She complained of painful walking at left hip joint. There was also evidence of chronic infective and degenerative arthritis of acetabular component of the affected hip joint. Cemented revision total hip replacement surgery was performed with expert multidisciplinary involvement. On 2nd postoperative day the patient was allowed to walk on operated limb with the aid of walker. On 12th postoperative day all the stitches were removed and wound was found healthy.

  2. Pertunjukan Teater Karo Hip Hop Kontemporer KAI

    Directory of Open Access Journals (Sweden)

    Silvia Anggreni Purba

    2013-11-01

    Full Text Available Pertunjukan ini berawal dari sebuah ide untuk mengkolaborasikan tradisi Karo dengan budaya populer. Dengan cara seperti ini pertunjukan bisa dinikmati tanpa batasan bahasa dan budaya. Proses menggabungkan dua budaya yang berbeda merupakan bentuk budaya hibrida dan terjadi akibat proses globalisasi. Melalui proses pengendapan pengamatan dan kesan yang kuat, pertunjukan ini dibawa ke dalam bentuk Hip Hop. Pertunjukan ini merupakan bagian dari sebuah tragedi modern dengan karakter destruktif, mengeksplorasi emosi dan menyampaikannya kepada penonton. Eksplorasi budaya Karo dan tari Hip Hop sebagai bahasa simbol mampu memperkuat kata-kata. Gerak tidak diungkapkan dengan kata lisan tetapi disajikan melalui gerak tari Hip Hop. Penafsiran legenda dan teks ke dalam gerak, melalui proses pelatihan di laboratorium sebagai proses pencarian dan eksperimentasi diwujudkan dengan mempertimbangkan unsur-unsur dasar dari Hip Hop, unsur budaya Karo dan tontonan. Karo Hip Hop diharapkan menjadi bentuk estetika teater modern yang diinginkan tanpa kehilangan tradisi.Kata kunci: Tari Karo kontemporer, Hip-hop, budaya hibridaABSTRACTPertunjukan Teater Karo Hip Hop Kontemporer KAI. The performance of Karo Theater collaborated with Hip Hop stems from a simple idea to collaborate Karo cultural traditions with popular culture. The performances can be enjoyed without having limitation on the language and culture. The process of combining two different cultures is a form of hybrid culture, and it may occur due to the globalization process. Through the process of deposition of the observations and strong impression, this performance is then brought into the form of Hip Hop as a preferred form which is energetic, personal and global. This performance is part of a modern tragedy with its destructive character which has explored the emotion and has presented it to the audiences. The exploration of Karo cultural tradition and Hip Hop dance as a language of symbols is able to

  3. Rose hip (Rosa canina L: A functional food perspective

    Directory of Open Access Journals (Sweden)

    Cui Fan

    2014-12-01

    Full Text Available Rose hip (Rosa canina L. is the pseudo-fruit of the rose plant, which is widely known as a valuable source of polyphenols and vitamin C. Both in vivo and in vitro studies have demonstrated that this fruit exhibits anti-inflammatory, antioxidant, and antiobesogenic activities. The health benefits of Rose hip (RH have been attributed to its wide range of bioactive compounds including the anti-inflammatory galactolipid: (2S-1,2-di-O-[(9Z,12Z,15Z-octadeca-9,12,15-trienoyl]-3-O-β-D galactopyranosyl glycerol (GOPO, vitamin C, phenolics, lycopene, lutein, zeaxanthin, and other carotenoids. As cyclooxygenase inhibitors, RH compounds may reduce the risk of cancer, heart disease, and various inflammatory conditions. The aim of this review is to present an overview of the functional, medical, and physiological properties of RH.

  4. Knitted outer gloves in primary hip and knee arthroplasty.

    Science.gov (United States)

    Tanner, J; Wraighte, P; Howard, P

    2006-01-01

    A randomised trial was carried out to determine the rate of perforation to inner gloves when comparing latex with knitted gloves during hip and knee arthroplasty. Members of the surgical team were randomised to wear either two pairs of latex gloves (standard double gloving) or a knitted glove on top of a latex glove. In addition, participants completed a visual analogue assessment of their overall satisfaction with the gloves. A total of 406 inner gloves were tested for perforations over a four-month period: 23% of inner gloves were perforated when latex outer gloves were used and 6% of inner gloves were perforated when knitted outer gloves were used. In total, there were 64 perforations to the inner gloves; only one of these perforations was detected by the glove wearer. Wearing knitted outer gloves during hip and knee arthroplasty statistically significantly reduces the risk of perforation to inner latex gloves (p<0.0001).

  5. Autonomous hip exoskeleton saves metabolic cost of walking uphill.

    Science.gov (United States)

    Seo, Keehong; Lee, Jusuk; Park, Young Jin

    2017-07-01

    We have developed a hip joint exoskeleton to boost gait function in the elderly and rehabilitation of post-stroke patients. To quantitatively evaluate the impact of the power and mass of the exoskeleton, we measured the metabolic cost of walking on slopes of 0, 5, and 10% grade, once not wearing the exoskeleton and then wearing it. The exoskeleton reduced the metabolic cost by 13.5,15.5 and 9.8% (31.9, 51.6 and 45.6 W) at 0, 5, and 10% grade, respectively. The exoskeleton performance index was computed as 0.97, 1.24, and 1.24 at each grade, implicating that the hip exoskeleton was more effective on slopes than level ground in saving the metabolic cost.

  6. Conventional Versus Cross-Linked Polyethylene for Total Hip Arthroplasty.

    Science.gov (United States)

    Surace, Michele F; Monestier, Luca; Vulcano, Ettore; Harwin, Steven F; Cherubino, Paolo

    2015-09-01

    The clinical and radiographic outcomes of 88 patients who underwent primary total hip arthroplasty with either conventional polyethylene or cross-linked polyethylene (XLPE) from the same manufacturer were compared. There were no significant differences between the 2 subpopulations regarding average age, gender, side affected, or prosthetic stem and cup size. The average follow-up was 104 months (range, 55 to 131 months). To the authors' knowledge, this is the longest follow-up for this particular insert. Clinical and radiographic evaluations were performed at 1, 3, 6, and 12 months and then annually. Results showed that XLPE has a significantly greater wear reduction than that of standard polyethylene in primary total hip arthroplasty. At the longest available follow-up for these specific inserts, XLPE proved to be effective in reducing wear.

  7. Supervised neuromuscular exercise prior to hip and knee replacement

    DEFF Research Database (Denmark)

    Fernandes, Linda; Roos, Ewa M; Overgaard, Søren

    2017-01-01

    BACKGROUND: There are indications of beneficial short-term effect of pre-operative exercise in reducing pain and improving activity of daily living after total hip replacement (THR) and total knee replacement (TKR) surgery. Though, information from studies conducting longer follow-ups and economic...... evaluations of exercise prior to THR and TKR is needed. The aim of the study was to analyse 12-month clinical effect and cost-utility of supervised neuromuscular exercise prior to THR and TKR surgery. METHODS: The study was conducted alongside a randomised controlled trial including 165 patients scheduled...... for standard THR or TKR at a hospital located in a rural area of Denmark. The patients were randomised to replacement surgery with or without an 8-week preoperative supervised neuromuscular exercise program (Clinical Trials registration no.: NCT01003756). Clinical effect was measured with Hip disability...

  8. Alternative outcome measures in young total hip arthroplasty patients

    DEFF Research Database (Denmark)

    Klit, Jakob; Jacobsen, Steffen; Schmiegelow, Victoria

    2015-01-01

    In this prospective multicentre cohort study we studied subjects younger than 60 years of age scheduled for primary total hip arthroplasty (THA). The study assessed patients' overall satisfaction, fulfillment of preoperative expectations, the effect on socioeconomic parameters, and quality of sex......-life. Questionnaires including Oxford Hip Score (OHS) and SF-36 were evaluated preoperatively and 3, 6 and 12 months postoperatively. OHS and SF-36 showed significant improvements (ppatients' socioeconomic status. Increased frequency of intercourse or better...... abilities in intercourse positions were experienced by 18 of 39 females due to reduced pain and increased range of motion. Patients sexually active before THA surgery remained active. These findings constitute important new information to young patients and surgeons during the decision making process....

  9. Strengthening Nordic-Baltic Defense Capabilities

    DEFF Research Database (Denmark)

    Breitenbauch, Henrik Ø.

    2014-01-01

    , there is no reason why this framework could not be extended to the Baltic states.36 A NORBALDEFCO would not only cement the prominent role of Sweden and Finland within NATO as premier partners, it would also formally continue the work begun with Baltic independ- ence after the Cold War, and furthermore strengthen...... the NATO aspect of Nordic-Baltic security....

  10. Strengthening 4-H Program Communication through Technology

    Science.gov (United States)

    Robideau, Kari; Santl, Karyn

    2011-01-01

    Advances in technology are transforming how youth and parents interact with programs. The Strengthening 4-H Communication through Technology project was implemented in eight county 4-H programs in Northwest Minnesota. This article outlines the intentional process used to effectively implement technology in program planning. The project includes:…

  11. Institutional strengthening in Egyptian development aid projects

    NARCIS (Netherlands)

    Walbeek, M.M.; Vlotman, W.F.

    2003-01-01

    In recent years Dutch aid projects have focused more on institutional strengthening. The overall impact of this type of aid has been limited. This paper explores possible reasons for this. In Egypt, it appeared to be difficult to make significant changes in the institutional setting. Main constraint

  12. Institutional strengthening in Egyptian development aid projects

    NARCIS (Netherlands)

    Walbeek, M.M.; Vlotman, W.F.

    2003-01-01

    In recent years Dutch aid projects have focused more on institutional strengthening. The overall impact of this type of aid has been limited. This paper explores possible reasons for this. In Egypt, it appeared to be difficult to make significant changes in the institutional setting. Main

  13. Strengthening 4-H by Analyzing Enrollment Data

    Science.gov (United States)

    Hamilton, Stephen F.; Northern, Angela; Neff, Robert

    2014-01-01

    The study reported here used data from the ACCESS 4-H Enrollment System to gain insight into strengthening New York State's 4-H programming. Member enrollment lists from 2009 to 2012 were analyzed using Microsoft Excel to determine trends and dropout rates. The descriptive data indicate declining 4-H enrollment in recent years and peak enrollment…

  14. IMAGING OF HIP JOINT PATHOLOGIES

    Directory of Open Access Journals (Sweden)

    Parul Dutta

    2016-08-01

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

  15. Pigmented villonodular synovitis of the hip.

    Science.gov (United States)

    Steinmetz, Sylvain; Rougemont, Anne-Laure; Peter, Robin

    2016-06-01

    Pigmented villonodular synovitis (PVNS) is a rare disease that can affect any joint, bursa or tendon sheath.The hip is less frequently affected than the knee, and hence is less discussed in scientific journals.PVNS of the hip mainly occurs in young adults, requiring early diagnosis and adequate treatment to obtain good results.There is no consensus on the management of PVNS of the hip in current literature.We will discuss the options for surgical intervention in hip PVNS using a literature review of clinical, biological, etiological, histological and radiographic aspects of the disease. Cite this article: Steinmetz S, Rougemont A-L, Peter R. Pigmented villonodular synovitis of the hip. EFORT Open Rev 2016;1:260-266. DOI: 10.1302/2058-5241.1.000021.

  16. Femoral head fracture without hip dislocation

    Institute of Scientific and Technical Information of China (English)

    Aditya K Aggarwal; Ashwani Soni; Daljeet Singh

    2013-01-01

    Femoral head fractures without dislocation or subluxation are extremely rare injuries.We report a neglected case of isolated comminuted fracture of femoral head without hip dislocation or subluxation of one year duration in a 36-year-old patient who sustained a high energy trauma due to road traffic accident.He presented with painful right hip and inability to bear full weight on right lower limb with Harris hip score of 39.He received cementless total hip replacement.At latest follow-up of 2.3 years,functional outcome was excellent with Harris hip score of 95.Such isolated injuries have been described only once in the literature and have not been classified till now.The purpose of this report is to highlight the extreme rarity,possible mechanism involved and a novel classification system to classify such injuries.

  17. Unstable total hip arthroplasty: detailed overview.

    Science.gov (United States)

    Berry, D J

    2001-01-01

    Hip dislocation is one of the most common complications of THA. Good preoperative planning, good postoperative patient education, accurate intraoperative component positioning, rigorous intraoperative testing of hip stability, and good repair of soft tissues during closure all help prevent dislocation. Early postoperative dislocations and first or second dislocations usually are treated with closed reduction and a hip guide brace or hip spica cast, but when dislocation becomes recurrent, surgical treatment usually is needed. When possible, surgical treatment is based on identifying and treating a specific problem leading to the dislocation, such as implant malposition, inadequate soft-tissue tension, or impingement. In selected circumstances, constrained implants or bipolar or tripolar implants provide powerful tools to restore hip stability.

  18. Hip Resurfacing Arthroplasty and Perioperative Blood Testing

    Directory of Open Access Journals (Sweden)

    Andrew Cook

    2014-01-01

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

  19. Preoperative gait adaptations persist one year after surgery in clinically well-functioning total hip replacement patients.

    Science.gov (United States)

    Foucher, Kharma C; Hurwitz, Debra E; Wimmer, Markus A

    2007-01-01

    The purpose of this study was to evaluate whether preoperative gait adaptations persist one year after THR in the same set of subjects. The hypothesis tested was that hip dynamic range of motion and peak external moments during walking return to normal after THR. Hip kinematics and kinetics were measured for 28 subjects before and one year after THR and compared to those of 25 subjects with radiographically normal hips. All THR subjects improved clinically after surgery with Harris hip scores improving from 33-85 (average 53) to 61-100 (average 95) (sign test pPreoperatively dynamic hip range of motion (ROM), and all peak external moments were reduced compared to normal (Mann-Whitney ppreoperative and postoperative values of the ROM, and peak flexion, abduction and external rotation moments were all significantly correlated (Spearman prehabilitation before and after surgery.

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

    Directory of Open Access Journals (Sweden)

    Eitzen Ingrid

    2012-12-01

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

  1. Ab initio identified design principles of solid-solution strengthening in Al

    Directory of Open Access Journals (Sweden)

    Duancheng Ma, Martin Friák, Johann von Pezold, Dierk Raabe and Jörg Neugebauer

    2013-01-01

    Full Text Available Solid-solution strengthening in six Al–X binary systems is investigated using first-principle methods. The volumetric mismatch parameter and the solubility enthalpy per solute were calculated. We derive three rules for designing solid-solution strengthened alloys: (i the solubility enthalpy per solute is related to the volumetric mismatch by a power law; (ii for each annealing temperature, there exists an optimal solute–volume mismatch to achieve maximum strength; and (iii the strengthening potential of high volumetric mismatch solutes is severely limited by their low solubility. Our results thus show that the thermodynamic properties of the system (here Al–X alloys set clear upper bounds to the achievable strengthening effects owing to the reduced solubility with increasing volume mismatch.

  2. Relationship between change in femoral neck bone mineral density and hip fracture incidence during treatment with strontium ranelate.

    Science.gov (United States)

    Bruyère, O; Roux, C; Badurski, J; Isaia, G; de Vernejoul, M C; Cannata, J; Ortolani, S; Slosman, D; Detilleux, J; Reginster, J-Y

    2007-12-01

    Strontium ranelate (SR) increases bone mineral density (BMD) in postmenopausal osteoporotic women and reduces vertebral and non-vertebral fracture incidence. Hip fracture reduction has also been observed during 3-year treatment with SR in osteoporotic women at high risk of hip fracture. The objective of this study is to analyse the association between BMD changes and hip fracture incidence during treatment with SR. In this post-hoc analysis, 465 women aged over 74 years with low BMD at the femoral neck (T-score TROPOS). BMD was assessed at the femoral neck at baseline and after a follow-up of 3 years. Hip fractures were reported by study investigators. After adjusting for age, body mass index, femoral neck BMD at baseline and number of prevalent vertebral fractures, we found that for each 1% increase in femoral neck BMD observed after 3 years, the risk to experience a hip fracture after 3 years decreased by 7% (95% CI: 1-14%) (p = 0.04). In patients experiencing a hip fracture over 3 years of treatment with SR, femoral neck BMD increased by (mean [SE]) 3.41 (1.02)% compared to 7.23 (0.81)% in patients without hip fracture (p = 0.02). In this post-hoc analysis of women undergoing 3 years of SR treatment, an increase in femoral neck BMD is associated with a decrease in hip fracture incidence.

  3. The capsular ligaments provide more hip rotational restraint than the acetabular labrum and the ligamentum teres : an experimental study.

    Science.gov (United States)

    van Arkel, R J; Amis, A A; Cobb, J P; Jeffers, J R T

    2015-04-01

    In this in vitro study of the hip joint we examined which soft tissues act as primary and secondary passive rotational restraints when the hip joint is functionally loaded. A total of nine cadaveric left hips were mounted in a testing rig that allowed the application of forces, torques and rotations in all six degrees of freedom. The hip was rotated throughout a complete range of movement (ROM) and the contributions of the iliofemoral (medial and lateral arms), pubofemoral and ischiofemoral ligaments and the ligamentum teres to rotational restraint was determined by resecting a ligament and measuring the reduced torque required to achieve the same angular position as before resection. The contribution from the acetabular labrum was also measured. Each of the capsular ligaments acted as the primary hip rotation restraint somewhere within the complete ROM, and the ligamentum teres acted as a secondary restraint in high flexion, adduction and external rotation. The iliofemoral lateral arm and the ischiofemoral ligaments were primary restraints in two-thirds of the positions tested. Appreciation of the importance of these structures in preventing excessive hip rotation and subsequent impingement/instability may be relevant for surgeons undertaking both hip joint preserving surgery and hip arthroplasty.

  4. The efficacy of modern spinal orthoses and hip protectors used in the management of osteoporosis: a review

    Directory of Open Access Journals (Sweden)

    Liora Colobățiu

    2016-05-01

    Full Text Available Globally, osteoporosis is considered a widespread metabolic bone disease, vertebral fractures being probably one of the most common clinical manifestations encountered in osteoporotic patients. Non-pharmacologic therapies of osteoporosis include, among others, the use of different types of orthoses, such as spinal orthoses or hip protectors. To date there is a limited number of studies that evaluate the efficacy of spinal orthoses and hip protectors used in osteoporotic patients, therefore providing insufficient information to clinicians regarding these aspects. This article reviewed the use and efficacy of the most commonly prescribed spinal orthoses and hip protectors in osteoporotic patients. According to a significant number of studies, modern spinal orthoses proved to be effective in the management of vertebral fractures in osteoporotic patients. However, the efficacy of hip protectors in reducing the impact of falls onto the hip and preventing hip fractures still seems to be controversial. Osteoporosis is a condition that should be treated using a comprehensive approach that includes both pharmacological and non-pharmacological treatment options. Orthoses, such as modern spinal orthoses or back braces and hip protectors might represent an efficacious non-pharmacological option in the management of osteoporotic vertebral or hip fractures.

  5. Effects of strengthening and stretching exercise programmes on kinematics and kinetics of running in older adults: a randomised controlled trial.

    Science.gov (United States)

    Fukuchi, Reginaldo K; Stefanyshyn, Darren J; Stirling, Lisa; Ferber, Reed

    2016-09-01

    The aim of this study was to investigate the effects of strengthening and stretching exercises on running kinematics and kinetics in older runners. One hundred and five runners (55-75 years) were randomly assigned to either a strengthening (n = 36), flexibility (n = 34) or control (n = 35) group. Running kinematics and kinetics were obtained using an eight-camera system and an instrumented treadmill before and after the eight-week exercise protocol. Measures of strength and flexibility were also obtained using a dynamometer and inclinometer/goniometer. A time effect was observed for the excursion angles of the ankle sagittal (P = 0.004, d = 0.17) and thorax/pelvis transverse (P effect was observed for knee transverse plane impulse (P = 0.013, d = 0.26) and ground reaction force propulsion (P = 0.042, d = -0.15). A time effect for hip adduction (P = 0.006, d = 0.69), ankle dorsiflexion (P = 0.002, d = 0.47) and hip internal rotation (P = 0.048, d = 0.30) flexibility, and hip extensor (P = 0.001, d = -0.48) and ankle plantar flexor (P = 0.01, d = 0.39) strength were also observed. However, these changes were irrespective of exercise group. The results of the present study indicate that an eight-week stretching or strengthening protocol, compared to controls, was not effective in altering age-related running biomechanics despite changes in ankle and trunk kinematics, knee kinetics and ground reaction forces along with alterations in muscle strength and flexibility were observed over time.

  6. Strengthening health workforce capacity through work-based training.

    Science.gov (United States)

    Matovu, Joseph K B; Wanyenze, Rhoda K; Mawemuko, Susan; Okui, Olico; Bazeyo, William; Serwadda, David

    2013-01-24

    Although much attention has been given to increasing the number of health workers, less focus has been directed at developing models of training that address real-life workplace needs. Makerere University School of Public Health (MakSPH) with funding support from the Centers for Disease Control and Prevention (CDC) developed an eight-month modular, in-service work-based training program aimed at strengthening the capacity for monitoring and evaluation (M&E) and continuous quality improvement (CQI) in health service delivery. This capacity building program, initiated in 2008, is offered to in-service health professionals working in Uganda. The purpose of the training is to strengthen the capacity to provide quality health services through hands-on training that allows for skills building with minimum work disruptions while encouraging greater involvement of other institutional staff to enhance continuity and sustainability. The hands-on training uses practical gaps and challenges at the workplace through a highly participatory process. Trainees work with other staff to design and implement 'projects' meant to address work-related priority problems, working closely with mentors. Trainees' knowledge and skills are enhanced through short courses offered at specific intervals throughout the course. Overall, 143 trainees were admitted between 2008 and 2011. Of these, 120 (84%) from 66 institutions completed the training successfully. Of the trainees, 37% were Social Scientists, 34% were Medical/Nursing/Clinical Officers, 5.8% were Statisticians, while 23% belonged to other professions. Majority of the trainees (80%) were employed by Non-Government Organizations while 20% worked with the public health sector. Trainees implemented 66 projects which addressed issues such as improving access to health care services; reducing waiting time for patients; strengthening M&E systems; and improving data collection and reporting. The projects implemented aimed to improve trainees

  7. Strengthening health workforce capacity through work-based training

    Directory of Open Access Journals (Sweden)

    Matovu Joseph KB

    2013-01-01

    Full Text Available Abstract Background Although much attention has been given to increasing the number of health workers, less focus has been directed at developing models of training that address real-life workplace needs. Makerere University School of Public Health (MakSPH with funding support from the Centers for Disease Control and Prevention (CDC developed an eight-month modular, in-service work-based training program aimed at strengthening the capacity for monitoring and evaluation (M&E and continuous quality improvement (CQI in health service delivery. Methods This capacity building program, initiated in 2008, is offered to in-service health professionals working in Uganda. The purpose of the training is to strengthen the capacity to provide quality health services through hands-on training that allows for skills building with minimum work disruptions while encouraging greater involvement of other institutional staff to enhance continuity and sustainability. The hands-on training uses practical gaps and challenges at the workplace through a highly participatory process. Trainees work with other staff to design and implement ‘projects’ meant to address work-related priority problems, working closely with mentors. Trainees’ knowledge and skills are enhanced through short courses offered at specific intervals throughout the course. Results Overall, 143 trainees were admitted between 2008 and 2011. Of these, 120 (84% from 66 institutions completed the training successfully. Of the trainees, 37% were Social Scientists, 34% were Medical/Nursing/Clinical Officers, 5.8% were Statisticians, while 23% belonged to other professions. Majority of the trainees (80% were employed by Non-Government Organizations while 20% worked with the public health sector. Trainees implemented 66 projects which addressed issues such as improving access to health care services; reducing waiting time for patients; strengthening M&E systems; and improving data collection and

  8. Implementing, Adapting, and Validating an Evidence-Based Algorithm for Hip Fracture Surgery

    DEFF Research Database (Denmark)

    Ban, I.; Palm, H.; Birkelund, Lasse;

    2014-01-01

    Reoperations are common after surgical treatment of hip fractures but may be reduced by optimal choice of implant based on fracture classification. We hypothesized that implementing a surgical treatment algorithm was possible in our hospital and would result in a reduced reoperation rate....

  9. Low risk of thromboembolic complications after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B;

    2010-01-01

    Pharmacological prophylaxis can reduce the risk of deep venous thrombosis (DVT), pulmonary embolism (PE), and death, and it is recommended 10–35 days after total hip arthroplasty (THA) and at least 10 days after total knee arthroplasty (TKA). However, early mobilization might also reduce the risk...

  10. Open reduction for congenital dislocation of the hip: comparison of the long-term results of the wide exposure method and Ludloff's method.

    Science.gov (United States)

    Matsushita, T; Miyake, Y; Akazawa, H; Eguchi, S; Takahashi, Y

    1999-01-01

    We compared the long-term clinical and radiographic results of two methods of open reduction for congenital dislocation of the hip; a wide exposure method (360-degree circumferential capsulotomy) versus Ludloff's method (limited capsulotomy via the medial approach). Thirty-one hips in 24 patients assigned to group A received the wide exposure method and 32 hips in 27 patients assigned to group B had the Ludloff reduction. All patients were surgically reduced at less than 3 years of age. The follow-up averaged 16 years. None of the hips in group A required additional operations; however, 34.4% of the hips in group B did. At the latest review, 26 (83.9%) of the hips in group A were rated as Severin class I or II. Except for one patient, none had pain or a limp. Of the hips in group B, 18 (56.3%) were rated as Severin class I or II. Three patients had pain or Trendelenburg gait. Avascular necrosis occurred in 3.2% of hips in group A and in 21.9% of hips in group B. The wide exposure method is capable of completely releasing the posterosuperior tightness resulting from capsular adhesion to the ilium and the contracted short external rotators. Releasing the posterosuperior tightness from these structures seemed to provide a better chance of achieving an anatomically and functionally satisfactory hip.

  11. 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

    2013-04-01

    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.

  12. Total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Alexander Tsertsvadze

    Full Text Available Evolvements in the design, fixation methods, size, and bearing surface of implants for total hip replacement (THR have led to a variety of options for healthcare professionals to consider. The need to determine the most optimal combinations of THR implant is warranted. This systematic review evaluated the clinical effectiveness of different types of THR used for the treatment of end stage arthritis of the hip.A comprehensive literature search was undertaken in major health databases. Randomised controlled trials (RCTs and systematic reviews published from 2008 onwards comparing different types of primary THR in patients with end stage arthritis of the hip were included.Fourteen RCTs and five systematic reviews were included. Patients experienced significant post-THR improvements in Harris Hip scores, but this did not differ between impact types. There was a reduced risk of implant dislocation after receiving a larger femoral head size (36 mm vs. 28 mm; RR = 0.17, 95% CI: 0.04, 0.78 or cemented cup (vs. cementless cup; pooled odds ratio: 0.34, 95% CI: 0.13, 0.89. Recipients of cross-linked vs. conventional polyethylene cup liners experienced reduced femoral head penetration and revision. There was no impact of femoral stem fixation and cup shell design on implant survival rates. Evidence on mortality and complications (aseptic loosening, femoral fracture was inconclusive.The majority of evidence was inconclusive due to poor reporting, missing data, or uncertainty in treatment estimates. The findings warrant cautious interpretation given the risk of bias (blinding, attrition, methodological limitations (small sample size, low event counts, short follow-up, and poor reporting. Long-term pragmatic RCTs are needed to allow for more definitive conclusions. Authors are encouraged to specify the minimal clinically important difference and power calculation for their primary outcome(s as well CONSORT, PRISMA and STROBE guidelines to ensure better

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

    Science.gov (United States)

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

    2016-01-01

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

  14. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in total hip replacement.

    Science.gov (United States)

    Sakellariou, Vasileios I; Christodoulou, Michael; Sasalos, Gregory; Babis, George C

    2014-09-01

    Developmental dysplasia of the hip (DDH) or congenital hip dysplasia (CDH) is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is challenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH) differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.

  15. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in Total Hip Replacement

    Directory of Open Access Journals (Sweden)

    Vasileios Sakellariou

    2014-09-01

    Full Text Available Developmental dysplasia of the hip (DDH or congenital hip dysplasia (CDH is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is hallenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.

  16. Risk Factors for Hip Fractures in Elderly Patients

    Directory of Open Access Journals (Sweden)

    Erhan Bayram

    2014-09-01

    Full Text Available Aim: In this study, we aimed to determine the risk factors for hip fractures in elderly patients in order to contribute to efforts to reduce the incidence of hip fractures. Methods: We evaluated 54 patients aged 79.12±8.83 (range: 55-95 years, who presented to our emergency department due to hip fractures (Group 1 and 52 hospitalized patients aged 69.04±7.66 (range: 60-83 years, without a hip fracture (Group 2. We compare the groups in terms of neuropathy symptom score (NSS, neurological impairment score (NIS, accompanying diseases, foot deformities, dermal and nail problems, body mass index (BMI, osteoporosis, and use of walking aid devices. Results: The mean BMI score was 24.81±3.67 and 27.67±4.86 in Group 1 and in Group 2, respectively. The difference was statistically significant (p=0.001. The mean NSS and NIS in Group 1 was 2.87±2.89 and 2.06±1.17, respectively, while the mean NSS was 1.83±2.84 and NIS was 0.6±0.82 in group 2. The two scores were higher in group 1 than in Group 2, however, the difference in NISs between the groups was statistically significant (p<0.001. In Group 1, the number of patients smoking or drinking alcohol was higher than in Group 2, but the difference was not significant (p=0.37, p=0.324. There were no significant relationship between foot deformities and hip fractures. The number of patients with osteoporosis and those using walking aid devices was significantly higher in Group 1 than in Group 2 (p=0.007, p<0.001. Conclusion: In this study including a limited number of patients, we determined that a low BMI score, osteoporosis, and use of walking aid device are the risk factors for hip fractures. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 187-90

  17. Writing Strengthens Orthography and Alphabetic-Coding Strengthens Phonology in Learning to Read Chinese

    NARCIS (Netherlands)

    Guan, C.Q.; Liu, Y.; Chan, D.H.L.; Ye, F.F.; Perfetti, C.A.

    2011-01-01

    Learning to write words may strengthen orthographic representations and thus support word-specific recognition processes. This hypothesis applies especially to Chinese because its writing system encourages character-specific recognition that depends on accurate representation of orthographic form. W

  18. Writing Strengthens Orthography and Alphabetic-Coding Strengthens Phonology in Learning to Read Chinese

    NARCIS (Netherlands)

    Guan, C.Q.; Liu, Y.; Chan, D.H.L.; Ye, F.F.; Perfetti, C.A.

    2011-01-01

    Learning to write words may strengthen orthographic representations and thus support word-specific recognition processes. This hypothesis applies especially to Chinese because its writing system encourages character-specific recognition that depends on accurate representation of orthographic form.

  19. Writing Strengthens Orthography and Alphabetic-Coding Strengthens Phonology in Learning to Read Chinese

    NARCIS (Netherlands)

    Guan, C.Q.; Liu, Y.; Chan, D.H.L.; Ye, F.F.; Perfetti, C.A.

    2011-01-01

    Learning to write words may strengthen orthographic representations and thus support word-specific recognition processes. This hypothesis applies especially to Chinese because its writing system encourages character-specific recognition that depends on accurate representation of orthographic form. W

  20. The Benefits of Streamlined Hip Fracture Management in a Regional Hospital.

    Science.gov (United States)

    Mow, T C; Lukeis, Jen; Sutherland, A G

    2017-06-01

    Hip fracture is an increasingly common injury in the growing elderly population. The morbidity and mortality associated with this injury can be reduced by minimizing delays to surgical treatment. We describe the impact of a regional hospital service redesign project that utilized the principles of smart simplicity, a management strategy that lays emphasis on collaboration to achieve desired goals. Prior to the redesign, patients with hip fractures were taking an average of 72 hours for surgical treatment. A hip fracture working group was created to examine closely the process of hip fracture care, and a single key performance indicator (KPI) of "surgery within 48 hours" was adopted. This allowed identification of processes that could be clarified and streamlined, with the agreement of relevant stakeholders, in the creation of a new hip fracture pathway. In the first 3 months of the pathway's implementation, 16 of 18 patients had surgery within 48 hours of presentation. In a 6-month follow-up audit after 2 years of implementation, 36 of 39 patients were treated within 48 hours. This was significantly different to the time to surgery seen in the 12 months prior to the redesign (P KPI has allowed a significant culture shift in the treatment of hip fractures in our institution in the months following its institution. Collaborative, multidisciplinary collaboration has facilitated a higher standard of care and demonstrated significant cost benefit.

  1. Adhesive capsulitis of the hip: a case report: an entity in question.

    Science.gov (United States)

    Lowe, Rebecca

    2013-12-01

    Very little has been discussed in the medical literature concerning adhesive capsulitis of the hip (ACH). There are no articles to date in the physical therapy literature regarding ACH and only a dozen or so in medical journals. Evidence suggests ACH may present in a similar progression through four stages as adhesive capsulitis of the shoulder (ACS) (from synovial inflammation to capsular fibrosis). Consensus does not exist for management of ACS or ACH. However, most clinicians agree that treatment should be guided by the stage of the disorder, whether medically, surgically, or through physical therapy. A large part of the confusion for management of adhesive capsulitis (ACS and ACH) is due to the many studies that have not reported their findings by stage. Arthroscopy and synovial/capsular biopsy can confirm the presence and stage of adhesive capsulitis. Primary (idiopathic) ACH is proposed to be caused by biomechanical dysfunction in the hip or other joints related to the mechanical function of the hip. The treatment for stages 1 and 2 consists of using techniques to reduce inflammation and correct biomechanical faults that affect the hip. In stages 3 and 4 treatment focuses on the biomechanical dysfunction of the spine, hip(s), pelvic ring, and lower limb, if needed. In this case, the 55-year-old female patient presenting with probable stage 3 adhesive capsulitis, responded well to manual therapy and has been able to return to functional activities and maintain them with a home program.

  2. Developmental dysplasia of the hip: What has changed in the last 20 years?

    Science.gov (United States)

    Kotlarsky, Pavel; Haber, Reuben; Bialik, Victor; Eidelman, Mark

    2015-12-18

    Developmental dysplasia of the hip (DDH) describes the spectrum of structural abnormalities that involve the growing hip. Early diagnosis and treatment is critical to provide the best possible functional outcome. Persistence of hip dysplasia into adolescence and adulthood may result in abnormal gait, decreased strength and increased rate of degenerative hip and knee joint disease. Despite efforts to recognize and treat all cases of DDH soon after birth, diagnosis is delayed in some children, and outcomes deteriorate with increasing delay of presentation. Different screening programs for DDH were implicated. The suspicion is raised based on a physical examination soon after birth. Radiography and ultrasonography are used to confirm the diagnosis. The role of other imaging modalities, such as magnetic resonance imaging, is still undetermined; however, extensive research is underway on this subject. Treatment depends on the age of the patient and the reducibility of the hip joint. At an early age and up to 6 mo, the main treatment is an abduction brace like the Pavlik harness. If this fails, closed reduction and spica casting is usually done. After the age of 18 mo, treatment usually consists of open reduction and hip reconstruction surgery. Various treatment protocols have been proposed. We summarize the current practice for detection and treatment of DDH, emphasizing updates in screening and treatment during the last two decades.

  3. The Hip Functional Retrieval after Elective Surgery May Be Enhanced by Supplemented Essential Amino Acids

    Directory of Open Access Journals (Sweden)

    Eleonora Baldissarro

    2016-01-01

    Full Text Available It is not known whether postsurgery systemic inflammation and plasma amino acid abnormalities are still present during rehabilitation of individuals after elective hip arthroplasty (EHA. Sixty subjects (36 females; age 66.58±8.37 years were randomized to receive 14-day oral EAAs (8 g/day or a placebo (maltodextrin. At admission to and discharge from the rehabilitation center, serum C-reactive protein (CRP and venous plasma amino acid concentrations were determined. Post-EHA hip function was evaluated by Harris hip score (HHS test. Ten matched healthy subjects served as controls. At baseline, all patients had high CRP levels, considerable reduction in several amino acids, and severely reduced hip function (HHS 40.78±2.70 scores. After treatment, inflammation decreased both in the EAA group and in the placebo group. Only EAA patients significantly improved their levels of glycine, alanine, tyrosine, and total amino acids. In addition, they enhanced the rate of hip function recovery (HHS (from baseline 41.8±1.15 to 76.37±6.6 versus baseline 39.78±4.89 to 70.0±7.1 in placebo one; p=0.006. The study documents the persistence of inflammation and plasma amino acid abnormalities in post-EHA rehabilitation phase. EAAs enhance hip function retrieval and improve plasma amino acid abnormalities.

  4. The Hip Functional Retrieval after Elective Surgery May Be Enhanced by Supplemented Essential Amino Acids

    Science.gov (United States)

    Baldissarro, Eleonora; Aquilani, Roberto; Boschi, Federica; Baiardi, Paola; Iadarola, Paolo; Fumagalli, Marco; Pasini, Evasio; Verri, Manuela; Dossena, Maurizia; Gambino, Arianna; Cammisuli, Sharon; Viglio, Simona

    2016-01-01

    It is not known whether postsurgery systemic inflammation and plasma amino acid abnormalities are still present during rehabilitation of individuals after elective hip arthroplasty (EHA). Sixty subjects (36 females; age 66.58 ± 8.37 years) were randomized to receive 14-day oral EAAs (8 g/day) or a placebo (maltodextrin). At admission to and discharge from the rehabilitation center, serum C-reactive protein (CRP) and venous plasma amino acid concentrations were determined. Post-EHA hip function was evaluated by Harris hip score (HHS) test. Ten matched healthy subjects served as controls. At baseline, all patients had high CRP levels, considerable reduction in several amino acids, and severely reduced hip function (HHS 40.78 ± 2.70 scores). After treatment, inflammation decreased both in the EAA group and in the placebo group. Only EAA patients significantly improved their levels of glycine, alanine, tyrosine, and total amino acids. In addition, they enhanced the rate of hip function recovery (HHS) (from baseline 41.8 ± 1.15 to 76.37 ± 6.6 versus baseline 39.78 ± 4.89 to 70.0 ± 7.1 in placebo one; p = 0.006). The study documents the persistence of inflammation and plasma amino acid abnormalities in post-EHA rehabilitation phase. EAAs enhance hip function retrieval and improve plasma amino acid abnormalities. PMID:27110573

  5. 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.

  6. The envelope of passive motion allowed by the capsular ligaments of the hip.

    Science.gov (United States)

    van Arkel, Richard J; Amis, Andrew A; Jeffers, Jonathan R T

    2015-11-05

    Laboratory data indicate the hip capsular ligaments prevent excessive range of motion, may protect the joint against adverse edge loading and contribute to synovial fluid replenishment at the cartilage surfaces of the joint. However, their repair after joint preserving or arthroplasty surgery is not routine. In order to restore their biomechanical function after hip surgery, the positions of the hip at which the ligaments engage together with their tensions when they engage is required. Nine cadaveric left hips without pathology were skeletonised except for the hip joint capsule and mounted in a six-degrees-of-freedom testing rig. A 5 N m torque was applied to all rotational degrees-of-freedom separately to quantify the passive restraint envelope throughout the available range of motion with the hip functionally loaded. The capsular ligaments allowed the hip to internally/externally rotate with a large range of un-resisted rotation (up to 50±10°) in mid-flexion and mid-ab/adduction but this was reduced towards the limits of flexion/extension and ab/adduction such that there was a near-zero slack region in some positions (pligamentous restraint averaged 0.8±0.3 N m/° and was greater in positions where there were large slack regions. These data provide a target for restoration of normal capsular ligament tensions after joint preserving hip surgery. Ligament repair is technically demanding, particularly for arthroscopic procedures, but failing to restore their function may increase the risk of osteoarthritic degeneration.

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Structural Assessment of Externally Strengthened Bridge Deck Panels

    Science.gov (United States)

    Sim, Jongsung; Oh, Hongseob; Meyer, Christian

    2006-03-01

    Deteriorated concrete bridge decks are strengthened with external bonding technique using either steel plate or various FRPs to enhance the decreased load carrying capacity and serviceability. But the failure characteristics of bridge decks strengthened with various materials can be changed according to mechanical properties of strengthening materials or strengthening scheme as well as the strengthening amount. In this paper, strengthening effect of deck strengthened with carbon fiber sheets, glass fiber sheets or steel plates is compared. And the theoretical load carrying capacity are evaluated using yield line theory and punching shear model properly modified for the strengthened RC member. The panels strengthened with sheet type FRP materials failed more often in a ductile mode, indicating that the failure developed after the rebar yielded.

  9. Canine Hip Dysplasia Screening Within the United States: Pennsylvania Hip Improvement Program and Orthopedic Foundation for Animals Hip/Elbow Database.

    Science.gov (United States)

    Reagan, Jennifer K

    2017-07-01

    Canine hip dysplasia (CHD) is a complex, polygenic disease radiographically associated with hip subluxation and development of osteoarthritis. Screening programs have been established with the goal of hip improvement, with the most common in the United States being OFA hip scoring and the PennHIP method. When evaluating the single hip-extended view used by OFA versus the 3 radiographic views and associated distraction index (DI) used by PennHIP for CHD screening, the scientific evidence supports the use of the DI and PennHIP method. OFA scoring can be used to effect hip improvement, especially when incorporated into estimated breeding values. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. The Current State of Screening and Decolonization for the Prevention of Staphylococcus aureus Surgical Site Infection After Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Weiser, Mitchell C; Moucha, Calin S

    2015-09-01

    The most common pathogens in surgical site infections after total hip and knee arthroplasty are methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), and coagulase-negative staphylococci. Patients colonized with MSSA or MRSA have an increased risk for a staphylococcal infection at the site of a total hip or knee arthroplasty. Most colonized individuals who develop a staphylococcal infection at the site of a total hip or total knee arthroplasty have molecularly identical S. aureus isolates in their nares and wounds. Screening and nasal decolonization of S. aureus can potentially reduce the rates of staphylococcal surgical site infection after total hip and total knee arthroplasty.

  11. Pain in the hip joint

    Directory of Open Access Journals (Sweden)

    Yuri Aleksandrovich Olyunin

    2013-01-01

    Full Text Available Pathological changes that develop in the hip joints (HJ have different origins and mechanisms of development, but their main manifestation is pain. The nature of this pain cannot be well established on frequent occasions. The English-language medical literature currently classifies such disorders as greater trochanter pain syndrome (GTPS. Its major signs are chronic pain and local palpatory tenderness in the outer part of HJ. The development of GTPS may be associated with inflammation of the synovial bursae situated in the greater tronchanter, as well as with tendinitis, myorrhexis, iliotibial band syndrome, and other local changes in the adjacent tissues or with systemic diseases. So GTPS may be characterized as regional pain syndrome that frequently mimics pain induced by different diseases, including myofascial pain syndrome, osteoarthrosis, spinal diseases, etc.

  12. 结识Hip-Hop

    Institute of Scientific and Technical Information of China (English)

    尚劲

    2010-01-01

    Hip-Hop是一种美国街头黑人文化,可分成五个要素:音乐、舞蹈、涂鸦、刺青和衣着。源自80年代美国纽约的黑人社区BRONX,他们将生活上的娱乐发展成为现今多样的Hip—HOP文化,发挥黑人独有的特质,如节奏感及歌声进而舒缓情绪和消遣。因带有乐观开朗的特质,逐渐地在全美蔓延开来,进而扩散到全世界。

  13. Low levels of human HIP14 are sufficient to rescue neuropathological, behavioural, and enzymatic defects due to loss of murine HIP14 in Hip14-/- mice.

    Directory of Open Access Journals (Sweden)

    Fiona B Young

    Full Text Available Huntingtin Interacting Protein 14 (HIP14 is a palmitoyl acyl transferase (PAT that was first identified due to altered interaction with mutant huntingtin, the protein responsible for Huntington Disease (HD. HIP14 palmitoylates a specific set of neuronal substrates critical at the synapse, and downregulation of HIP14 by siRNA in vitro results in increased cell death in neurons. We previously reported that mice lacking murine Hip14 (Hip14-/- share features of HD. In the current study, we have generated human HIP14 BAC transgenic mice and crossed them to the Hip14-/- model in order to confirm that the defects seen in Hip14-/- mice are in fact due to loss of Hip14. In addition, we sought to determine whether human HIP14 can provide functional compensation for loss of murine Hip14. We demonstrate that despite a relative low level of expression, as assessed via Western blot, BAC-derived human HIP14 compensates for deficits in neuropathology, behavior, and PAT enzyme function seen in the Hip14-/- model. Our findings yield important insights into HIP14 function in vivo.

  14. 21 CFR 890.3665 - Congenital hip dislocation abduction splint.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Congenital hip dislocation abduction splint. 890....3665 Congenital hip dislocation abduction splint. (a) Identification. A congenital hip dislocation abduction splint is a device intended for medical purposes to stabilize the hips of a young child...

  15. Microstructure and Mechanism of Strengthening of Microalloyed Pipeline Steel: Ultra-Fast Cooling (UFC) Versus Laminar Cooling (LC)

    Science.gov (United States)

    Zhao, J.; Wang, X.; Hu, W.; Kang, J.; Yuan, G.; Di, H.; Misra, R. D. K.

    2016-06-01

    A novel thermo-mechanical controlled processing (TMCP) schedule involving ultra-fast cooling (UFC) technique was used to process X70 (420 MPa) microalloyed pipeline steel with high strength-high toughness combination. A relative comparison is made between microstructure and mechanical properties between conventionally processed (CP) and ultra-fast cooled (UFC) pipeline steels, together with differences in strengthening mechanisms with respect to both types of processes. UFC-processed steel exhibited best combination of strength and good toughness compared to the CP process. The microstructure of CP pipeline steel mainly consisted of acicular ferrite (AF), bainitic ferrite (BF), and dispersed secondary martensite/austenite (M/A) constituent and a small fraction of fine quasi-polygonal ferrite. In contrast, the microstructure of UFC-processed pipeline steel was predominantly composed of finer AF, BF, and dispersed M/A constituent. The primary strengthening mechanisms in UFC pipeline steel were grain size strengthening and dislocation strengthening with strength increment of ~277 and ~151 MPa, respectively. However, the strengthening contribution in CP steel was related to grain size strengthening, dislocation strengthening, and precipitation strengthening, and the corresponding strength increments were ~212, ~149 and ~86 MPa, respectively. The decrease in strength induced by reducing Nb and Cr in UFC pipeline steel was compensated by enhancing the contribution of grain size strengthening in the UFC process. In conclusion, cooling schedule of UFC combined with LC is a promising method for processing low-cost pipeline steels.

  16. Study of scattered radiation during fluoroscopy in hip surgery*

    Science.gov (United States)

    Lesyuk, Oksana; Sousa, Patrick Emmanuel; Rodrigues, Sónia Isabel do Espirito Santo; Abrantes, António Fernando; de Almeida, Rui Pedro Pereira; Pinheiro, João Pedro; Azevedo, Kevin Barros; Ribeiro, Luís Pedro Vieira

    2016-01-01

    Objective To measure the scattered radiation dose at different positions simulating hip surgery. Materials and Methods We simulated fluoroscopy-assisted hip surgery in order to study the distribution of scattered radiation in the operating room. To simulate the patient, we used a anthropomorphic whole-body phantom, and we used an X-ray-specific detector to quantify the radiation. Radiographs were obtained with a mobile C-arm X-ray system in continuous scan mode, with the tube at 0º (configuration 1) or 90º (configuration 2). The operating parameters employed (voltage, current, and exposure time) were determined by a statistical analysis based on the observation of orthopedic surgical procedures involving the hip. Results For all measurements, higher exposures were observed in configuration 2. In the measurements obtained as a function of height, the maximum dose rates observed were 1.167 (± 0.023) µSv/s and 2.278 (± 0.023) µSv/s in configurations 1 and 2, respectively, corresponding to the chest level of health care professionals within the operating room. Proximal to the patient, the maximum values were recorded in the position occupied by the surgeon. Conclusion We can conclude that, in the scenario under study, health care professionals workers are exposed to low levels of radiation, and that those levels can be reduced through the use of personal protective equipment. PMID:27777477

  17. Design of a biomimetic polymer-composite hip prosthesis.

    Science.gov (United States)

    Bougherara, Habiba; Bureau, Martin; Campbell, Melissa; Vadean, Aurelian; Yahia, L'Hocine

    2007-07-01

    A new biomimetic composite hip prosthesis (stem) was designed to obtain properties similar to those of the contiguous bone, in particular stiffness, to allow normal loading of the surrounding femoral bone. This normal loading would reduce excessive stress shielding, known to result in bone loss, and micromotions at the bone-implant interface, leading to aseptic prosthetic loosening. The design proposed is based on a hollow substructure made of hydroxyapatite-coated, continuous carbon fiber (CF) reinforced polyamide 12 (PA12) composite with an internal soft polymer-based core. Different composite configurations were studied to match the properties of host tissue. Nonlinear three-dimensional analysis of the hip prosthesis was carried out using a three-dimensional finite element bone model based on the composite femur. The performance of composite-based hip and titanium alloy-based (Ti-6Al-4V) stems embedded into femoral bone was compared. The effect of core stiffness and ply configuration was also analyzed. Results show that stresses in composite stem are lower than those in Ti stem, and that the femoral bone implanted with composite structure sustains more load than the one implanted with Ti stem. Micromotions in the composite stem are significantly smaller than those in Ti stem over the entire bone-implant surface because of the favorable interfacial stress distribution.

  18. Cemented total hip arthroplasty with Boneloc bone cement.

    Science.gov (United States)

    Markel, D C; Hoard, D B; Porretta, C A

    2001-01-01

    Boneloc cement (WK-345, Biomet Inc, Warsaw, Ind) attempted to improve cement characteristics by reducing exotherm during polymerization, lowering residual monomer and solubility, raising molecular weight, and lowering airborne monomer and aromatic amines. To study the efficacy of this cement, a selected group of 20 patients were prospectively enrolled and followed up after hip arthroplasty. All components were cemented. During the enrollment period, approximately 70 other hip arthroplasties were performed. Clinical evaluation was based on the Harris hip score. Radiographic evaluation was based on assessment of position of the components, subsidence, and/or presence of radiolucencies. Patients had follow-up for an average of 42 months (11 to 58 months); 1 was lost to follow-up. Of these, 7 (35%) had failure at last follow-up. Despite its initial promise, Boneloc cement had an unacceptably high failure rate over a relatively short follow-up period and is not recommended for use. Despite the longevity and odor toxicity problems with conventional bone cement, new cement technologies must be approached with caution.

  19. Risk-factors for surgical delay following hip fracture.

    Science.gov (United States)

    Sanz-Reig, J; Salvador Marín, J; Ferrández Martínez, J; Orozco Beltrán, D; Martínez López, J F

    To identify pre-operative risk factors for surgical delay of more than 2 days after admission in patients older than 65 years with a hip fracture. A prospective observational study was conducted on 180 hip fractures in patients older than 65 years of age admitted to our hospital from January 2015 to April 2016. The data recorded included, patient demographics, day of admission, pre-fracture comorbidities, mental state, level of mobility and physical function, type of fracture, antiaggregant and anticoagulant medication, pre-operative haemoglobin value, type of treatment, and surgical delay. The mean age of the patients was 83.7 years. The mean Charlson Index was 2.8. The pre-fracture baseline co-morbidities were equal or greater than 2 in 70% of cases. Mean timing of surgery was 3.1 days. At the time of admission, 122 (67.7%) patients were fit for surgery, of which 80 (44.4%) underwent surgery within 2 days. A Charlson index greater than 2, anticoagulant therapy, and admission on Thursday to Saturday, were independently associated with a surgical delay greater than 2 days. The rate of hip fracture patients undergoing surgery within 2 days is low. Risk factors associated to surgical delay are non-modifiable. However, their knowledge should allow the development of protocols that can reduce surgical delay in this group of patients. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. 27 CFR 25.94 - Strengthening bonds.

    Science.gov (United States)

    2010-04-01

    ...) Requirement. When the penal sum of the brewer's bond (calculated as provided in § 25.93) in effect is not... strengthening bond in sufficient penal sum if the surety is the same as on the bond in effect. If the surety is... bond may not in any way release a former bond or limit a bond to less than the full penal sum. (c)...

  1. Strengthening an affiliation without a merger.

    Science.gov (United States)

    Hegwer, Laura Ramos

    2015-04-01

    Froedtert Health and the Medical College of Wisconsin have created a shared governance structure with joint committees focused on value, IT, marketing, strategic planning, and other areas. A new funds-flow model shifts a percentage of the health system's bottom line to the medical college to support physician recruitment,joint initiatives, academic programs, and a strategic reserve. The strengthened affiliation has enhanced the ability of the organizations to engage in accountable care and population health initiatives, among other benefits.

  2. The ligamentum teres of the adult hip.

    Science.gov (United States)

    Bardakos, N V; Villar, R N

    2009-01-01

    Advances in hip arthroscopy have renewed interest in the ligamentum teres. Considered by many to be a developmental vestige, it is now recognised as a significant potential source of pain and mechanical symptoms arising from the hip joint. Despite improvements in imaging, arthroscopy remains the optimum method of diagnosing lesions of the ligamentum teres. Several biological or mechanical roles have been proposed for the ligament. Unless these are disproved, the use of surgical procedures that sacrifice the ligamentum teres, as in surgical dislocation of the hip, should be carefully considered. This paper provides an update on the development, structure and function of the ligamentum teres, and discusses associated clinical implications.

  3. The hip abductors at MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, A., E-mail: adrienne.hoffmann@balgrist.ch [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich (Switzerland); Pfirrmann, C.W.A., E-mail: christian.pfirrmann@balgrist.ch [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich (Switzerland)

    2012-12-15

    Imaging of the hip abductors plays an increasing role for the evaluation of greater trochanteric pain in patients with and without total hip arthroplasty. This review article addresses the anatomy of the hip abductors and their intervening bursae. It highlights different possible imaging appearances such as tendinopathy or partial and full thickness tears of the gluteal tendons. Muscle atrophy or fatty degeneration of the gluteal muscles is an important reason for limping. Inflammatory diseases such as hydroxyapatite crystal deposition disease or spondylarthritis have to be considered. Knowledge of these different entities is important to achieve optimal treatment and outcomes.

  4. Total hip arthroplasty after previous fracture surgery.

    Science.gov (United States)

    Krause, Peter C; Braud, Jared L; Whatley, John M

    2015-04-01

    Total hip arthroplasty can be a very effective salvage treatment for both failed fracture surgery and hip arthritis that may occur after prior fracture surgery. The rate of complications is significantly increased including especially infection, dislocation, and loosening. Complications are more likely to occur after failed open reduction and internal fixation than after posttraumatic arthritis. Adequately ruling out infection before hip arthroplasty can be difficult. The best predictor of infection is a prior infection. Long-term outcomes can be comparable to outcomes in other conditions if complications are avoided.

  5. Factors Affecting Postsurgery Hip Fracture Recovery

    Directory of Open Access Journals (Sweden)

    Sydney Wallace

    2014-12-01

    Full Text Available After hip fracture surgery, patients seldom return to their prefracture functional state and there is a 43% rate of mortality and institutionalisation of postsurgery hip fracture patients. A systematic literature review was conducted to identify preoperative, perioperative, postoperative, and psychosocial factors that may hinder postsurgery hip fracture patients from returning to previous functionality. Factors that were identified as being associated with postsurgical outcomes were age, muscle strength, prefracture living arrangements, number of daily medications taken, oxygen levels, fracture type and location, haemoglobin (Hb level, wait time prior to surgery, length of hospital stay (LOS, and dementia or depression.

  6. Anterior iliopsoas impingement after total hip arthroplasty.

    Science.gov (United States)

    Trousdale, R T; Cabanela, M E; Berry, D J

    1995-08-01

    Pain after total hip arthroplasty (THA) can be caused by a multitude of conditions, including infection, aseptic loosening, heterotopic ossification, and referred pain. It is also recognized that soft tissue inflammation about the hip, such as trochanteric bursitis, can lead to hip pain after THA. Two cases of persistent iliopsoas tendinitis following THA are reported, which are believed to be caused by psoas tendon impingement against a malpositioned, uncemented, metal-backed acetabular component. The authors are unaware of previous reports of this problem, and suggest that the problem be considered in the differential diagnosis of groin pain following THA.

  7. Dislocation following revision total hip arthroplasty.

    Science.gov (United States)

    Gioe, Terence J

    2002-04-01

    Dislocation is a relatively common complication following revision total hip arthroplasty. Risk factors include surgical approach, gender, underlying diagnosis, comorbidities, surgical experience, and previous surgery; for later dislocations, risk factors include wear/deformation of polyethylene, trauma, and decreased muscle strength. Prevention and precaution are the watchwords for dislocations following revision total hip arthroplasty. For dislocations that do occur, treatment rests first on identifying the source of instability. Most dislocations can be managed by closed reduction. Constrained components may increase success rates, but only for appropriate indications. Prevention and treatment of dislocations following revision total hip arthroplasty are discussed in this article.

  8. 够胆,Hip-Hop欢迎你

    Institute of Scientific and Technical Information of China (English)

    E.B.

    2012-01-01

    Hip-Hop音乐至今不过30多年历史,这个从无到有杀出重围的野孩子,血液里跳动着的满是突破条条框框、建立新秩序的冲劲。一切没有的,我们皆生造。没有比Hip-Hop圈的进入门槛再低的了。不问出身不论背景,只要你够胆,Hip-Hop欢迎你。

  9. Routine functional assessment for hip fracture patients

    DEFF Research Database (Denmark)

    Pedersen, Tonny J; Lauritsen, Jens M

    2016-01-01

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

  10. 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...

  11. Mid-term results of ReCap/Magnum/Taperloc metal-on-metal total hip arthroplasty with mean follow-up of 7.1 years.

    Science.gov (United States)

    Koutalos, Antonios A; Kourtis, Aristotelis; Clarke, Ian C; Smith, Evert J

    2017-05-12

    Despite enthusiasm for metal-on-metal bearings, disappointing short- to mid-term outcomes has all but halted the use of this bearing articulation. This review presents mid-term results for the ReCap Magnum total hip replacement. This prospective study evaluated 79 ReCap/Magnum/Taperloc total hip replacements with mean follow-up of 7.1 (range 3.7-9.2) years. 43 were female and 36 male. Metal ions were measured and radiographic measurement included a 'margin of safety' angle to quantify risk of edge loading. When a clinical suspicion of adverse reaction to metal debris was present, patients had metal artefact reduction sequence MRI. Harris Hip Score and Oxford Hip Score evaluated functional outcome and SF-12 and EQ-5L-5D assessed quality of life at final follow-up. 7 hips were revised indicating 91.1% survivorship at 7.1 years. Postoperative Harris Hip Score and Oxford Hip Score significantly improved. Females and symptomatic patients predicted increased metal ions. Margin of safety correlated with postoperative Oxford Hip Score. Symptomatic hips and positive MRI showed reduced survivorship. Compared to more traditional bearings like metal or ceramic on polyethylene the overall outcome of this ReCap/Magnum/Taperloc study cohort is modest. It is felt that further failures will occur in this group therefore cautious interpretation of the results is justified given the potential for reduced survival outcomes.

  12. Strengthening care of injured children globally.

    Science.gov (United States)

    Mock, Charles; Abantanga, Francis; Goosen, Jacques; Joshipura, Manjul; Juillard, Catherine

    2009-05-01

    Part of the solution to the growing problem of child injury is to strengthen the care that injured children receive. This paper will point out the potential health gains to be made by doing this and will then review recent advances in the care of injured children in individual institutions and countries. It will discuss how these individual efforts have been aided by increased international attention to trauma care. Although there are no major, well-funded global programmes to improve trauma care, recent guidance documents developed by WHO and a broad network of collaborators have stimulated increased global attention to improving planning and resources for trauma care. This has in turn led to increased attention to strengthening trauma care capabilities in countries, including needs assessments and implementation of WHO recommendations in national policy. Most of these global efforts, however, have not yet specifically addressed children. Given the special needs of the injured child and the high burden of injury-related death and disability among children, clearly greater emphasis on childhood trauma care is needed. Trauma care needs assessments being conducted in a growing number of countries need to focus more on capabilities for care of injured children. Trauma care policy development needs to better encompass childhood trauma care. More broadly, the growing network of individuals and groups collaborating to strengthen trauma care globally needs to engage a broader range of stakeholders who will focus on and champion the improvement of care for injured children.

  13. Comparison of acetabular reamings during hip resurfacing versus uncemented total hip arthroplasty.

    LENUS (Irish Health Repository)

    Brennan, S A

    2009-04-01

    PURPOSE: To compare the quantity of bone removed from the acetabulum during resurfacing hip arthroplasty versus uncemented total hip arthroplasty (THA). METHODS: 62 consecutive patients with osteoarthritis of the hip were prospectively studied. 24 men and 7 women aged 40 to 86 (mean, 59) years underwent Birmingham hip resurfacing. 13 men and 18 women aged 34 to 88 (mean, 61) years underwent uncemented THA using the trident acetabular cup. Obese elderly women at risk of femoral neck fracture and patients with large subchondral pseudocysts or a history of avascular necrosis of the femoral head were assigned to uncemented THA. Acetabular reamings were collected; marginal osteophytes were not included. The reamings were dehydrated, defatted, and weighed. RESULTS: The mean weight of acetabular reamings was not significantly different between patients undergoing hip resurfacing and uncemented THA (p=0.57). CONCLUSION: In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and removal of excessive bone stock.

  14. The prevalence of predisposing deformity in osteoarthritic hip joints

    DEFF Research Database (Denmark)

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

    2011-01-01

    relationship in both sexes with the clinical presentation. The study cohort which fulfilled these inclusion criteria consisted of 322 females (149 right hips and 173 left hips) and 162 males (77 right hips and 85 left hips) with osteoarthritis. We found an overall prevalence of predisposing hip deformities...... in females of 62.4% and in males of 78.9%. Minor and major deformities showed the same prevalence. Both sexes had a comparable prevalence of minor and major hip joint deformity, except for pistol grip deformity, which was more prevalent in men. We concluded that 'idiopathic osteoarthritis' is uncommon......, and that even minor predisposing deformities are associated with hip osteoarthritis....

  15. EFFECT OF KAPALBHATI PRANAYAMA ON WAIST AND HIP CIRCUMFERENCE

    Directory of Open Access Journals (Sweden)

    Dinkar

    2013-03-01

    Full Text Available ABSTRACT: CONTEXT (BACKGROUND AND AIMS: Rapid industrialization, environmental pollution, overcrowding, sedentary lifestyle and var ious stress factors are responsible for the deterioration of the physical health of a person. Als o, prevalence of obesity in developing countries is believed to be on the rise. This requi res special and specific techniques to transcend the limits of our physical and mental abilities exper ienced in everyday life. Hence, in the present study beneficial effect of Kapalbhati pranayama on wa ist circumference and hip circumference was studied in overweight individuals. METHODS AND MATERIALS: This study was conducted in a well-known tertiary hospital in Mumbai after th e institutional ethical clearance and written consent from each participant. A total of 60 overweig ht resident doctors were recruited in this study. The participants were divided into study and c ontrol groups, each group containing 30 subjects of both sexes. The study group was asked to perform Kapalbhati pranayama. The duration of the study was eight weeks. Waist circum ference and hip circumference were assessed in both the groups. STATISTICAL ANALYSIS: Paired t- test was applied for statistical analysis and p value <0.05 was considered the level of significance. RESULTS AND CONCLUSION: In study group, waist circumference and hip circumfe rence decreased significantly as compared to that of control group. T his shows that Kapalbhati pranayama has reducing impact on waist circumference and hip circum ference in overweight individuals. The neuroendocrine and autonomic nervous system mechani sms might be involved in the effects of Kapalbhati pranayama, which need further study.

  16. The hip and knee replacement operation: an extensive life event.

    Science.gov (United States)

    Gustafsson, Birgitta Åkesdotter; Ekman, Sirkka-Liisa; Ponzer, Sari; Heikkilä, Kristiina

    2010-12-01

    A total hip replacement and a total knee replacement have shown to effectively reduce pain and disability in patients with osteoarthritis of the hip and knee joint despite associated risks. Even though the intervention primarily concerns older people with additional health problems, the patients stand on their feet the day after the operation and are discharged a few days later. Previous research indicates that reflections about life are related to the operation. The aim of this study was to illuminate the meaning of reflections related to hip and knee replacement surgery. A phenomenological hermeneutical approach with a longitudinal design was chosen in order to study the participants' experiences of the hip and knee replacement intervention across the entire perioperative period. Four themes emerged from the structural analysis; choosing the challenge, past memories connect to the current situation, moving from happiness to ordinary everyday life and moving from despair towards reluctant acceptance of unexpected bad conditions for everyday life. There was inner negotiations about having surgery or not, and existential anxiety that reminded people that life cannot be taken for granted. Our findings indicate the operation was seen as an extensive life event including reflections about life and death and about hope and fear. Previous bad experiences of care seemed to influence the way patients dealt with fear and hope. Fear had to be overcome by inner negotiations about undergoing surgery or not. Relief was expressed about surviving the actual operation, but soon after fears arose about how to manage on the actual road to recovery. Hope for a good life grew either stronger or weaker, depending on the progress following the operation. The outcome eventually generated a transition from happiness to ordinary everyday life, or a transition from despair towards reluctant acceptance of unfulfilled expectations. © 2010 The Authors. Scandinavian Journal of Caring Sciences

  17. On the permanent hip-stabilizing effect of atmospheric pressure.

    Science.gov (United States)

    Prietzel, Torsten; Hammer, Niels; Schleifenbaum, Stefan; Kaßebaum, Eric; Farag, Mohamed; von Salis-Soglio, Georg

    2014-08-22

    Hip joint dislocations related to total hip arthroplasty (THA) are a common complication especially in the early postoperative course. The surgical approach, the alignment of the prosthetic components, the range of motion and the muscle tone are known factors influencing the risk of dislocation. A further factor that is discussed until today is atmospheric pressure which is not taken into account in the present THA concepts. The aim of this study was to investigate the impact of atmospheric pressure on hip joint stability. Five joint models (Ø 28-44 mm), consisting of THA components were hermetically sealed with a rubber capsule, filled with a defined amount of fluid and exposed to varying ambient pressure. Displacement and pressure sensors were used to record the extent of dislocation related to intraarticular and ambient pressure. In 200 experiments spontaneous dislocations of the different sized joint models were reliably observed once the ambient pressure was lower than 6.0 kPa. Increasing the ambient pressure above 6.0 kPa immediately and persistently reduced the joint models until the ambient pressure was lowered again. Displacement always exceeded half the diameter of the joint model and was independent of gravity effects. This experimental study gives strong evidence that the hip joint is permanently stabilized by atmospheric pressure, confirming the theories of Weber and Weber (1836). On basis of these findings the use of larger prosthetic heads, capsular repair and the deployment of an intracapsular Redon drain are proposed to substantially decrease the risk of dislocation after THA.

  18. Effect of HIP/ribosomal protein L29 deficiency on mineral properties of murine bones and teeth.

    Science.gov (United States)

    Sloofman, Laura G; Verdelis, Kostas; Spevak, Lyudmila; Zayzafoon, Majd; Yamauchi, Mistuo; Opdenaker, Lynn M; Farach-Carson, Mary C; Boskey, Adele L; Kirn-Safran, Catherine B

    2010-07-01

    Mice lacking HIP/RPL29, a component of the ribosomal machinery, display increased bone fragility. To understand the effect of sub-efficient protein synthetic rates on mineralized tissue quality, we performed dynamic and static histomorphometry and examined the mineral properties of both bones and teeth in HIP/RPL29 knock-out mice using Fourier transform infrared imaging (FTIRI). While loss of HIP/RPL29 consistently reduced total bone size, decreased mineral apposition rates were not significant, indicating that short stature is not primarily due to impaired osteoblast function. Interestingly, our microspectroscopic studies showed that a significant decrease in collagen crosslinking during maturation of HIP/RPL29-null bone precedes an overall enhancement in the relative extent of mineralization of both trabecular and cortical adult bones. This report provides strong genetic evidence that ribosomal insufficiency induces subtle organic matrix deficiencies which elevates calcification. Consistent with the HIP/RPL29-null bone phenotype, HIP/RPL29-deficient teeth also showed reduced geometric properties accompanied with relative increased mineral densities of both dentin and enamel. Increased mineralization associated with enhanced tissue fragility related to imperfection in organic phase microstructure evokes defects seen in matrix protein-related bone and tooth diseases. Thus, HIP/RPL29 mice constitute a new genetic model for studying the contribution of global protein synthesis in the establishment of organic and inorganic phases in mineral tissues.

  19. Living history in current orthopaedic hip surgery: intrapelvic teflon granuloma after total hip replacement.

    Science.gov (United States)

    Gheorghiu, Daniel; Peter, Viju; Lynch, Martin

    2010-02-01

    The teflon hip arthroplasty design was used by Sir John Charnley in the early 60's but was taken off the market due to high complication rates. A case is reported of an intrapelvic granuloma after total hip arthroplasty following the use of a teflon socket. This appears to be the last surviving patient treated by Sir John Charnley using a Teflon hip socket design.

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

    Directory of Open Access Journals (Sweden)

    Chatla

    2016-03-01

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