Integrating a hip belt with body armour reduces the magnitude and changes the location of shoulder pressure and perceived discomfort in soldiers.

Science.gov (United States)

Lenton, Gavin K; Doyle, Tim L A; Saxby, David J; Billing, Dan; Higgs, Jeremy; Lloyd, David G

2018-04-01

Soldiers carry heavy loads that may cause general discomfort, shoulder pain and injury. This study assessed if new body armour designs that incorporated a hip belt reduced shoulder pressures and improved comfort. Twenty-one Australian soldiers completed treadmill walking trials wearing six different body armours with two different loads (15 and 30 kg). Contact pressures applied to the shoulders were measured using pressure pads, and qualitative assessment of comfort and usability were acquired from questionnaires administered after walking trials. Walking with hip belt compared to no hip belt armour resulted in decreased mean and maximum shoulder pressures (p armour and backpack designs should integrate a hip belt and distribute load closer to shoulder midline to reduce load carriage discomfort and, potentially, injury risk. Practitioner Summary: Soldiers carry heavy loads that increase their risk of discomfort and injury. New body armour designs are thought to ease this burden by transferring the load to the hips. This study demonstrated that designs incorporating a hip belt reduced shoulder pressure and shoulder discomfort compared to the current armour design.

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

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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.)

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

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

2017-08-01

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 35:1774-1783, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

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.

The effect and clinical significance of Shuxuetong injection on the changes of plasma TXB2 and 6-Keto-PGF1α levels in patients after hip orthopedic operation

International Nuclear Information System (INIS)

Mao Zhaoguang; Xu Shenggen; Wu Qingxin; Zhu Huihua; Liu Bingsheng; Yu Binwei; Xu Shang'ao; Zheng Yihua

2011-01-01

Objective: To investigate shuxuetong injection on the changes of thromboxane B 2 (TXB 2 ) and 6-keto-prostacyclin(6-Keto-PGF 1α ) levels on the patients after hip orthopedic operation and its clinical significance. Methods: 50 hip orthopedic surgery patients were randomly divided into the shuxuetong group and the low-molecular-weight heparin (LMWH) group. Both groups were treated with conventional therapy. Shuxuetong group were 23 cases, including 7 cases of total hip replacement (THR), 16 patients of internal fixation after hip fracture. Each patient were given Shuxuetong intravenous injection 6 ml once a day, LMWH group contain 27 patients, including 9 cases of total hip replacement(THR), 18 patients of applying internal fixation to hip fracture. Each patient was given LMWH 5000 IU subcutaneously once daily. Both groups were treated for 14 days. In the day of surgery and the morning after therapy,fasting venous blood were collected respectively. The levels of plasma TXB 2 and 6-Keto-PGF 1α were measured by radioimmunoassay. Seven days after the surgery, patients in both groups were given low extremity venography examination. The changes of TXB 2 , 6-Keto-PGF 1α level and the incidence of lower extremity deep vein thrombosis (DVT) between two groups were compared before and after treatment. Results: The levels of TXB 2 and 6-Keto-PGF 1α is not mach significant difference between the two groups before treatment (P>0.05). After treatment,the increased of 6-Keto-PGF 1α and the decreased of TXB 2 were statistically significant difference (P 1α level of LMWH group was significantly higher after the treatment (P 2 had no obvious difference (P>0.05). The levels of TXB 2 and 6-Keto-PGF 1α was significant difference between the two groups after treatment(P 0.05). Two groups were not found more intraoperative and postoperative bleeding and the consequent adverse reactions. Conclusion: Shuxuetong injection adjust the plasma TXB 2 /6-Keto-PGF 1α balance after hip

Comparison of orally administered bisphosphonate drugs in reducing the risk of hip fracture in older adults: a population-based cohort study.

Science.gov (United States)

Cadarette, Suzanne M; Lévesque, Linda; Mamdani, Muhammad; Perreault, Sylvie; Juurlink, David N; Paterson, J Michael; Carney, Greg; Gunraj, Nadia; Hawker, Gillian A; Tadrous, Mina; Wong, Lindsay; Dormuth, Colin R

2013-09-01

Orally administered bisphosphonate drugs (i.e., alendronate, etidronate, risedronate) can reduce the risk of vertebral fracture. However, only alendronate and risedronate have proven efficacy in reducing the risk of hip fracture. We sought to examine the comparative effectiveness of orally administered bisphosphonate drugs in reducing hip fractures among older adults. We identified new users of orally administered bisphosphonate drugs in British Columbia and Ontario between 2001 and 2008. We used province- and sex-specific propensity score-matching strategies to maximize comparability between exposure groups. We used Cox proportional hazards models to compare time-to-hip fracture within 1 year of treatment between exposures by sex in each province. Our secondary analyses considered hip fracture rates within 2 and 3 years' follow-up. We used alendronate as the reference for all comparisons and pooled provincial estimates using random effects variance-weighted meta-analysis. We identified 321 755 patients who were eligible for inclusion in the study. We found little difference in fracture rates between men (pooled hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.74-1.14) or women (pooled HR 1.15, 95% CI 0.73-1.56) taking risedronate and those taking alendronate. We similarly identified little difference in fracture rates between women taking etidronate and those taking alendronate (pooled HR 1.00, 95% CI 0.82-1.18). However, we identified lower rates of hip fracture among men taking etidronate relative to alendronate (pooled HR 0.77, 95% CI 0.60-0.94). Results extended to 2 and 3 years' follow-up were similar. However, with 3 years' follow-up, rates of hip fracture were lower among women in British Columbia who had taken alendronate. We identified little overall difference between alendronate and risedronate in reducing the risk of hip fracture in men or women. Our finding that etidronate is associated with lower fracture risk among men is likely due to

Developmental dysplasia of the hip: impact of sonographic newborn hip screening on the outcome of early treated decentered hip joints-a single center retrospective comparative cohort study based on Graf's method of hip ultrasonography.

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Tschauner, Christian; Fürntrath, Frank; Saba, Yasaman; Berghold, Andrea; Radl, Roman

2011-12-01

PURPOSE/BACKGROUND/INTRODUCTION: The aim of this study was to retrospectively evaluate the impact of neonatal sonographic hip screening using Graf's method for the management and outcome of orthopaedic treatment of decentered hip joints with developmental dysplasia of the hip (DDH), using three decades (1978-2007) of clinical information compiled in a medical database. Three representative cohorts of consecutive cases of decentered hip joints were selected according to different search criteria and inclusion and exclusion parameters: (1) cohort 1 (1978-1982; n = 80), without sonographic screening; (2) cohort 2.1 (1994-1996; n = 91), with nationwide established general sonographic screening according to the Graf-method; (3) cohort 2.2 (2003-2005; n = 91), with sonographic screening including referred cases for open reduction from non-screened populations. These three cohorts were compared for the following parameters: age at initial treatment, successful closed reduction, necessary overhead traction, necessary adductor-tenotomy, rate of open reduction, rate of avascular necrosis (AVN) and rate of secondary acetabuloplasty. The age at initial treatment was reduced from 5.5 months in the first cohort to 2 months in the two subsequent two cohorts and the rate of successful closed reduction increased from 88.7 to 98.9 and 95.6%, respectively. There was a statistically significant improvement in six out of seven parameters with sonographic hip screening; only the rate of secondary acetabuloplasty did not improve significantly. Compared to the era before the institution of a sonographic hip screening programme according to the Graf-method in Austria in 1992, ultrasound screening based-treatment of decentered hip joints has become safer, shorter and simpler: "safer" means lower rate of AVN, "shorter" means less treatment time due to earlier onset and "simpler" means that the devices are now less invasive and highly standardized.

There Is a Significant Discrepancy Between "Big Data" Database and Original Research Publications on Hip Arthroscopy Outcomes: A Systematic Review.

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Sochacki, Kyle R; Jack, Robert A; Safran, Marc R; Nho, Shane J; Harris, Joshua D

2018-06-01

The purpose of this study was to compare (1) major complication, (2) revision, and (3) conversion to arthroplasty rates following hip arthroscopy between database studies and original research peer-reviewed publications. A systematic review was performed using PRISMA guidelines. PubMed, SCOPUS, SportDiscus, and Cochrane Central Register of Controlled Trials were searched for studies that investigated major complication (dislocation, femoral neck fracture, avascular necrosis, fluid extravasation, septic arthritis, death), revision, and hip arthroplasty conversion rates following hip arthroscopy. Major complication, revision, and conversion to hip arthroplasty rates were compared between original research (single- or multicenter therapeutic studies) and database (insurance database using ICD-9/10 and/or current procedural terminology coding terminology) publishing studies. Two hundred seven studies (201 original research publications [15,780 subjects; 54% female] and 6 database studies [20,825 subjects; 60% female]) were analyzed (mean age, 38.2 ± 11.6 years old; mean follow-up, 2.7 ± 2.9 years). The database studies had a significantly higher age (40.6 + 2.8 vs 35.4 ± 11.6), body mass index (27.4 ± 5.6 vs 24.9 ± 3.1), percentage of females (60.1% vs 53.8%), and longer follow-up (3.1 ± 1.6 vs 2.7 ± 3.0) compared with original research (P database studies (P = .029; relative risk [RR], 1.3). There was a significantly higher rate of femoral neck fracture (0.24% vs 0.03%; P database studies. Reoperations occurred at a significantly higher rate in the database studies (11.1% vs 7.3%; P database studies (8.0% vs 3.7%; P Database studies report significantly increased major complication, revision, and conversion to hip arthroplasty rates compared with original research investigations of hip arthroscopy outcomes. Level IV, systematic review of Level I-IV studies. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights

Impaired hip muscle strength in patients with femoroacetabular impingement syndrome.

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Kierkegaard, Signe; Mechlenburg, Inger; Lund, Bent; Søballe, Kjeld; Dalgas, Ulrik

2017-12-01

Patients with femoroacetabular impingement (FAI) experience hip pain as well as decreased function and lowered quality of life. The aim was to compare maximal isometric and isokinetic muscle strength (MVC) during hip flexion and extension and rate of force development (RFD) during extension between patients with FAI and a matched reference group. Secondary, the aim was to compare patient hips and subgroups defined by gender and age as well as to investigate associations between hip muscle strength and self-reported outcomes. Design Cross-sectional, comparative study Methods Sixty patients (36±9 years, 63% females) and 30 age and gender matched reference persons underwent MVC tests in an isokinetic dynamometer. During hip flexion and extension, patients' affected hip showed a strength deficit of 15-21% (phip of the patients was significantly weaker than their contralateral hip. RFD was significantly decreased for both patient hips compared to the reference group (phip muscle strength. Patients with FAI demonstrate decreased hip flexion and extension strength when compared to (1) reference persons and (2) their contralateral hip. There seems to be a gender specific affection which should be investigated further and addressed when planning training protocols. Furthermore, self-reported measures were associated with isometric muscle strength, which underlines the clinical importance of the reduced muscle strength. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Danish Hip Arthroscopy Registry

DEFF Research Database (Denmark)

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

2016-01-01

Danish Hip Arthroscopy Registry (DHAR) was initiated in 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the epidemiologic and perioperative data of the first 2000 procedures in a Danish hip arthroscopy population and to describe the development of DHAR...... was 0.65 and HAGOS sub-scores were 51 (pain), 49 (symptoms), 53 (ADL), 35 (sport), 20 (physical activity) and 29, respectively. We conclude that patients undergoing hip arthroscopy report considerable pain, loss of function, reduced level of activity and reduced quality-of-life prior to surgery....... 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...

Modular femoral component for conversion of previous hip surgery in total hip arthroplasty.

Science.gov (United States)

Goldstein, Wayne M; Branson, Jill J

2005-09-01

The conversion of previous hip surgery to total hip arthroplasty creates a durable construct that is anatomically accurate. Most femoral components with either cemented or cementless design have a fixed tapered proximal shape. The proximal femoral anatomy is changed due to previous hip surgery for fixation of an intertrochanteric hip fracture, proximal femoral osteotomy, or a fibular allograft for avascular necrosis. The modular S-ROM (DePuy Orthopaedics Inc., Warsaw, Ind) hip stem accommodates these issues and independently prepares the proximal and distal portion of the femur. In preparation and implantation, the S-ROM hip stem creates less hoop stresses on potentially fragile stress risers from screws and thin bone. The S-ROM hip stem also prepares a previously distorted anatomy by milling through cortical bone that can occlude the femoral medullar canals and recreate proper femoral anteversion and reduces the risk of intraoperative or postoperative periprosthetic fracture due to the flexible titanium-slotted stem. The S-ROM femoral stem is recommended for challenging total hip reconstructions.

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

International Nuclear Information System (INIS)

Vossinakis, I.C.; Georgiades, G.; Hartofilakidis, G.; Kafidas, D.

2008-01-01

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.)

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

DEFF Research Database (Denmark)

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

2007-01-01

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

Effectiveness of fluoroscopy-guided intra-articular steroid injection for hip osteoarthritis

International Nuclear Information System (INIS)

Subedi, N.; Chew, N.S.; Chandramohan, M.; Scally, A.J.; Groves, C.

2015-01-01

Aim: To demonstrate the benefits of fluoroscopy-guided intra-articular steroid injection in the hip with varying degrees of disease severity, and to investigate the financial aspects of the procedure and impact on waiting time. Materials and methods: A prospective study was undertaken of patients who underwent fluoroscopic intra-articular steroid injection over the 9-month study period. Comparative analysis of the Oxford hip pain score pre- and 6–8 weeks post-intra-articular injection was performed. Hip radiographs of all patients were categorised as normal, mild, moderate, or severe disease (four categories) based on the modified Kellgren–Lawrence severity scale, and improvement on the Oxford hip pain score on each of these four severity categories were assessed. Results: Within the study cohort of 100 patients, the mean increase in post-procedure hip score of 7.32 points confirms statistically significant benefits of the therapy (p<0.001, 95% confidence interval: 5.55–9.09). There was no significant difference in pre-injection hip score or change in score between the four severity categories (p=0.51). Significant improvement in hip score (p<0.05) was demonstrated in each of the four severity categories 6–8 weeks post-injection. No associated complications were observed. Conclusion: The present study confirms that fluoroscopy-guided intra-articular steroid injection is a highly effective therapeutic measure for hip osteoarthritis across all grades of disease severity with significant cost savings and the potential to reduce waiting times. - Highlights: • Comparable clinical effectiveness of fluoroscopy guided and theatre based therapeutic intra-articular hip injections. • Significant cost savings on fluoroscopy guided hip injection performed in a radiology department. • A potential reduction in patients' waiting time for the procedure.

Lifestyle and health-related quality of life in Asian patients with total hip arthroplasties.

Science.gov (United States)

Fujita, Kimie; Xia, Zhenlan; Liu, Xueqin; Mawatari, Masaaki; Makimoto, Kiyoko

2014-09-01

Total hip arthroplasty reduces pain and restores physical function in patients with hip joint problems. This study examined lifestyle and health-related quality of life before and after total hip arthroplasty in Japanese and Chinese patients. Two hospitals in China recruited 120 patients and 120 Japanese patients matched by age and operative status were drawn from a prospective cohort database. Oxford Hip Score, EuroQol, and characteristics of Asian lifestyle and attitudes toward the operation were assessed. There were no differences between patients from the two countries in quality-of-life-scale scores: postoperative patients had significantly better quality-of-life scores than preoperative patients in both countries. In China, patients who reported that living at home was inconvenient had significantly worse Oxford Hip Scores than those who did not. Mean scores for anxiety items concerning possible dislocation and durability of the implant were significantly higher in Japanese than in Chinese subjects. Our findings suggest that providing information about housing conditions and lifestyles would result in improved quality of life and reduced anxiety in patients with implanted joints. © 2014 Wiley Publishing Asia Pty Ltd.

Joint Moment-Angle Properties of the Hip Extensors in Subjects With and Without Patellofemoral Pain.

Science.gov (United States)

Kindel, Curtis; Challis, John

2018-04-01

Strength deficits of hip extension in individuals with patellofemoral syndrome are commonly reported in literature. No literature to date has examined these deficits with variable positions of the knee and hip; altering knee angle alters the length and therefore potentially the force produced by the biarticular muscles. Beyond strength, neuromuscular control can also be assessed through the analysis of isometric joint moment steadiness. Subjects consisted of a group of individuals with patellofemoral syndrome (n = 9), and a group of age- and size-matched controls with no symptoms (n = 9). Maximum isometric joint moments for hip extension were measured at 4 points within the joint's range of motion, at 2 different knee positions (0° and 90°) for each group. The joint moment signals were analyzed by computing signal Coefficient of Variation (CV). The results indicate that no significant differences were found between the groups of subjects for the hip extension moments when the knee was extended. However, there was a significant difference between the groups for the joint moments of hip extension with the knee flexed at all 4 hip positions. Results also showed hip extension CV values to be significantly higher in the patellofemoral group compared with the control group, indicating greater signal noise and therefore poorer neuromuscular control of the hip extensor musculature. This study demonstrated that individuals with patellofemoral syndrome have reduced hip extension strength and reduced neuromuscular control with the knee flexed compared with a control group. These results have implications for the etiology of patellofemoral syndrome and its rehabilitation.

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

Directory of Open Access Journals (Sweden)

Ines Kutzner

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

Inpatient cost for hip fracture patients managed with an orthogeriatric care model in Singapore.

Science.gov (United States)

Tan, Lester Teong Jin; Wong, Seng Joung; Kwek, Ernest Beng Kee

2017-03-01

The estimated incidence of hip fractures worldwide was 1.26 million in 1990 and is expected to double to 2.6 million by 2025. The cost of care for hip fracture patients is a significant economic burden. This study aimed to look at the inpatient cost of hip fractures among elderly patients placed under a mature orthogeriatric co-managed system. This study was a retrospective analysis of 244 patients who were admitted to the Department of Orthopaedics of Tan Tock Seng Hospital, Singapore, in 2011 for hip fractures under a mature orthogeriatric hip fracture care path. Information regarding costs, surgical procedures performed and patient demographics was collected. The mean cost of hospitalisation was SGD 13,313.81. The mean cost was significantly higher for the patients who were managed surgically than for the patients who were managed non-surgically (SGD 14,815.70 vs. SGD 9,011.38; p 48 hours was SGD 2,716.63. Reducing the time to surgery and preventing pre- and postoperative complications can help reduce overall costs. A standardised care path that empowers allied health professionals can help to reduce perioperative complications, and a combined orthogeriatric care service can facilitate prompt surgical treatment. Copyright: © Singapore Medical Association

Revision hip preservation surgery with hip arthroscopy: clinical outcomes.

Science.gov (United States)

Domb, Benjamin G; Stake, Christine E; Lindner, Dror; El-Bitar, Youseff; Jackson, Timothy J

2014-05-01

To analyze and report the clinical outcomes of a cohort of patients who underwent revision hip preservation with arthroscopy and determine predictors of positive and negative outcomes. During the study period from April 2008 to December 2010, all patients who underwent revision hip preservation with arthroscopy were included. This included patients who had previous open surgery and underwent revision with arthroscopy. Patient-reported outcome (PRO) scores were obtained preoperatively and at 3-month, 1-year, 2-year, and 3-year follow-up time points. Any revision surgeries and conversions to total hip arthroplasty were noted. A multiple regression analysis was performed to look for positive and negative predictive factors for improvement in PROs after revision hip arthroscopy. Forty-seven hips in 43 patients had completed 2 years' follow-up or needed total hip arthroplasty. The mean length of follow-up was 29 months (range, 24 to 47 months). Of the hips, 31 (66%) had either unaddressed or incompletely treated femoroacetabular impingement. There was a significant improvement in all PRO scores at a mean of 29 months after revision (P arthroscopy can achieve moderately successful outcomes and remains a viable treatment strategy after failed primary hip preservation surgery. Preoperative predictors of success after revision hip arthroscopy include segmental labral defects, unaddressed or incompletely addressed femoroacetabular impingement, heterotopic ossification, and previous open surgery. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

EFFECTIVENESS OF RADIOFREQUENCY DENERVATION FOR PAIN RELIEF IN HIP DEGENERATIVE DISEASES

Directory of Open Access Journals (Sweden)

G. I. Nazarenko

2014-01-01

Full Text Available Objective - to compare the effectiveness of radiofrequency denervation (RFD and conservative treatment of patients with hip degenerative diseases. Material and methods. 66 patients with various stages of hip degeneration were followed up for 12 months, including 36 patients who underwent RFD and 30 patients of control group with conservative treatment. Treatment results were assessed using Visual Analogue Scale (VAS and Harris Hip Score before treatment, during the first day, 2 days later, as well as at 1, 6 and 12 months. Results: RFD patients demonstrated significantly better results compared with conservative group. Patients with coxarthrosis stage I and II, besides higher efficiency had prolonged period of remission, while patients with coxarthrosis stage III returned to the near-baseline level of pain only in 3-6 months. Conclusions: RFD is an effective treatment modality for patients with initial coxarthrosis stages, which helps to reduce significantly the disability period compared with conservative therapy. RFD is the only method of effective hip pain relieve in patients with severe comorbidities allowing to reduce analgesic consumption. This method is minimally invasive, has low cost, permits repeated procedures, making it attractive for both physicians and patients.

Don't forget the hip! Hip arthritis masquerading as knee pain

Directory of Open Access Journals (Sweden)

Florian F. Dibra, MD

2018-03-01

Full Text Available Background: Hip osteoarthritis typically manifests with groin or thigh pain. Other atypical pain patterns, including knee pain, have been described. Except for 2 case reports, there is no literature on this subject. Methods: From our institutional database, between 2011 and 2016, we identified 21 patients who were referred for treatment of knee pain but ultimately diagnosed with hip pathology as the cause of their pain. This group was evaluated for duration of symptoms prior to diagnosis, previous interventions, presence of walking aids, and symptom resolution after treatment of the hip pathology. Results: Fifteen of the 21 patients were referred from musculoskeletal providers (12 from orthopaedic surgeons. Prior to diagnosis of the hip etiology, 16 patients were reduced to major assistive devices including wheelchairs. Twelve of 21 patients had undergone surgical knee interventions, including total knee arthroplasty, with minimal to no relief of their pain. Seventeen of 21 referred patients underwent total hip arthroplasty at our institution. Fourteen patients had complete resolution of knee pain after total hip arthroplasty. Conclusions: Although knee pain referred from hip disease may be considered a basic and common knowledge, it continues to be an overlooked phenomenon. Most of the cases were misdiagnosed by musculoskeletal providers including orthopaedic surgeons and this highlights the need for continued education and awareness of this clinical scenario. Keywords: Hip pain, Knee pain, Referred pain, Delay in diagnosis, Unnecessary surgery

Manual calf massage and passive ankle motion reduce the incidence of deep vein thromboembolism after total hip arthroplasty.

Science.gov (United States)

Imai, Norio; Ito, Tomoyuki; Suda, Ken; Miyasaka, Dai; Endo, Naoto

2017-07-01

Venous thromboembolism is one of the general complications following total hip arthroplasty, wherein various preventive treatments have been recommended. Several studies reported that venous thromboembolism incidence after total hip arthroplasty was similar in patients who were administered prophylaxis with a conventional mechanical procedure alone, and those who were administered pharmacological anticoagulation therapy. Therefore, the optimum methods of prophylaxis are still controversial. The purpose of this study was to investigate whether manual calf massage and passive ankle motion could lower the risk for venous thromboembolism after total hip arthroplasty. We retrospectively reviewed the data of 126 consecutive patients undergoing elective primary unilateral total hip arthroplasty wherein manual calf massage and passive ankle motion were performed after the surgery at our hospitals between January and October 2014. The 138 patients of the control group underwent total hip arthroplasty using the same surgical approach and pre- and postoperative protocols without this mechanical prophylaxis between January and December 2013. This mechanical prophylaxis was performed simultaneously 30 times during approximately 10 s; these procedures were repeated thrice immediately after total hip arthroplasty. Duplex ultrasonography was performed to observe the veins of both legs in all the patients on postoperative day 7. The incidence of deep vein thrombosis was 6.52% and 0.79% in the control and manual calf massage and passive ankle motion groups, respectively. The odds ratio for the manual calf massage and passive ankle motion groups was 8.72. Performing this mechanical prophylaxis reduced the incidence of venous thromboembolism after total hip arthroplasty. This mechanical prophylaxis is not only simple and easy, but is also safe and inexpensive. We therefore recommend that manual calf massage and passive ankle motion be performed in patients who will undergo total hip

Reduced survival for uncemented compared to cemented total hip arthroplasty after operatively treated acetabular fractures.

Science.gov (United States)

Clarke-Jenssen, John; Westberg, Marianne; Røise, Olav; Storeggen, Stein Arne Øvre; Bere, Tone; Silberg, Ingunn; Madsen, Jan Erik

2017-11-01

Post traumatic arthritis and avascular necrosis of the femoral head are common complications after operatively treated acetabular fractures. This may cause severe disabilities for the patient, necessitating a total hip arthroplasty. Even though an arthroplasty may provide good symptomatic relief, the long-term results are more uncertain and no consensus exists according to preferred prosthetic designs. With this cohort study, we aimed to investigate the medium to long term arthroplasty survival and clinical results of total hip arthroplasty after operatively treated acetabular fractures. We included 52 patients treated with a secondary total hip arthroplasty at a median of 2.4 (0.1-14.1) years after an operatively treated acetabular fracture. The median age was 54 (11-82) years. Cemented arthroplasty was used for 33 patients, 10 patients had an uncemented arthroplasty and 9 patients received a hybrid arthroplasty. Average follow up was 8.0 (SD 5.0) years. Ten-year revision free arthroplasty survival was 79%. Uncemented arthroplasties had a significantly worse 10-year survival of 57%. Arthroplasties performed at a centre without a pelvic fracture service also had a significantly worse 10-years survival of 51%. Cox regression showed similar results with an 8-fold increase in risk of revision for both uncemented arthroplasties and operations performed at a non-pelvic trauma centre. Total hip arthroplasty secondary to an operatively treated acetabular fracture provides good symptomatic relief. These patients are, however, complex cases and are probably best treated at specialist centres with both pelvic trauma surgeons and arthroplasty surgeons proficient in complex revisions present. Copyright © 2017 Elsevier Ltd. All rights reserved.

Seasonality of service provision in hip and knee surgery: a possible contributor to waiting times? A time series analysis.

Science.gov (United States)

Upshur, Ross E G; Moineddin, Rahim; Crighton, Eric J; Mamdani, Muhammad

2006-03-01

The question of how best to reduce waiting times for health care, particularly surgical procedures such as hip and knee replacements is among the most pressing concern of the Canadian health care system. The objective of this study was to test the hypothesis that significant seasonal variation exists in the performance of hip and knee replacement surgery in the province of Ontario. We performed a retrospective, cross-sectional time series analysis examining all hip and knee replacement surgeries in people over the age of 65 in the province of Ontario, Canada between 1992 and 2002. The main outcome measure was monthly hospitalization rates per 100,000 population for all hip and knee replacements. There was a marked increase in the rate of hip and knee replacement surgery over the 10-year period as well as an increasing seasonal variation in surgeries. Highly significant (Fisher Kappa = 16.05, p Holidays and utilization caps appear to exert a significant influence on the rate of service provision. It is expected that waiting times for hip and knee replacement could be reduced by reducing seasonal fluctuations in service provision and benchmarking services to peak delivery. The results highlight the importance of system behaviour in seasonal fluctuation of service delivery.

Effect of postoperative epidural analgesia on rehabilitation and pain after hip fracture surgery

DEFF Research Database (Denmark)

Foss, Nicolai Bang; Kristensen, Morten Tange; Kristensen, Billy Bjarne

2005-01-01

Hip fracture surgery usually carries a high demand for rehabilitation and a significant risk of perioperative morbidity and mortality. Postoperative epidural analgesia may reduce morbidity and has been shown to facilitate rehabilitation in elective orthopedic procedures. No studies exist...... on the effect of postoperative epidural analgesia on pain and rehabilitation after hip fracture surgery....

Resolving controversies in hip fracture care: the need for large collaborative trials in hip fractures

NARCIS (Netherlands)

Bhandari, Mohit; Sprague, Sheila; Schemitsch, Emil H.; Einhorn, Thomas; Guyatt, Gordon H.; Haidukewych, George; Keating, John; Koval, Kenneth; Rosen, Clifford; Swiontkowski, Marc; Tornetta, Paul; Walter, Stephen D.; Motsitsi, Silas; Pei, Fuxing; Yang, Tian-fu; Zhou, Zong-ke; Arora, Shobha; Babhulkar, Sushrut; Bhargava, Rakesh; Desai, Mohan M.; Dhillon, Mandeep S.; Gill, Harpreet Singh; Goel, S. C.; Reddy, A. V. Gurava; Jain, Anil K.; Kalore, Niraj V.; Kammatkar, Nitin; Kumar, Vijay; Malhorta, Rajesh; Marthandam, S. S. K.; Pankaj, Amite; Patinharayil, Gopinathan; Rai, B. Sachidanand; Ramteke, Alankar Ambadas; Sancheti, Parag K.; Thakkar, Navin N.; Thomas, George S.; Robinson, Dror; Steinberg, Ely; Higuchi, Fujio; Kawamura, Sumito; Ohashi, Hirotsugu; Sawaguchi, Takeshi; Park, Myung-Sik; Yun, Ho Hyun; Poduval, Murali; Siddiqui, Ahmed; Chang, Je-Ken; Wang, Gwo-Jaw; Goslings, J. Carel

2009-01-01

Hip fractures are a significant cause of morbidity and mortality worldwide and the burden of disability associated with hip fractures globally vindicate the need for high-quality research to advance the care of patients with hip fractures. Historically, large, multi-centre randomized controlled

Effectiveness of acute in-hospital physiotherapy with knee-extension strength training in reducing strength deficits in patients with a hip fracture: A randomised controlled trial.

Directory of Open Access Journals (Sweden)

Lise Kronborg

Full Text Available 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?Assessor blinded, randomised controlled trial with intention-to-treat analysis.90 patients with a hip fracture admitted to an acute orthopaedic Hip Fracture Unit at a university hospital between October 2013 and May 2015.Daily physiotherapy with or without progressive knee-extension strength training (10RM, 3 x 10 repetitions, of the fractured limb using ankle weight cuffs conducted by ward physical therapists during hospital stay.Primary outcome was the change in maximal isometric knee-extension strength in the fractured limb in percentage of the non-fractured limb from inclusion to postoperative day 10 or discharge (follow-up. Secondary outcome was Timed Up and Go test measured early after surgery and at follow-up.In the intention-to-treat analysis of between-group differences, the primary outcome improved 8.1% (95% CI -2.3; 18.4 by additional 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.Physiotherapy with addition of 5 sessions of ST yielded no additional improvements compared to physiotherapy without strength training in reducing the knee-extension strength deficit at follow-up in patients with a hip fracture. It is debatable whether larger improvements than the observed 8-10% can be expected given that only five exercise sessions, on average, were completed. In fragile patients with a hip fracture in the acute phase, where the ability to participate in functional exercise is compromised, we still consider early strength training a

The effect of reduced oxygen content powder on the impact toughness of 316 steel powder joined to 316 steel by low temperature HIP

International Nuclear Information System (INIS)

Lind, Anders; Sundstroem, Johan; Peacock, Alan

2005-01-01

During the manufacture of the blanket modules, 316L steel powder is simultaneously consolidated and joined to tubes and blocks of 316L materials by hot isostatic pressing (HIP). The high processing temperature can detrimentally increase the grain size of the water-cooling tubes in the structure and the blocks reducing their strength. It is well known [L. Arnberg, A. Karlsson, Influence of powder surface oxidation on some properties of a HIPed martensitic chromium steel, Int. J. Powder Metall. 24 (2) (1988) 107-112] that surface oxides on the powder particles negatively influence the impact toughness of material and joints consolidated in this way. At a high HIP temperature, the oxides are at least partly transformed, thereby improving the impact toughness [L. Nyborg, I. Olefjord, Surface analysis of PM martensitic steel before and after consolidation. Part 2. Surface analysis of compacted material, Powder Metall. 31 (1) (1988) 40-44]. In order to get acceptable mechanical properties of materials produced at a low HIP temperature, the oxygen content on the powder surfaces needs to be reduced. In order to study the effect of reducing the powder oxygen content, it was reduced and the results were compared to those of specimens with ordinary oxygen content. The effect on the impact toughness and the tensile strength of low temperature (1020 and 1060 deg. C) HIP joints between steel blocks and powder consolidated material with low and ordinary oxygen content was measured

The Hip Hop peer crowd: An opportunity for intervention to reduce tobacco use among at-risk youth.

Science.gov (United States)

Walker, Matthew W; Navarro, Mario A; Hoffman, Leah; Wagner, Dana E; Stalgaitis, Carolyn A; Jordan, Jeffrey W

2018-07-01

Peer crowds, peer groups with macro-level connections and shared norms that transcend geography and race/ethnicity, have been linked to risky health behaviors. Research has demonstrated that Hip Hop peer crowd identification, which is common among multicultural youth, is associated with increased risk of tobacco use. To address this, the FDA Center for Tobacco Products created Fresh Empire, the first national tobacco education campaign tailored for Hip Hop youth aged 12-17 who are multicultural (Hispanic, African American, Asian-Pacific Islander, or Multiracial). As part of campaign development, peer crowd (Hip Hop, Mainstream, Popular, Alternative, Country) and cigarette smoking status were examined for the first time with a nationally recruited sample. Youth were recruited via targeted social media advertisements. Participants aged 13-17 (n = 5153) self-reported peer crowd identification via the I-Base Survey™ and cigarette smoking status. Differences in smoking status by peer crowd were examined using chi-square and followed up with z-tests to identify specific differences. Alternative youth were most at risk of cigarette smoking, followed by Hip Hop. Specifically, Hip Hop youth were significantly less likely to be Non-susceptible Non-triers than Popular, Mainstream, and Country youth, and more likely to be Experimenters than Popular and Mainstream youth. Representative studies show that Alternative is relatively small compared to other high-risk crowds, such as the Hip Hop peer crowd. The current research underscores the potential utility of interventions tailored to larger at-risk crowds for campaigns like Fresh Empire. Published by Elsevier Ltd.

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.

[The hip joint in neuromuscular disorders].

Science.gov (United States)

Strobl, W M

2009-07-01

Physiologic motor and biomechanical parameters are prerequisites for normal hip development and hip function. Disorders of muscle activity and lack of weight bearing due to neuromuscular diseases may cause clinical symptoms such as an unstable hip or reduced range of motion. Disability and handicap because of pain, hip dislocation, osteoarthritis, gait disorders, or problems in seating and positioning are dependent on the severity of the disease, the time of occurrence, and the means of prevention and treatment. Preservation of pain-free and stable hip joints should be gained by balancing muscular forces and by preventing progressive dislocation. Most important is the exact indication of therapeutic options such as movement and standing therapy as well as drugs and surgery.

Seasonality of service provision in hip and knee surgery: A possible contributor to waiting times? A time series analysis

Directory of Open Access Journals (Sweden)

Upshur Ross EG

2006-03-01

Full Text Available Abstract Background The question of how best to reduce waiting times for health care, particularly surgical procedures such as hip and knee replacements is among the most pressing concern of the Canadian health care system. The objective of this study was to test the hypothesis that significant seasonal variation exists in the performance of hip and knee replacement surgery in the province of Ontario. Methods We performed a retrospective, cross-sectional time series analysis examining all hip and knee replacement surgeries in people over the age of 65 in the province of Ontario, Canada between 1992 and 2002. The main outcome measure was monthly hospitalization rates per 100 000 population for all hip and knee replacements. Results There was a marked increase in the rate of hip and knee replacement surgery over the 10-year period as well as an increasing seasonal variation in surgeries. Highly significant (Fisher Kappa = 16.05, p 2Autoreg = 0.85 seasonality was identified in the data. Conclusion Holidays and utilization caps appear to exert a significant influence on the rate of service provision. It is expected that waiting times for hip and knee replacement could be reduced by reducing seasonal fluctuations in service provision and benchmarking services to peak delivery. The results highlight the importance of system behaviour in seasonal fluctuation of service delivery.

Matched cohort study of topical tranexamic acid in cementless primary total hip replacement.

Science.gov (United States)

Sanz-Reig, Javier; Mas Martinez, Jesus; Verdu Román, Carmen; Morales Santias, Manuel; Martínez Gimenez, Enrique; Bustamante Suarez de Puga, David

2018-03-29

Tranexamic acid has been shown to be effective in reducing blood loss after total hip replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use to reduce blood loss after primary total hip replacement and to compare these outcomes with those of a matched control group from a similar cohort that did not have received tranexamic acid. This is a prospective matched control study to assess the effect of a 2 g topical tranexamic acid in 50 mL physiological saline solution in total hip replacement. Primary outcomes were hemoglobin and hematocrit drop, and total blood loss. Secondary outcomes were transfusion rates, length of hospital stay, deep vein thrombosis, and pulmonary embolism events. We could match 100 patients to a control group. There were no statistical significantly differences between the two groups. The hemoglobin and hematocrit postoperative values were significantly higher in topical tranexamic acid group than in control group (P tranexamic acid group and 1163 in control group with significant differences (P = 0.001), which meant 34% reduction in total blood loss. Length of stay was lower in topical tranexamic acid group. The risk of deep vein thrombosis and pulmonary events did not increase. A single dose of 2 g tranexamic acid in 50 mL physiological saline solution topical administration was effective and safe in reducing bleeding in patients undergoing unilateral primary non-cemented total hip replacement compared to a matched control group.

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.

Analysis of hip perfusion at early and reversible stages of aseptic hip necrosis

International Nuclear Information System (INIS)

Predic, P.; Dodig, D.; Karner, I.

2002-01-01

Aim: A proper early diagnosis of aseptic hip necrosis is very important for further therapy.Since there has always been a question of the amount of perfusion in hips at different stages of aseptic hip necrosis we tried to impartially examine the perfusion in hips at early and reversible stages of aseptic hip necrosis. Material and Methods:Study included 143 patients with aseptic hip necrosis.The 550-740 MBq of Tc-99m-DPD were on bolus injected.All patients were subjected to 3-phase scintigraphy of hips and quantitative calculation of relative perfusion in the artery phase (3T) at early and repeated at reversible stages of aseptic hip necrosis. Results: At the early stage of aseptic hip necrosis the obtained 3T was decreased from 0.94-0.69 (3T=0.80).Scintigrams showed a moderate increase or diffuse accumulation. At the reversible stages we obtained 3T decreased from 0.92-0.71 (3T=0.79) thus evidencing hypoperfusion.Scintigrams showed an diffuse increased accumulation. Conclusion: With the aseptic hip necrosis quantitative analysis of perfusion in the artery phase-3T indicates that the perfusion is decreased at all stages of the process which however shows a significantly falling trend with the progress of the disease

Results of hip arthroplasty using Paavilainen technique in patients with congenitally dislocated hip

Directory of Open Access Journals (Sweden)

R. M. Tikhilov

2014-01-01

Full Text Available The purpose of the study was to analyze the medium- and long-term results of hip arthroplasty using Paavilainen technique in patients with the congenitally dislocated hip. Methods: From 2001 to 2012 180 operations were carried out were using the Paavilainen technique in 140 patients with high dislocation of the hip (Crowe IV. All patients were clinically evaluated using the Harris Hip Score (HHS, VAS and radiography. Statistical analysis was performed using the Pearson correlation coefficients, multiple regression analysis and classification trees analysis. Results: The average Harris score improved from preoperative 41.6 (40,3-43,5 to 79.3 (77,9-82,7 at final follow-up, and the difference was significant. Early complications were 9% (the most frequent were fractures of the proximal femur, later - 16.7% (pseudoarthrosis of the greater trochanter, 13.9%; disclocations-1,1%, aseptic loosening of the components - 1.7%, reoperation performed in 8.3% of cases. Such factors as age and limb length has statistically significant effect on functional outcomes. Established predictive model allows to get the best possible functional outcome in such patients with severe dysplasia. Conclusions: Total Hip arthroplasty using the Paavilainen technique is an effective method of surgical treatment in patients with the congenitally dislocated hip, but it is technically difficult operation with a high incidence of complications in comparison with standard primary total hip replacement.

Antifracture efficacy and reduction of mortality in relation to timing of the first dose of zoledronic acid after hip fracture

DEFF Research Database (Denmark)

Eriksen, Erik Fink; Lyles, Kenneth W; Colón-Emeric, Cathleen S

2009-01-01

undergone surgical repair of hip fracture. In this analysis, we examined whether timing of the first infusion of zoledronic acid study drug after hip fracture repair influenced the antifracture efficacy and mortality benefit observed in the study. A total of 2127 patients (1065 on active treatment and 1062...... was approximately 6 wk. Posthoc analyses were performed by dividing the study population into 2-wk intervals (calculated from time of first infusion in relation to surgical repair) to examine effects on BMD, fracture, and mortality. Analysis by 2-wk intervals showed a significant total hip BMD response......Annual infusions of zoledronic acid (5 mg) significantly reduced the risk of vertebral, hip, and nonvertebral fractures in a study of postmenopausal women with osteoporosis and significantly reduced clinical fractures and all-cause mortality in another study of women and men who had recently...

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.)

Adverse Outcomes in Infantile Bilateral Developmental Dysplasia of the Hip.

Science.gov (United States)

Morbi, Abigail H M; Carsi, Belen; Gorianinov, Vitalli; Clarke, Nicholas M P

2015-01-01

It is believed that bilateral developmental dysplasia of the hip (DDH) has poorer outcomes with higher rates of avascular necrosis (AVN) and reintervention, compared with unilateral DDH. However, there is limited evidence in the literature, with few studies looking specifically at bilateral cases. A retrospective review of 36 patients (72 hips) with >4 years of follow-up. Patient population included surgically treated DDH including late presentations and failures of conservative treatment. The dislocated hips underwent either simultaneous closed or 1 open and 1 closed, or sequential open reduction. AVN and secondary procedures were used as endpoints for analysis as well as clinical and radiologic outcomes. At the last follow-up, 33% of hips had radiologic signs of AVN. Those hips that had no ossific nucleus (ON) at the time of surgery had an odds ratio of developing AVN of 3.05 and a statistically significant association between the 2 variables, whereas open/closed or simultaneous/sequential reduction did not increase the risk for AVN. In addition, 45.8% of those hips required further surgery. The estimated odds ratio of needing additional surgery after simultaneous reduction was 4.04. Clinically, 79.2% of the hips were graded as McKay I, whereas radiologically only 38.8% were Severin I. The AVN rate in bilateral DDH treated surgically is greater than the rate noted in unilateral cases from the same institution undergoing identical protocols. There was no difference in AVN rates between simultaneous and sequential or between the first and second hip to be sequentially reduced. Presence of ON decreases the risk for AVN, suggesting that in bilateral cases, awaiting the appearance of the ON is an important tool to reduce the incidence of AVN. IV.

[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.

Exercise induced effects on muscle function and range of motion in patients with hip osteoarthritis

DEFF Research Database (Denmark)

Bieler, Theresa; Siersma, Volkert; Magnusson, S Peter

2018-01-01

BACKGROUND AND PURPOSE: Patients with hip osteoarthritis have impairments in muscle function (muscle strength and power) and hip range of motion (ROM), and it is commonly believed that effective clinical management of osteoarthritis should address these impairments to reduce pain and disability......-two patients were randomized to either 4 months of physiotherapist-supervised, moderate, progressive, strength training (n = 50), physiotherapist-supervised NW (n = 50), or unsupervised HBE (n = 52). Maximal isometric hip and thigh muscle strength and leg extensor power and active hip ROM were assessed...... at baseline 2, 4, and 12 months. RESULTS: Intention-to-treat-analyses did not show any significant between-group differences for improvements in muscle strength and power or ROM at any time points. Short-term significant (p

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.

Hip dysplasia and congenital hip dislocation

Energy Technology Data Exchange (ETDEWEB)

Lingg, G.; Nebel, G.; von Torklus, D.

1981-11-01

In human genetics and orthopedics quite different answers have been given to the question of hereditary transmission and frequency of hip dysplasia in families of children with congenital hip dislocation. We therefore have made roentgenometric measurements of 110 parents of children with congenital hip dislocation. In 25% we found abnormal flat acetabulae, whereas 12% had pathologic deep hips. This may propose a new concept of morphology of congenital hip dysplasia.

CT findings of traumatic posterior hip dislocation after reduction

International Nuclear Information System (INIS)

Moon, Sung Kyoung; Park, Ji Seon; Ryu, Kyung Nam; Jin, Wook; Jin Wook

2008-01-01

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

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

HPLC/DAD Intercomparison on Phytoplankton Pigments (HIP-1, HIP-2, HIP-3 and HIP-4)

OpenAIRE

CANUTI Elisabetta; RAS Josephine; GRUNG Merete; ROTTGERS Rudiger; COSTA GOELA Priscilla; ARTUSO Florinda; CATALDI Dario

2016-01-01

From 2009 to 2015, in the context of the MERIS (Medium Resolution Imaging Spectrometer) validation activities, the JRC Marine Optical Laboratory organised four HPLC Intercomparison exercises for Phytoplankton Pigment measurements (HIP-1, HIP-2, HIP-3 and HIP-4), involving seven European accredited and reference laboratories. The objectives of these intercomparison exercises were: creating a reference community at European level for phytoplankton pigment analysis capable of supporting satel...

Traumatic hip dislocations in children

International Nuclear Information System (INIS)

Minhas, M.S.

2010-01-01

Objectives: To evaluate clinical features, treatment and relationship to the time period between dislocation, reduction and early complications of traumatic dislocation of hip in children. Methods: Case series conducted at Jinnah Post Graduate Medical Centre Karachi from July 2005 to August 2009. Children with traumatic hip dislocation up to fifteen years of age who presented in last four years were included in this study. Their clinical information, etiology, associated injuries, duration, method of reduction and early complications are evaluated through emergency room proforma and indoor record. Follow up of patient was updated in outpatient department. Results: We had eight patients, six boys and two girls. Youngest 2.4 years and eldest was 12 years with mean age of 6.2 +- 3.8 years. All presented with posterior hip dislocation. Etiology was road traffic accident in two and history of fall in remaining six patients. Average duration of time between dislocation and reduction was 19 hours range 3-72 hours. Dislocated hips were reduced under General Anaesthesia in two patients and under sedation analgesia in six patients. No complications were noted in eight cases with mean 18.75 +- 13.23 months follows up. Conclusion: Traumatic hip dislocation in children is not rare. Slight trauma causes dislocation in younger age and immediate closed reduction and Immobilization reduces complications. (author

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

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D. D. Selivanov

2010-01-01

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

Effect of HIP/ribosomal protein L29 deficiency on mineral properties of murine bones and teeth.

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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. 2010 Elsevier Inc. All rights reserved.

Automatic assessment of volume asymmetries applied to hip abductor muscles in patients with hip arthroplasty

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Klemt, Christian; Modat, Marc; Pichat, Jonas; Cardoso, M. J.; Henckel, Joahnn; Hart, Alister; Ourselin, Sebastien

2015-03-01

Metal-on-metal (MoM) hip arthroplasties have been utilised over the last 15 years to restore hip function for 1.5 million patients worldwide. Althoug widely used, this hip arthroplasty releases metal wear debris which lead to muscle atrophy. The degree of muscle wastage differs across patients ranging from mild to severe. The longterm outcomes for patients with MoM hip arthroplasty are reduced for increasing degrees of muscle atrophy, highlighting the need to automatically segment pathological muscles. The automated segmentation of pathological soft tissues is challenging as these lack distinct boundaries and morphologically differ across subjects. As a result, there is no method reported in the literature which has been successfully applied to automatically segment pathological muscles. We propose the first automated framework to delineate severely atrophied muscles by applying a novel automated segmentation propagation framework to patients with MoM hip arthroplasty. The proposed algorithm was used to automatically quantify muscle wastage in these patients.

Influence of bone mineral density and hip geometry on the different types of hip fracture.

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Li, Yizhong; Lin, Jinkuang; Cai, Siqing; Yan, Lisheng; Pan, Yuancheng; Yao, Xuedong; Zhuang, Huafeng; Wang, Peiwen; Zeng, Yanjun

2016-01-01

The aim of this study was to assess the influence of bone mineral density and hip geometry on the fragility fracture of femoral neck and trochanteric region. There were 95 menopausal females of age ≥ 50 years with fragility fracture of hip, including 55 cases of femoral neck fracture and 40 cases of trochanteric fracture. Another 63 non-fractured females with normal bone mineral density (BMD) were chosen as control. BMD, hip axis length, neck-shaft angle and structural parameters including cross surface area, cortical thickness and buckling ratio were detected and compared. Compared with control group, the patients with femoral neck fracture or trochanteric fractures had significantly lower BMD of femoral neck, as well as lower cross surface area and cortical thickness and higher buckling ratio in femoral neck and trochanteric region. There were no significant differences of BMD and structural parameters in the femoral neck fracture group and intertrochanteric fracture group. Hip axis length and neck-shaft angle were not significantly different among three groups. The significant changes of BMD and proximal femur geometry were present in the fragility fracture of femoral neck and trochanteric region. The different types of hip fractures cannot be explained by these changes.

Influence of bone mineral density and hip geometry on the different types of hip fracture

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Yizhong Li

2016-01-01

Full Text Available The aim of this study was to assess the influence of bone mineral density and hip geometry on the fragility fracture of femoral neck and trochanteric region. There were 95 menopausal females of age ≥ 50 years with fragility fracture of hip, including 55 cases of femoral neck fracture and 40 cases of trochanteric fracture. Another 63 non-fractured females with normal bone mineral density (BMD were chosen as control. BMD, hip axis length, neck-shaft angle and structural parameters including cross surface area, cortical thickness and buckling ratio were detected and compared. Compared with control group, the patients with femoral neck fracture or trochanteric fractures had significantly lower BMD of femoral neck, as well as lower cross surface area and cortical thickness and higher buckling ratio in femoral neck and trochanteric region. There were no significant differences of BMD and structural parameters in the femoral neck fracture group and intertrochanteric fracture group. Hip axis length and neck-shaft angle were not significantly different among three groups. The significant changes of BMD and proximal femur geometry were present in the fragility fracture of femoral neck and trochanteric region. The different types of hip fractures cannot be explained by these changes.

Hip Resurfacing: An Alternative to Conventional Hip Replacement?

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... Is hip resurfacing a good alternative to hip replacement? Answers from Mark Spangehl, M.D. Hip resurfacing has lost favor with many surgeons ... women with poor bone quality. Unlike traditional hip replacement, hip resurfacing doesn't completely replace the "ball" ...

[Efficacy analysis on hip replacement for hip-joint diseases with Parkinson disease].

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Sun, Qi-Cai; Ru, Xuan-Liang; Xia, Yan-Fei; Liu, Xiao-Li; Song, Bai-Shan; Qiao, Song; Yan, Shi-Gui; Wang, Xiang-Hua

2017-12-25

To explore clinical efficacy of hip replacement for hip-joint diseases with Parkinson disease. From December 2011 to December 2016, 18 patients with hip-joint diseases with Parkinson disease treated by hip replacement, including 8 males and 10 females aged from 59 to 87 years old with an average of 71 years old. Among them, 3 cases were developmental dysplasia of hip, 3 cases were femoral head necrosis and 12 cases were femoral neck fracture. All patients manifested with obvious pain and limitation of stepping ability. Postoperative complications were observed and Harris score were used to compare hip joint function after operation. The incision were healed well, and pain were alleviated or disappeared, and hip joint function were improved. Eighteen patients were followed up from 1 to 3 years with an average of 2.3 years. At the latest follow up, 14 cases recovered freedom-walk, 2 cases could walk with walking stick, 1 case could walk with walking aid and 1 case was died. Among 18 patients, 2 cases were occurred dislocation, and 1 case were died for cardiac disease at 3 months after operation. Four patients were occurred slight pain. There were significant differences in Harris scores among preoperative (41.7±1.4), 6 months after operation(80.1±5.4) and the final follow-up (83.4±2.1), and 10 cases got excellent result, 4 good, 1 fair and 2 poor. Application of hip replacement for hip-joint diseases with Parkinson disease is a safe and effective clinical therapy, and has advantages of less complications and rapid recovery of hip joint function.

Hip arthroscopy versus open surgical dislocation for femoroacetabular impingement

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Zhang, Dagang; Chen, Long; Wang, Guanglin

2016-01-01

Abstract Background: This meta-analysis aims to evaluate the efficacy and safety of hip arthroscopy versus open surgical dislocation for treating femoroacetabular impingement (FAI) through published clinical trials. Methods: We conducted a comprehensive literature search using PUBMED, EMBASE, and the Cochrane Central Register of Controlled Trials databases for relevant studies on hip arthroscopy and open surgical dislocation as treatment options for FAI. Results: Compared with open surgical dislocation, hip arthroscopy resulted in significantly higher Nonarthritic Hip Scores (NAHS) at 3- and 12-month follow-ups, a significant improvement in NAHS from preoperation to 3 months postoperation, and a significantly lower reoperation rate. Open surgical dislocation resulted in a significantly improved alpha angle by the Dunn view in patients with cam osteoplasty from preoperation to postoperation, compared with hip arthroscopy. This meta-analysis demonstrated no significant differences in the modified Harris Hip Score, Hip Outcome Score-Activities of Daily Living, or Hip Outcome Score-Sport Specific Subscale at 12 months of follow-up, or in complications (including nerve damage, wound infection, and wound dehiscence). Conclusion: Hip arthroscopy resulted in higher NAHS and lower reoperation rates, but had less improvement in alpha angle in patients with cam osteoplasty, than open surgical dislocation. PMID:27741133

Pre-fracture individual characteristics associated with high total health care costs after hip fracture.

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Schousboe, J T; Paudel, M L; Taylor, B C; Kats, A M; Virnig, B A; Dowd, B E; Langsetmo, L; Ensrud, K E

2017-03-01

Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted. The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims. Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture. Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed total health care costs after hip fracture in older women. Studies to investigate if targeted health care interventions for these individuals can reduce the costs of hip fractures are warranted.

[Acute traumatic and especially neglected traumatic hip dislocations are very rare in children].

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Fernandez, F F; Wirth, T; Eberhardt, O

2012-09-01

We report about the first hip arthroscopies of extracapsular neglected hip dislocations with concomitant injuries in two children (2 and 4 years old). The major problem of traumatic hip dislocation is avascular necrosis. Further problems are possible concomitant injuries. It is important not to cause further damage by therapeutic procedures. In a 4-year-old child the hip could be reduced under visualization and in a 2-year-old child with epiphyseal fracture the extent of the operation could be reduced. In both children large avulsion injuries of the ligamentum capitis femoris could be resected via hip arthroscopy. Hip arthroscopy can reduce surgical morbidity considerably and can possibly contribute to prevention of the feared avascular necrosis of the femoral head.

The impact of surface and geometry on coefficient of friction of artificial hip joints.

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Choudhury, Dipankar; Vrbka, Martin; Mamat, Azuddin Bin; Stavness, Ian; Roy, Chanchal K; Mootanah, Rajshree; Krupka, Ivan

2017-08-01

Coefficient of friction (COF) tests were conducted on 28-mm and 36-mm-diameter hip joint prostheses for four different material combinations, with or without the presence of Ultra High Molecular Weight Polyethylene (UHMWPE) particles using a novel pendulum hip simulator. The effects of three micro dimpled arrays on femoral head against a polyethylene and a metallic cup were also investigated. Clearance played a vital role in the COF of ceramic on polyethylene and ceramic on ceramic artificial hip joints. Micro dimpled metallic femoral heads yielded higher COF against a polyethylene cup; however, with metal on metal prostheses the dimpled arrays significantly reduced the COF. In situ images revealed evidence that the dimple arrays enhanced film formation, which was the main mechanism that contributed to reduced friction. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

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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.

Association of Hip Radiograph Findings With Pain and Function in Patients Presenting With Low Back Pain.

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

2018-01-01

Relationships between low back pain (LBP) and the hip in patient cohorts have been described primarily in patients with moderate to severe hip osteoarthritis (OA). Less is known about the links of LBP with hip radiographic findings of hip deformity and minimal OA. To describe the incidence of radiographic hip deformity or hip OA; to describe and compare spine- and hip-related pain and function in the subset of patients who were found to have radiographic hip deformity or hip OA; and to compare patients with evidence of radiographic hip deformity or hip OA to patients without hip radiographic findings. Prospective cohort study with cross-sectional design. Tertiary university. A total of 63 patients (40 women, 23 men) with a mean age of 48.5 ± 14 years with LBP and a minimum of one positive provocative hip test. Hip radiographs were assessed by an independent examiner for hip OA and deformity. Comparisons of hip and lumbar spine pain and function were completed for patients with radiographic findings of hip OA or deformity. Moderate to severe hip OA was found in 12 of 60 patients (20.0%). At least one measurement of femoroacetabular impingement (FAI) was found in 14 of 60 patients (23.3%) to 33 of 45 patients (73.3%). At least one measurement of developmental hip dysplasia (DDH) was found in 7 of 60 patients (11.6%) to 11 of 63 patients (17.4%). Greater pain and reduced hip and lumbar spine function were found in the patients with moderate to severe hip OA. Patients with LBP and FAI were found to have significantly greater extremes of pain and reduced lumbar spine function. Links between the hip and the spine affecting pain and function may be found in patients with LBP and hip deformity and before the onset of radiographic hip OA, and may be associated with hip deformity. Further investigation is needed to better understand these links and their potential impact on prognosis and treatment of LBP. II. Copyright © 2018 American Academy of Physical Medicine and

The Role of Hip Arthroscopy in Investigating and Managing the Painful Hip Resurfacing Arthroplasty.

Science.gov (United States)

Mei-Dan, Omer; Pascual-Garrido, Cecilia; Moreira, Brett; McConkey, Mark O; Young, David A

2016-03-01

To determine the safety and efficacy of hip arthroscopy performed in the peripheral compartment as a diagnostic and therapeutic treatment option for patients with hip pain after hip resurfacing surgery. Indications for hip arthroscopy after hip resurfacing included patients with a symptomatic hip-resurfaced arthroplasties who did not respond to nonoperative treatment. Patients who underwent a hip arthroscopy after a painful hip resurfacing were included with a minimum of 1 year follow-up. Subgroup analysis was performed according to whether an established diagnosis was made before arthroscopic intervention or not. Subjective measures were based on Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, and results were calculated and analyzed. We included 68 patients (26 male [38%] and 42 female [62%]) who underwent subsequent hip arthroscopy from a population of 978 consecutive hip-resurfaced arthroplasties performed between 1999 and 2010. The average age was 58 (range, 37 to 78 years). The mean follow-up after hip arthroscopy was 3.4 years (range, 12 months to 5.8 years). Patients who had an established diagnosis (n = 41) before hip arthroscopy showed statistical improvement in their WOMAC scores (7 to 2, P arthroscopy showed statistical worsening of the WOMAC (15 to 21, P = .002). Ten (37%) of these 27 patients without a diagnosis failed and needed to be converted to a THR. A significant correlation was found between the collections found on ultrasound (psoas bursa and/or in the hip joint) and the need for synovectomy (P = .01). The overall revision rate to THR after hip resurfacing in our group of patients was 1.3% (n = 13). Female patients were more likely to require postresurfacing hip arthroscopy with 42 (60%) female to only 26 (40%) male patients undergoing this procedure. In our study population, 70% (14/21, P arthroscopy. Hip arthroscopy is a safe surgical treatment option for those patients with a painful hip resurfacing

Danish Hip Arthroscopy Registry (DHAR)

DEFF Research Database (Denmark)

Lund, Bent; Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten

2017-01-01

The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI......) undergoing hip arthroscopic treatment. Our primary hypothesis was that patients undergoing hip arthroscopy would improve significantly in pain, quality of life and sports related outcome measurements in Patient Related Outcome Measures (PROM). Peri-operative data and Patient Reported Outcome Measures (PROM......-5 D demonstrated improvement after 1 and 2 years from 0.66 pre-op to 0.78 at 2 years. HSAS improved significantly from 2.5 to 3.3. Pain score data demonstrated improvement in NRS-rest 39 to 17 and NRS Walk 49 to 22 at follow-up. We conclude that patients with FAI undergoing hip arthroscopy...

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

International Nuclear Information System (INIS)

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

1988-01-01

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

Hip fracture in hospitalized medical patients

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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.

The Timing of Hip Arthroscopy After Intra-articular Hip Injection Affects Postoperative Infection Risk.

Science.gov (United States)

Wang, Dean; Camp, Christopher L; Ranawat, Anil S; Coleman, Struan H; Kelly, Bryan T; Werner, Brian C

2017-11-01

To evaluate the association of preoperative intra-articular hip injection with surgical site infection after hip arthroscopy. A large administrative database was used to identify all patients undergoing hip arthroscopy from 2007 to 2015 within a single private insurer and from 2005 to 2012 within Medicare in the United States. Those that received an ipsilateral preoperative intra-articular hip injection were identified. The patients were then divided into the following groups based on the interval between preoperative injection and ipsilateral hip arthroscopy: (1) 12 months) of preoperative hip injection. Patients developing a surgical site infection within 6 months following hip arthroscopy were identified using International Classification of Diseases, Ninth Revision, and Current Procedural Terminology codes associated with infection. Groups were compared using a multivariate logistic regression analysis to control for age, gender, body mass index, smoking status, alcohol usage, and multiple medical comorbidities including diabetes mellitus, hemodialysis use, inflammatory arthritis, and peripheral vascular disease. In total, 19% of privately insured and 6% of Medicare patients received a hip injection within 12 months of hip arthroscopy. The overall infection rate in privately insured and Medicare patients was 1.19% and 1.10%, respectively. Preoperative hip injection within 3 months of surgery was associated with a significantly higher risk of postoperative infection versus controls (2.16%, odds ratio [OR] 6.1, P arthroscopy increased when preoperative intra-articular hip injections were given within 3 months of surgery. Level III, retrospective comparative study. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

The Amsterdam Hip Protector Study: Compliance and determinants of compliance

NARCIS (Netherlands)

van Schoor, N.M.; Asma, G.; Smit, J.H.; Bouter, L.M.; Lips, P.T.A.M.

2003-01-01

Hip protectors appear to be effective in reducing the incidence of hip fractures. However, compliance is often poor. Therefore, the objective of this study was to examine the compliance and determinants of compliance with external hip protectors. A prospective study was performed in residents from

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

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Kaustubh Ahuja

2017-09-01

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

Hip, Hip, Soret!

Science.gov (United States)

Müller-Plathe, Florian

Many years ago, Ludwig did detect the behaviour now called the Soret effect. Sodium sulphate in eighteen-fifty-six did not obediently follow Fick's first law. But if he cooled down one side the salt went left, the water to the right. He was surprised in every way. Hip, hip, Soret!

Complications in Hip Arthroscopy

Science.gov (United States)

Nakano, Naoki; Khanduja, Vikas

2016-01-01

Summary Background Recent developments in hip arthroscopic techniques and technology have made it possible in many cases to avoid open surgical dislocation for treating a variety of pathology in the hip. Although early reports suggest favourable results’ using hip arthroscopy and it has been shown to be a relatively safe procedure, complications do exist and can sometimes lead to significant morbidity. Methods This is a review article. The aim of this manuscript is to present the most frequent and/or serious complications that could occur at or following hip arthroscopy and some guidelines to avoid these complications. Conclusion Most complications of hip arthroscopy are minor or transient but serious complications can occur as well. A lot of complication e.g. acetabular labral puncture go unreported. Appropriate education and training, precise and meticulous surgical technique with correct instrumentation, the right indication in the right patient and adherence to advice from mentors and experienced colleagues are all essential factors for a successful outcome. Level of evidence: V. PMID:28066747

Risk factors for osteoarthritis of the hip

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Filipović Karmela

2013-01-01

Full Text Available INTRODUCTION: Osteoarthritis of the hip is a degenerative disease of hip unknown origin, with pain, stiffness and diminished joint function. AIM: determine the influence of the load of the hip joint during professional activity and BMI as risk factors for the hip osteoarthritis. MATERIAL AND METHOD: We analysed 148 patients. Patients were divided into two groups ( I group with osteoarthritis of the hip, II group without osteoarthritis of the hip. In all, performed diagnostic procedure: anamnesis, physical examination (estimate of walking and hip joint movement, laboratory blood test and urine test radiological examination and taking data on the height and weight to calculated BMI. We assessed the data that is related to the load of the hip joint during professional activities (mostly sitting work and mostly standing job with carrying load. Statistical analysis was done using the software package SPSS 14.0, Microsoft Office Word 2003. RESULTS: In the first group, average age was 67.76 years, with females prevailing (67.6%. In this group the larger body mass was noted (81.82 ± 12.18, with statistically significant difference (T-test 2.923, p<0.01; the average BMI was higher the average BMI was higher (30.18 ± 4.6, with statistically significant difference (T-test 3.832, p<0.01. This group had more overweight patients (87.7%,with statistically significant difference (Fisher test, p<0.01. In I group 62,2% of patients were doing hard physical work (standing job with repeated carrying load and we found statistically significant difference between groups (Fisher test p<0,01. CONCLUSION: Patients with osteoarthritis of the hip had a higher body weight, higher BMI. Also we found the influence of hard physical labor at work, and they were performed mostly standing job with carrying load.

Economic viability of geriatric hip fracture centers.

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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.

TREATMENT OF HIP DYSPLASIA

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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.

Mechanical Evaluation of Polymer Composite Hip Protectors

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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.

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

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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.

Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in Total Hip Replacement

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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.

Epsilon Aminocaproic Acid to Reduce Blood Loss and Transfusion After Total Hip and Total Knee Arthroplasty.

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Hobbs, Juliann C; Welsby, Ian J; Green, Cynthia L; Dhakal, Ishwori B; Wellman, Samuel S

2018-01-01

Total hip and knee arthroplasty (THA and TKA) are associated with significant blood loss and some patients require postoperative blood transfusion. While tranexamic acid has been studied extensively among this population, we tested the hypothesis that epsilon aminocaproic acid (EACA) can reduce blood loss and transfusion after joint arthroplasty. In April 2014, our Veterans Affairs Medical Center introduced a protocol to administer EACA during THA and TKA. No antifibrinolytics were used previously. We retrospectively compared blood loss and incidence of transfusion among patients who underwent primary arthroplasty in the year before standardized administration of EACA with patients having the same procedures the following year. Blood loss was measured as delta hemoglobin (preoperative hemoglobin - hemoglobin on postoperative day 1). All patients undergoing primary THA or TKA were included. Patients having revision surgery were excluded. We identified 185 primary arthroplasty patients from the year before and 184 from the year after introducing the EACA protocol. There were no changes in surgical technique or attending surgeons during this period. Delta hemoglobin was significantly lower in the EACA group (2.7 ± 0.8 mg/dL) compared to the control group (3.4 ± 1.1 mg/dL) (P blood transfusion was also significantly lower in the EACA group (2.7%) compared to the control group (25.4%) (P transfusion following introduction of the EACA protocol in patients undergoing primary arthroplasty. EACA offers a lower cost alternative to TXA for reducing blood loss and transfusion in this population. Published by Elsevier Inc.

Psychological factors as risk factors for poor hip function after total hip arthroplasty

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Benditz A

2017-02-01

Full Text Available Achim Benditz,1 Petra Jansen,2 Jan Schaible,1 Christina Roll,1 Joachim Grifka,1 Jürgen Götz1 1Department of Orthopedics, University Medical Center Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, 2Department of Sport Science, University of Regensburg, Regensburg, Germany Abstract: Recovery after total hip arthroplasty (THA is influenced by several psychological aspects, such as depression, anxiety, resilience, and personality traits. We hypothesized that preoperative depression impedes early functional outcome after THA (primary outcome measure. Additional objectives were perioperative changes in the psychological status and their influence on perioperative outcome. This observational study analyzed depression, anxiety, resilience, and personality traits in 50 patients after primary unilateral THA. Hip functionality was measured by means of the Harris Hip Score. Depression, state anxiety, and resilience were evaluated preoperatively as well as 1 and 5 weeks postoperatively. Trait anxiety and personality traits were measured once preoperatively. Patients with low depression and anxiety levels had significantly better outcomes with respect to early hip functionality. Resilience and personality traits did not relate to hip functionality. Depression and state anxiety levels significantly decreased within the 5-week stay in the acute and rehabilitation clinic, whereas resilience remained at the same level. Our study suggests that low depression and anxiety levels are positively related to early functionality after THA. Therefore, perioperative measurements of these factors seem to be useful to provide the best support for patients with risk factors. Keywords: total hip arthroplasty, psychological factors, depression, state anxiety, trait anxiety, resilience, personality traits

Trochanteric Soft Tissue Thickness and Hip Fracture in Older Men

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Nielson, Carrie M.; Bouxsein, Mary L.; Freitas, Sinara S.; Ensrud, Kristine E.; Orwoll, Eric S.

2009-01-01

Background: Greater thickness of the tissue extending laterally from the greater trochanter has been associated with a lower risk of hip fracture in women. The effect of trochanteric soft tissue thickness on the risk of incident hip fracture has not been evaluated in men. Methods: We measured trochanteric soft tissue thickness by dual-energy x-ray absorptiometry for all incident hip fracture cases (n = 70) and 222 randomly selected noncases in older men (≥65 yr) enrolled in the Osteoporotic Fractures in Men (MrOS) Study. Differences in tissue thickness between cases and controls were examined. Changes in fall force and factor-of-risk (the ratio of force from a sideways fall to femoral bone strength) associated with tissue thickness were determined. The relative risk for incident hip fracture per sd decrease in tissue thickness was calculated. Results: Mean trochanteric soft tissue thickness did not differ significantly between cases and noncases (29.1 ± 11.9 vs 31.0 ± 11.5 mm; P = 0.2). Although increased tissue thickness reduced both the estimates of fall force and the factor-of-risk, tissue thickness was not associated with the risk of hip fracture (age- and bone mineral density-adjusted relative risk per sd decrease in tissue thickness = 0.90; 95% confidence interval, 0.70–1.16). Conclusions: In this study of elderly community-dwelling men, we found no significant association between trochanteric soft tissue thickness and incident hip fracture. Trochanteric soft tissue thickness in these men was less than previously reported in older women and may explain the difference between these results and those reported in women. PMID:19017753

Surgical Dislocation of the Hip for the Treatment of Pre-Arthritic Hip Disease.

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Beaulé, Paul E; Singh, Amardeep; Poitras, Stéphane; Parker, Gillian

2015-09-01

The purpose of this study was to report the clinical results of surgical dislocation of the hip in the treatment of pre-arthritic hip disease. Between 2005 and 2010, eighty-two patients (89 hips) underwent a surgical dislocation of the hip at a mean age of 30.5 years (range 14.8-51.7); 10 females and 72 males. At a mean follow-up of 7.1 years (range 5-9.6) clinical function improved significantly. 6 patients were converted to total hip arthroplasty and 3 patients underwent an arthroscopy and an additional three patients had >1mm of joint space narrowing at latest follow-up giving us a 9-year cumulative Kaplan-Meier survivorship of 86.4% (CI, 79% to 94%). Thirty-four patients underwent internal fixation removal at a mean of 12.0 months (range 0.3-40.8 months). Although effective in the treatment of early hip disease, the surgical dislocation approach carries a high re-operation rate for removal of internal fixation; consequently, less invasive approaches should be considered for less complex deformities. Copyright © 2015 Elsevier Inc. All rights reserved.

Hip sonography in the newborn

International Nuclear Information System (INIS)

Riboni, G.; Serantoni, S.; De Simoni, M.; Bascape', P.; Facchini, R.; Pirovano, G.

1991-01-01

The authors report the data relative to 1507 cases studied with clinical and US examinations, in the neonatal period, in order to exclude hip dysplasia dislocation. US examination was carried out according to Graf's technique and the newborns were classified according to US hip type, to clinical examination and to possible risk factors. The patients were included in a protocol including orthopedic and US controls. Seventeen treated infants were considered as pathologic. Ten of them had IIc or D hips ar birth; the other 7, with IIa hips at birth, presented a X-ray pathologic hip after the 4th months of life. At about one year of age all infants could normally walk, excpet for one who was being treated with herness. No statistically significant differences were observed between the number of pathologic infants in the risk group (1.7%) and that in the no-risk group (0.8%). Clinical examination of the newborn has low sensitivity in detecting pathologic hips. On the basis of their results, thw authors belive US examination of the newborn to be a valuable screening method to diagnose hip dysplasia/dislocation. Moreover, Graf's morphologic method is the best one for US screening of the hip in the neonatal period

Synovial plicae of the hip: evaluation using MR arthrography in patients with hip pain

International Nuclear Information System (INIS)

Bencardino, Jenny T.; La Rocca Vieira, Renata; Kassarjian, Ara; Schwartz, Richard; Mellado, Jose M.; Kocher, Mininder

2011-01-01

The appearance and distribution of the intra-articular plicae of the hip have been addressed in few reports in the anatomic and radiological literature. This study aims to determine the prevalence of visible synovial hip plicae using MR arthrography and to measure the association of visible synovial hip plicae with MR arthrographic diagnosis of labral tears, femoroacetabular impingement, and osteoarthritis. Following institutional review board approval, 63 direct MR arthrographic examinations of the hip in 61 patients with a clinical history of hip pain were retrospectively reviewed by two experienced musculoskeletal radiologists in consensus. The following variables were measured using a binary system (0 = absent; 1 = present): labral plica, neck plica, ligamental plica, labral tear, femoroacetabular impingement, and osteoarthritis. The surgical reports and arthroscopic images of 10 patients were reviewed. Statistical analysis was performed using the Fisher's exact test. In all 63 cases at least one plica was visualized on MR-arthrographic images. Labral, neck, and ligamental plicae were found with a prevalence of 76, 97, and 78%, respectively. There was no statistically significant association between the presence of labral tears, femoroacetabular impingement, and osteoarthritis among patients with visible labral, neck, and ligamental plicae. The prevalence of labral tears, femoroacetabular impingement, and osteoarthritis in our patient population was 79, 28, and 28%, respectively. The presence of intra-articular plicae was the only MR-arthrographic finding in 5 of our 63 symptomatic cases. Visible labral, neck, and/or ligamental plicae are highly prevalent on MR-arthrographic images of the hip performed in the setting of hip pain. There was no statistically significant association between the presence of labral tears, femoroacetabular impingement, and osteoarthritis and visible labral, neck, and ligamental plicae. (orig.)

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

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Sinclair Jonathan

2014-12-01

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

Hip joint replacement

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Hip arthroplasty; Total hip replacement; Hip hemiarthroplasty; Arthritis - hip replacement; Osteoarthritis - hip replacement ... Your hip joint is made up of 2 major parts. One or both parts may be replaced during surgery: ...

Hip joint mobility in dancers: preliminary report.

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Drężewska, Marlena; Gałuszka, Renata; Sliwiński, Zbigniew

2012-01-01

The aim of this study was to evaluate the impact of dancing on hip joint mobility and to assess the relationship between active movements of the hips and injuries among dancers, which may be important in planning rehabilitation in this group. The sample comprised 49 dancers (37 women and 12 men) aged 15 to 32 years. The participants were the professional dancers of the Kielce Dance Theatre and members of two youth jazz dance teams from the Kielce Dance Theatre. The active range of motion of the hips was measured in three planes using a goniometer in order to assess the influence of dance training on hip joint mobility. A questionnaire-based survey was also conducted. The range of flexion, extension and external rotation was significantly greater in the group of long-time dancers (p <0.05). There was a significantly greater range of flexion, abduction and external rotation in previously injured hip joints (p<0.05). 1. Injuries to hip joints in dancers may result in increased ranges of motion, which may lead to disturbances of joint stability. 2. Being a long-time dancer and the female gender were associated with an increased range of hip joint motion.

The efficiency and safety of fibrin sealant for reducing blood loss in primary total hip arthroplasty: A systematic review and meta-analysis.

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Wang, Zhiyuan; Xiao, Lin; Guo, Hao; Zhao, Guanghui; Ma, Jianbing

2017-01-01

Total hip arthroplasty (THA) is associated with substantial blood loss. The objective of present systematic review and meta-analysis is to provide evidence from randomized controlled trials (RCTs) on the efficiency and safety of administration of fibrin sealant (FS) for reducing blood loss in patients undergoing primary THA. Potential relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect, web of science and Cochrane Library. Gray academic studies were also identified from the reference list of included studies. There was no language restriction. Pooling of data was carried out by using RevMan 5.1. Six randomized controlled trials (RCTs) met the inclusion criteria. Current meta-analysis indicated that there were significant differences in terms of total blood loss (MD = -153.77, 95% CI: -287.21 to -20.34, P = 0.02), postoperative hemoglobin level (MD = -0.25, 95% CI: -0.46 to -0.05, P = 0.02) and transfusion rate (RD = -0.12, 95% CI: -0.22 to -0.03, P = 0.01) between groups. No significant differences were found regarding the incidence of deep venous thrombosis (DVT) (RD = 0.00, 95% CI: -0.01to 0.01, P = 0.51) or other side effects. Administration of fibrin sealant in total hip arthroplasty may reduce total blood loss, postoperative hemoglobin decline and transfusion requirements. Moreover, no adverse effect was related to FS. Due to the limited quality of the evidence currently available, higher quality RCTs are required. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Osteochondritis Dissecans of the Hip

International Nuclear Information System (INIS)

Linden, B.; Jonsson, K.; Redlund-Johnell, I.

2003-01-01

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

Osteochondritis Dissecans of the Hip

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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.

Effect of timing of hip extension assistance during loaded walking with a soft exosuit.

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Ding, Ye; Panizzolo, Fausto A; Siviy, Christopher; Malcolm, Philippe; Galiana, Ignacio; Holt, Kenneth G; Walsh, Conor J

2016-10-03

Recent advances in wearable robotic devices have demonstrated the ability to reduce the metabolic cost of walking by assisting the ankle joint. To achieve greater gains in the future it will be important to determine optimal actuation parameters and explore the effect of assisting other joints. The aim of the present work is to investigate how the timing of hip extension assistance affects the positive mechanical power delivered by an exosuit and its effect on biological joint power and metabolic cost during loaded walking. In this study, we evaluated 4 different hip assistive profiles with different actuation timings: early-start-early-peak (ESEP), early-start-late-peak (ESLP), late-start-early-peak (LSEP), late-start-late-peak (LSLP). Eight healthy participants walked on a treadmill at a constant speed of 1.5 m · s -1 while carrying a 23 kg backpack load. We tested five different conditions: four with the assistive profiles described above and one unpowered condition where no assistance was provided. We evaluated participants' lower limb kinetics, kinematics, metabolic cost and muscle activation. The variation of timing in the hip extension assistance resulted in a different amount of mechanical power delivered to the wearer across conditions; with the ESLP condition providing a significantly higher amount of positive mechanical power (0.219 ± 0.006 W · kg -1 ) with respect to the other powered conditions. Biological joint power was significantly reduced at the hip (ESEP and ESLP) and at the knee (ESEP, ESLP and LSEP) with respect to the unpowered condition. Further, all assistive profiles significantly reduced the metabolic cost of walking compared to the unpowered condition by 5.7 ± 1.5 %, 8.5 ± 0.9 %, 6.3 ± 1.4 % and 7.1 ± 1.9 % (mean ± SE for ESEP, ESLP, LSEP, LSLP, respectively). The highest positive mechanical power delivered by the soft exosuit was reported in the ESLP condition, which showed also a

The effect of reduced oxygen content powder on the impact toughness of 316 steel powder joined to 316 steel by low temperature HIP

International Nuclear Information System (INIS)

Lind, Anders; Sundstroem, Johan

2004-11-01

During the manufacture of the blanket modules, 316L steel powder is simultaneously consolidated and joined to tubes and blocks of 316L materials by Hot Isostatic Pressing (HIP). The high processing temperature can detrimentally increase the grain size of the water cooling tubes in the structure and the blocks reducing their strength. It is well known that surface oxides on the powder particles negatively influence the impact toughness of material and joints consolidated in this way. By increasing the consolidation temperature the metallurgical bonding is improved, due to a redistribution of oxygen within the oxide layer towards more discrete oxide particles. In order to get acceptable mechanical properties of materials produced at a low HIP temperature the oxygen content on the powder surfaces needs to be reduced. The aim of this new techniques to reduce the oxygen content of the metal powder. The influence on Charpy impact energy and tensile strength were demonstrated

Gait symmetry and hip strength in women with developmental dysplasia following hip arthroplasty compared to healthy subjects: A cross-sectional study.

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Ruud A Leijendekkers

Full Text Available Untreated unilateral developmental dysplasia of the hip (DDH results in asymmetry of gait and hip strength and may lead to early osteoarthritis, which is commonly treated with a total hip arthroplasty (THA. There is limited knowledge about the obtained symmetry of gait and hip strength after the THA. The objectives of this cross-sectional study were to: a identify asymmetries between the operated and non-operated side in kinematics, kinetics and hip strength, b analyze if increased walking speed changed the level of asymmetry in patients c compare these results with those of healthy subjects.Women (18-70 year with unilateral DDH who had undergone unilateral THA were eligible for inclusion. Vicon gait analysis system was used to collect frontal and sagittal plane kinematic and kinetic parameters of the hip joint, pelvis and trunk during walking at comfortable walking speed and increased walking speed. Furthermore, hip abductor and extensor muscle strength was measured.Six patients and eight healthy subjects were included. In the patients, modest asymmetries in lower limb kinematics and kinetics were present during gait, but trunk lateral flexion asymmetry was evident. Patients' trunk lateral flexion also differed compared to healthy subjects. Walking speed did not significantly influence the level of asymmetry. The hip abduction strength asymmetry of 23% was not statistically significant, but the muscle strength of both sides were significantly weaker than those of healthy subjects.In patients with a DDH treated with an IBG THA modest asymmetries in gait kinematics and kinetics were present, with the exception of a substantial asymmetry of the trunk lateral flexion. Increased walking speed did not result in increased asymmetries in gait kinematics and kinetics. Hip muscle strength was symmetrical in patients, but significantly weaker than in healthy subjects. Trunk kinematics should be included as an outcome measure to assess the biomechanical

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

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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.

HIP JOINT AND HIP ENDOPROSTHESIS BIOMECHANICS

OpenAIRE

Jakub Gryka

2017-01-01

This article contains a description of the basic issues related to anatomy, loading of hip joint and its endoprosthesis research methods. The methods of testing and simulating hip joint loads, factors that influence the selection of parameters during the design of prostheses, typical solutions to engineering problems related to this topic are presented. The article concludes with short summary of the finite element method for the design of hip replacements.

Usefulness of Arthroscopic Treatment of Painful Hip after Acetabular Fracture or Hip Dislocation.

Science.gov (United States)

Hwang, Jung-Taek; Lee, Woo-Yong; Kang, Chan; Hwang, Deuk-Soo; Kim, Dong-Yeol; Zheng, Long

2015-12-01

Painful hip following hip dislocation or acetabular fracture can be an important signal for early degeneration and progression to osteoarthritis due to intraarticular pathology. However, there is limited literature discussing the use of arthroscopy for the treatment of painful hip. The purpose of this retrospective study was to analyze the effectiveness and benefit of arthroscopic treatment for patients with a painful hip after major trauma. From July 2003 to February 2013, we reviewed 13 patients who underwent arthroscopic treatment after acetabular fracture or hip dislocation and were followed up for a minimum of 2 postoperative years. The degree of osteoarthritis based on the Tonnis classification pre- and postoperatively at final follow-up was determined. Clinical outcomes were evaluated using visual analogue scale for pain (VAS) and modified Harris hip score (MHHS), and range of motion (ROM) of the hip pre- and postoperatively at final follow-up. There were nine male and four female patients with a mean age at surgery of 28 years (range, 20 to 50 years). The mean follow-up period of the patients was 59.8 months (range, 24 to 115 months), and the mean interval between initial trauma and arthroscopic treatment was 40.8 months (range, 1 to 144 months). At the final follow-up, VAS and MHHS improved significantly from 6.3 and 53.4 to 3.0 and 88.3, respectively (p = 0.002 and p hip flexion, abduction, adduction, external rotation, and internal rotation as minor improvements from 113.1°, 38.5°, 28.5°, 36.5°, and 22.7° to 118.5°, 39.0°, 29.2°, 38.9°, and 26.5° were observed, respectively (p = 0.070, p = 0.414, p = 0.317, p = 0.084, and p = 0.136, respectively). None of the patients exhibited progression of osteoarthritis of the hip at the final follow-up. Arthroscopic treatment after acetabular fracture or hip dislocation is effective and delays the progression of traumatic osteoarthritis.

Hip Abductor Muscle Volume and Strength Differences Between Women With Chronic Hip Joint Pain and Asymptomatic Controls.

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Mastenbrook, Matthew J; Commean, Paul K; Hillen, Travis J; Salsich, Gretchen B; Meyer, Gretchen A; Mueller, Michael J; Clohisy, John C; Harris-Hayes, Marcie

2017-12-01

Study Design Secondary analysis, cross-sectional study. Background Chronic hip joint pain (CHJP) can lead to limitations in activity participation, but the musculoskeletal factors associated with the condition are relatively unknown. Understanding the factors associated with CHJP may help develop rehabilitation strategies to improve quality of life of individuals with long-term hip pain. Objectives To compare measures of hip abductor muscle volume and hip abductor muscle strength between women with CHJP and asymptomatic controls. Methods Thirty women, 15 with CHJP and 15 matched asymptomatic controls (age range, 18-40 years), participated in this study. Magnetic resonance imaging was used to determine the volume of the primary hip abductor muscles, consisting of the gluteus medius, gluteus minimus, a small portion of the gluteus maximus, and the tensor fascia latae, within a defined region of interest. Break tests were performed using a handheld dynamometer to assess hip abductor strength. During the strength test, the participant was positioned in sidelying with the involved hip in 15° of abduction. Independent-samples t tests were used to compare muscle volume and strength values between those with CHJP and asymptomatic controls. Results Compared to asymptomatic controls, women with CHJP demonstrated significantly increased gluteal muscle volume (228 ± 40 cm 3 versus 199 ± 29 cm 3 , P = .032), but decreased hip abductor strength (74.6 ± 16.8 Nm versus 93.6 ± 20.2 Nm, P = .009). There were no significant differences in tensor fascia lata muscle volume between the 2 groups (P = .640). Conclusion Women with CHJP appear to have larger gluteal muscle volume, but decreased hip abductor strength, compared to asymptomatic controls. J Orthop Sports Phys Ther 2017;47(12):923-930. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7380.

Avoidance of activity and limitations in activities in patients with osteoarthritis of the hip or knee: a 5 year follow-up study on the mediating role of reduced muscle strength.

NARCIS (Netherlands)

Pisters, M.F.; Veenhof, C.; Dijk, G.M. van; Dekker, J.

2014-01-01

Objective: To evaluate the mediating role of reduced muscle strength in the relationship between avoidance of activity and limitations in activities in patients with knee or hip osteoarthritis (OA). Methods: A longitudinal cohort study with 5 years follow-up was conducted. Patients with knee or hip

Avoidance of activity and limitations in activities in patients with osteoarthritis of the hip or knee: a 5 year follow-up study on the mediating role of reduced muscle strength

NARCIS (Netherlands)

Pisters, M.F.; Veenhof, C.; van Dijk, G.M.; Dekker, J.

2014-01-01

Objective: To evaluate the mediating role of reduced muscle strength in the relationship between avoidance of activity and limitations in activities in patients with knee or hip osteoarthritis (OA). Methods: A longitudinal cohort study with 5 years follow-up was conducted. Patients with knee or hip

Bone-preserving total hip arthroplasty in avascular necrosis of the hip-a matched-pairs analysis.

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Merschin, David; Häne, Richard; Tohidnezhad, Mersedeh; Pufe, Thomas; Drescher, Wolf

2018-07-01

Short-stem hip arthroplasty has the potential advantage of femoral bone stock preservation, especially in view of the expected revisions in the often relatively young patients. Despite short-stem hip prosthesis are increasingly used for total hip arthroplasty, there are no sufficient mid- and long-term results especially for patients with avascular femoral head osteonecrosis. The present study investigates mid-term functional results as well as the revision rate following implantation of a short-stem prosthesis. In the period 06/2005 until 12/2013, a total of 351 short-stem hip prostheses were implanted. The study included 331 complete data sets. A retrospective analysis was performed using the Oxford Hip Score. All revisions were registered. In a total of 331 prostheses, the Oxford Hip Score was "excellent" in 66.2%, "good" in 12.7%, "fair" in 13.0%, and "poor" in 8.2% with a mean follow-up of 57.4 months (SD ± 29.8; range 24-115). In 26 cases, aseptic osteonecrosis of the hip was the indication (7.9%). The Oxford Hip Score was "excellent" in 66.7%, "good" in 0.0%, "fair" in 20.8%, and "poor" in 12.5%. The cumulated five year survival rate was 96.7%. In mid-term observation, the Metha® short-stem prosthesis shows no disadvantage in functional outcome and in survival time compared to a standard hip stem. Providing a correct indication, the Metha® short stem is a valuable option in total hip arthroplasty for younger patients with avascular osteonecrosis of the femoral head. Evaluation has shown no significant differences between aseptic osteonecrosis and other indications.

Hip Fracture

Science.gov (United States)

... hip fractures in people of all ages. In older adults, a hip fracture is most often a result of a fall from a standing height. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting. Risk factors The rate of hip fractures increases substantially with ...

The Relationship Between Hip Strength and the Y-Balance Test.

Science.gov (United States)

Wilson, Benjamin R; Robertson, Kaley E; Burnham, Jeremy M; Yonz, Michael C; Ireland, Mary Lloyd; Noehren, Brian

2017-07-17

The Y-Balance Test was developed as a test of dynamic postural control and has been shown to be predictive of lower extremity injury. However, the relationship between hip strength and performance on the Y-Balance Test has not been fully elucidated. The goal of this study was to identify the relationship between components of isometric hip strength and the Y-Balance Test, to provide clinicians better guidance as to specific areas of muscle performance to address in the event of poor performance on the Y-Balance Test. Laboratory Study. Biomechanics Laboratory. Seventy-three healthy participants, 40 males and 33 females, volunteered for this study. None. Participants completed the Y-Balance Test on the right leg. We then measured peak isometric torque in hip external rotation, abduction, and extension. Correlations were calculated between torque measurements, normalized for mass, and Y-Balance Test performance. Significant relationships were used in linear regression models to determine which variables were predictive of the Y-Balance Test performance. We found significant positive correlations between Y-Balance Test performance and hip abduction strength. We also found correlations between the Y-Balance Test and hip extension and external rotation strengths. Linear regression analysis showed hip abduction to be the only significant predictor of Y- Balance performance. We found the strongest association between the Y-Balance Test and hip abduction strength. We also showed smaller but significant associations with hip extension and external rotation strength. When entered into a linear regression analysis, hip abduction strength was the only significant predictor of Y-Balance performance. Using this information, practitioners should look to hip abduction strength when patients exhibit deficits in the Y-Balance Test.

A Biomechanical Comparison of Proportional Electromyography Control to Biological Torque Control Using a Powered Hip Exoskeleton

Directory of Open Access Journals (Sweden)

Aaron J. Young

2017-06-01

Full Text Available BackgroundDespite a large increase in robotic exoskeleton research, there are few studies that have examined human performance with different control strategies on the same exoskeleton device. Direct comparison studies are needed to determine how users respond to different types of control. The purpose of this study was to compare user performance using a robotic hip exoskeleton with two different controllers: a controller that targeted a biological hip torque profile and a proportional myoelectric controller.MethodsWe tested both control approaches on 10 able-bodied subjects using a pneumatically powered hip exoskeleton. The state machine controller targeted a biological hip torque profile. The myoelectric controller used electromyography (EMG of lower limb muscles to produce a proportional control signal for the hip exoskeleton. Each subject performed two 30-min exoskeleton walking trials (1.0 m/s using each controller and a 10-min trial with the exoskeleton unpowered. During each trial, we measured subjects’ metabolic cost of walking, lower limb EMG profiles, and joint kinematics and kinetics (torques and powers using a force treadmill and motion capture.ResultsCompared to unassisted walking in the exoskeleton, myoelectric control significantly reduced metabolic cost by 13% (p = 0.005 and biological hip torque control reduced metabolic cost by 7% (p = 0.261. Subjects reduced muscle activity relative to the unpowered condition for a greater number of lower limb muscles using myoelectric control compared to the biological hip torque control. More subjects subjectively preferred the myoelectric controller to the biological hip torque control.ConclusionMyoelectric control had more advantages (metabolic cost and muscle activity reduction compared to a controller that targeted a biological torque profile for walking with a robotic hip exoskeleton. However, these results were obtained with a single exoskeleton device with specific

A Biomechanical Comparison of Proportional Electromyography Control to Biological Torque Control Using a Powered Hip Exoskeleton.

Science.gov (United States)

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

2017-01-01

Despite a large increase in robotic exoskeleton research, there are few studies that have examined human performance with different control strategies on the same exoskeleton device. Direct comparison studies are needed to determine how users respond to different types of control. The purpose of this study was to compare user performance using a robotic hip exoskeleton with two different controllers: a controller that targeted a biological hip torque profile and a proportional myoelectric controller. We tested both control approaches on 10 able-bodied subjects using a pneumatically powered hip exoskeleton. The state machine controller targeted a biological hip torque profile. The myoelectric controller used electromyography (EMG) of lower limb muscles to produce a proportional control signal for the hip exoskeleton. Each subject performed two 30-min exoskeleton walking trials (1.0 m/s) using each controller and a 10-min trial with the exoskeleton unpowered. During each trial, we measured subjects' metabolic cost of walking, lower limb EMG profiles, and joint kinematics and kinetics (torques and powers) using a force treadmill and motion capture. Compared to unassisted walking in the exoskeleton, myoelectric control significantly reduced metabolic cost by 13% ( p  = 0.005) and biological hip torque control reduced metabolic cost by 7% ( p  = 0.261). Subjects reduced muscle activity relative to the unpowered condition for a greater number of lower limb muscles using myoelectric control compared to the biological hip torque control. More subjects subjectively preferred the myoelectric controller to the biological hip torque control. Myoelectric control had more advantages (metabolic cost and muscle activity reduction) compared to a controller that targeted a biological torque profile for walking with a robotic hip exoskeleton. However, these results were obtained with a single exoskeleton device with specific control configurations while level walking at a

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...

Hip and Groin Injuries in Baseball Players.

Science.gov (United States)

Mlynarek, Ryan A; Coleman, Struan H

2018-03-01

To discuss the clinical significance of the most common hip and groin injuries in baseball players, as well as an algorithmic approach to diagnosis and treatment of these injuries. (a) Limitations in throwing velocity, pitch control, and bat swing speed may be secondary to decreased mobility and strength within the proximal kinetic chain, which must harness power from the lower extremities and core. (b) Approximately 5.5% of all baseball injuries per year involve the hip/groin and may lead to a significant amount of time spent on the disabled list. Injuries involving the hip and groin are relatively common in baseball players. Our knowledge of the mechanics of overhead throwing continues to evolve, as does our understanding of the contribution of power from the lower extremities and core. It is paramount that the team physician be able to accurately diagnose and treat injuries involving the hip/groin, as they may lead to significant disability and inability to return to elite levels of play. This review focuses on hip- and groin-related injuries in the baseball player, including femoroacetabular impingement, core muscle injury, and osteitis pubis.

Roentgenography of hip-joint using tubus in infants

International Nuclear Information System (INIS)

Sakuyama, Keiko; Imamura, Keiko; Uji, Teruyuki; Fujikawa, Mitsuhiro; Ishikawa, Toru

1976-01-01

Roentgenography of hip-joint using tubus was discussed. This technique has been made at St. Marianna University, School of Medicine, in order to reduce the exposure dose in x-ray examination of congenital dislocation of hip-joint. The tubus is designed to butterfly-shaped. Only the site which is necessary for roentgenography of hip-joint is exposed, and the sexual gland is outside exposure. The exposure dose of the sexual gland using tubus is 1/10 in female infants and 1/30 in male infants of those without tubus (6.7 mR in male infants, 2.0 mR in female infants). There are some advantages in the tubus: it is clinically used for both sexes as well as reducing exposure doses, and it can be used widely from neonates to infants. (Serizawa, K.)

HIP AND GLENOHUMERAL PASSIVE RANGE OF MOTION IN COLLEGIATE SOFTBALL PLAYERS

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Plummer, Hillary; Brambeck, Allison

2016-01-01

Background and Purpose Range of motion deficits at the hip and glenohumeral joint (GHJ) may contribute to the incidence of injury in softball players. With injury in softball players on the rise, softball related studies in the literature are important. The purpose of this study was to examine hip and GHJ passive range of motion (PROM) patterns in collegiate softball players. Hypothesis It was hypothesized that the position players would exhibit significantly different PROM patterns than pitchers. Additionally, position players would exhibit significantly different side-to-side differences in PROM for both the hip and GHJ compared to pitchers. Study Design Prospective cohort study. Methods Forty-nine collegiate softball players (19.63 ± 1.15 years; 170.88 ± 8.08 cm; 72.96 ± 19.41 kg) participated. Passive hip and GHJ internal (IR) and external rotation (ER) measures were assessed. Glenohumeral PROM was measured with the participants supine with the arm abducted to 90 °. The measurements were recorded when the scapula began to move or a firm capsular end-feel was achieved. The hip was positioned in 90 ° of flexion and passively rotated until a capsular end-feel was achieved. Total PROM was calculated by taking the sum of IR and ER for both the hip and GHJ. Results No significant side-to-side PROM differences were observed in pitchers, at the GHJ or hip joint. Position players throwing side hip IR was significantly greater than the non-throwing side hip (p = 0.002). The non-throwing side hip had significantly greater ER compared to the throwing side hip (p = 0.002). When examining side-to-side differences at the GHJ, IR was significantly greater in the non-throwing shoulder (p = 0.047). No significant differences in total range of motion of the hip and GHJ were observed. Conclusion In the current study, position players displayed side-to-side differences in hip and GHJ IR PROM while no statistically significant differences were

Spine–hip relations in patients with hip osteoarthritis

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Rivière, Charles; Lazic, Stefan; Dagneaux, Louis; Van Der Straeten, Catherine; Cobb, Justin; Muirhead-Allwood, Sarah

2018-01-01

Patients with hip osteoarthritis often have an abnormal spine-hip relation (SHR), meaning the presence of a clinically deleterious spine-hip and/or hip-spine syndrome. Definition of the individual SHR is ideally done using the EOS® imaging system or, if not available, with conventional lumbopelvic lateral radiographs. By pre-operatively screening patients with abnormal SHR, it is possible to refine total hip replacement (THR) surgical planning, which may improve outcomes. An important component of the concept of kinematically aligned total hip arthroplasty (KA THA) consists of defining the optimal acetabular cup design and orientation based on the assessment of an individual’s SHR, and use of the transverse acetabular ligament to adjust the cup positioning. The Bordeaux classification might advance the understanding of SHR and hopefully help improve THR outcomes. Cite this article: EFORT Open Rev 2018;3:39-44. DOI: 10.1302/2058-5241.3.170020 PMID:29657844

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.

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

DEFF Research Database (Denmark)

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

2015-01-01

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

Postoperative Delirium in Elderly Patients Undergoing Hip Fracture Surgery in the Sugammadex Era: A Retrospective Study

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Oh, Chung-Sik; Rhee, Ka Young; Yoon, Tae-Gyoon; Woo, Nam-Sik; Hong, Seung Wan; Kim, Seong-Hyop

2016-01-01

Background. Residual neuromuscular block (NMB) after general anesthesia has been associated with pulmonary dysfunction and hypoxia, which are both associated with postoperative delirium (POD). We evaluated the effects of sugammadex on POD in elderly patients who underwent hip fracture surgery. Methods. Medical records of 174 consecutive patients who underwent hip fracture surgery with general anesthesia were reviewed retrospectively to compare the perioperative incidence of POD, pulmonary complications, time to extubation, incidence of hypoxia, and laboratory findings between patients treated with sugammadex and those treated with a conventional cholinesterase inhibitor. Results. The incidence of POD was not significantly different between the two groups (33.3% versus 36.5%, resp.; P = 0.750). Postoperative pulmonary complications and laboratory findings did not showed significant intergroup difference. However, time to extubation (6 ± 3 versus 8 ± 3 min; P sugammadex group than in the conventional cholinesterase inhibitor group. Conclusion. Sugammadex did not reduce POD or pulmonary complications compared to conventional cholinesterase inhibitors, despite reducing time to extubation and postoperative hypoxia in elderly patients who underwent hip fracture surgery under general anesthesia. PMID:26998480

Impact of comorbidities on hospitalization costs following hip fracture.

Science.gov (United States)

Nikkel, Lucas E; Fox, Edward J; Black, Kevin P; Davis, Charles; Andersen, Lucille; Hollenbeak, Christopher S

2012-01-04

Hip fractures are common in the elderly, and patients with hip fractures frequently have comorbid illnesses. Little is known about the relationship between comorbid illness and hospital costs or length of stay following the treatment of hip fracture in the United States. We hypothesized that specific individual comorbid illnesses and multiple comorbid illnesses would be directly related to the hospitalization costs and the length of stay for older patients following hip fracture. With use of discharge data from the 2007 Nationwide Inpatient Sample, 32,440 patients who were fifty-five years or older with an isolated, closed hip fracture were identified. Using generalized linear models, we estimated the impact of comorbidities on hospitalization costs and length of stay, controlling for patient, hospital, and procedure characteristics. Hypertension, deficiency anemias, and fluid and electrolyte disorders were the most common comorbidities. The patients had a mean of three comorbidities. Only 4.9% of patients presented without comorbidities. The average estimated cost in our reference patient was $13,805. The comorbidity with the largest increased hospitalization cost was weight loss or malnutrition, followed by pulmonary circulation disorders. Most other comorbidities significantly increased the cost of hospitalization. Compared with internal fixation of the hip fracture, hip arthroplasty increased hospitalization costs significantly. Comorbidities significantly affect the cost of hospitalization and length of stay following hip fracture in older Americans, even while controlling for other variables.

The effects of therapeutic hip exercise with abdominal core activation on recruitment of the hip muscles.

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Chan, Mandy Ky; Chow, Ka Wai; Lai, Alfred Ys; Mak, Noble Kc; Sze, Jason Ch; Tsang, Sharon Mh

2017-07-21

Core stabilization has been utilized for rehabilitation and prevention of lower limb musculoskeletal injuries. Previous studies showed that activation of the abdominal core muscles enhanced the hip muscle activity in hip extension and abduction exercises. However, the lack of the direct measurement and quantification of the activation level of the abdominal core muscles during the execution of the hip exercises affect the level of evidence to substantiate the proposed application of core exercises to promote training and rehabilitation outcome of the hip region. The aim of the present study was to examine the effects of abdominal core activation, which is monitored directly by surface electromyography (EMG), on hip muscle activation while performing different hip exercises, and to explore whether participant characteristics such as gender, physical activity level and contractile properties of muscles, which is assessed by tensiomyography (TMG), have confounding effect to the activation of hip muscles in enhanced core condition. Surface EMG of bilateral internal obliques (IO), upper gluteus maximus (UGMax), lower gluteus maximus (LGMax), gluteus medius (GMed) and biceps femoris (BF) of dominant leg was recorded in 20 young healthy subjects while performing 3 hip exercises: Clam, side-lying hip abduction (HABD), and prone hip extension (PHE) in 2 conditions: natural core activation (NC) and enhanced core activation (CO). EMG signals normalized to percentage of maximal voluntary isometric contraction (%MVIC) were compared between two core conditions with the threshold of the enhanced abdominal core condition defined as >20%MVIC of IO. Enhanced abdominal core activation has significantly promoted the activation level of GMed in all phases of clam exercise (P recruitment in Clam, HABD and PHE exercises, and this enhancement is correlated with higher physical activity and stiffer hip muscle. Our results suggest the potential application of abdominal core activation for

Hip fractures and pain following proton therapy for management of prostate cancer

International Nuclear Information System (INIS)

Valery, Raul; Mendenhall, Nancy P.; Nichols, Romaine C. Jr.; Henderson, Randal; Morris, Christopher G.; Su, Zhong; Li, Zuofeng; Hoppe, Bradford S.; Mendenhall, William M.; Williams, Christopher R.

2013-01-01

Background: Proton therapy (PT) for prostate cancer reduces rectal and bladder dose, but increases dose to the femoral necks. We assessed the risk of hip fracture and pain in men treated with PT for prostate cancer. Material and methods: From 2006 to 2008, 382 men were treated for prostate cancer and evaluated at six-month intervals after PT for toxicities at Univ. of Florida Proton Therapy Institute (UFPTI). The WHO Fracture Risk Assessment Tool (FRAX) generated annual hip-fracture risk for the cohort. The WHO FRAX tool was utilized to generate the expected number of patients with hip fractures and the observed-to-expected ratio; confidence intervals and p-value were generated with the mid-P exact test. Univariate analysis of hip pain as a function of several prognostic factors was accomplished with Fisher's exact test. Results. Median follow-up was four years (range, 0.1-5.5 years). Per FRAX, 3.02 patients were expected to develop a hip fracture without PT. Three PT patients actually developed fractures for a rate of 0.21 fractures per 100 person-years of follow-up. There was an observed-expected ratio of 0.99 (p-value not significant). Forty-eight patients (13%) reported new pain in the hip during follow-up; three required prescription analgesics. Conclusion. PT for prostate cancer did not increase hip-fractures in the first four years after PT compared to expected rates in untreated men

Are Hip-Specific Items Useful in a Quality of Life Questionnaire for Patients with Hip Fractures?

Science.gov (United States)

Yao, Kai-Ping Grace; Lee, Hsin-Yi; Tsauo, Jau-Yih

2009-01-01

Researchers measure the significance of hip fracture by the patient's impairment. The patient's quality of life (QOL) is usually also substantially affected. However, there is no specific quality of life (QOL) questionnaire for patients with hip fractures. This study was designed to determine whether adding a new set of specific questions about…

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

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral (hemi-hip...

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

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint (hemi-hip) acetabular metal cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3370 Hip joint (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular...

Utility of immediate postoperative hip MRI in developmental hip dysplasia: closed vs. open reduction.

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Jadhav, Siddharth P; More, Snehal R; Shenava, Vinitha; Zhang, Wei; Kan, J Herman

2018-04-25

Magnetic resonance imaging (MRI) of the hips is being increasingly used to confirm hip reduction after surgery and spica cast placement for developmental dysplasia of the hip (DDH). To review a single institutional experience with post-spica MRI in children undergoing closed or open hip reduction and describe the utility of MRI in directing the need for re-intervention. Seventy-four patients (52 female, 22 male) who underwent post-spica hip MRI over a 6-year period were retrospectively reviewed. One hundred and seven hips were included. Data reviewed included age at intervention, gender, type of intervention performed, MRI findings, the need for re-intervention and the interval between interventions. Gender was compared between the closed and open reduction groups via the Fisher exact test. Age at the first procedure was compared via the Wilcoxon rank test. Rates of re-intervention after closed and open reduction were calculated and the reasons for re-intervention were reviewed. The mean age at the time of the first intervention was 16.4 months (range: 4 to 63 months). Mean age for the closed reduction group was 10.5 months (range: 4-24 months) and for the open reduction group was 23.7 months (range: 5-63 months), which was significant (P-value open reduction, MRI was useful in deciding re-intervention in only 1 (2%). This patient had prior multiple failed closed and open reductions at an outside institute. Post intervention hip spica MRI is useful in determining the need for re-intervention after closed hip reduction, but its role after open reduction is questionable.

Successful staged hip replacement in septic hip osteoarthritis in osteopetrosis: a case report

Directory of Open Access Journals (Sweden)

Manzi Giovanni

2012-04-01

Full Text Available Abstract Background Osteopetrosis is a rare, inherited, bone disorder, characterized by osteosclerosis, obliteration of the medullary cavity and calcified cartilage. The autosomal dominant form is compatible with a normal life span, although fractures often result from minimal trauma, due to the pathologic nature of bone. Osteomyelitis is common in patients with osteopetrosis because of a reduced resistance to infection, attributed to the lack of marrow vascularity and impairment of white cell function. Only one case of osteomyelitis of the proximal third of the femur has been previously reported, treated with several repeated debridements and finally with femoral head resection. Here we present for the first time a case of a staged implant of a cementless total hip prosthesis for the treatment of a septic hip in femoral neck nonunion in osteopetrosis. Case presentation A 36-years-old woman, affected by autosomal dominant osteopetrosis was referred to our department because of a septic hip arthritis associated with femoral neck septic non-union, with draining fistulas. The infection occurred early after a plate osteosynthesis for a closed perthrocanteric fracture of the femur and persisted in spite of osteosynthesis removal, surgical debridement and external fixation. In our hospital the patient underwent accurate debridement, femoral head and greater trochanter resection, preparation of the diaphyseal intramedullary canal and implant of an antibiotic-loaded cement spacer. The spacer was exchanged after one month, due to infection recurrence and four months later, a cementless total hip arthroplasty was implanted, with no clinical and laboratory signs of infection recurrence at two years follow-up. Conclusions In case of hip septic arthritis and proximal femur septic non-union, femoral head resection may not be the only option available and staged total hip arthroplasty can be considered.

Hip Strength Testing of Soccer Players With Long-Standing Hip and Groin Pain: What are the Clinical Implications of Pain During Testing?

Science.gov (United States)

Rafn, Bolette S; Tang, Lars; Nielsen, Martin P; Branci, Sonia; Hölmich, Per; Thorborg, Kristian

2016-05-01

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. Cross-sectional study. Clinical assessments at Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Centre Amager, Copenhagen University Hospital, Denmark. Twenty-four male soccer players with unilateral long-standing hip and groin pain. The soccer players performed 5 reliable hip muscle strength tests (isometric hip flexion, adduction, abduction, isometric hip flexion-modified Thomas test, and eccentric hip adduction). Muscle strength was measured with a hand-held dynamometer, and the players rated the pain during testing on a numerical rating scale (0-10). In 4 tests (isometric hip adduction, abduction, flexion, and eccentric adduction), no significant correlations were found between pain during testing and hip muscle strength (Spearman rho = -0.28 to 0.06, P = 0.09-0.39). Isometric hip flexion (modified Thomas test position) showed a moderate negative correlation between pain and hip muscle strength (Spearman rho = -0.44, P = 0.016). Self-reported pain during testing does not seem to correlate with the majority of hip muscle strength tests used in soccer players with long-standing hip and groin pain.

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 hip-fracture 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.

The hip fluid seal--Part II: The effect of an acetabular labral tear, repair, resection, and reconstruction on hip stability to distraction.

Science.gov (United States)

Nepple, Jeffrey J; Philippon, Marc J; Campbell, Kevin J; Dornan, Grant J; Jansson, Kyle S; LaPrade, Robert F; Wijdicks, Coen A

2014-04-01

The acetabular labrum is theorized to be important to normal hip function by providing stability to distraction forces through the suction effect of the hip fluid seal. The purpose of this study was to determine the relative contributions of the hip capsule and labrum to the distractive stability of the hip, and to characterize hip stability to distraction forces in six labral conditions: intact labrum, labral tear, labral repair (looped vs. through sutures), partial resection, labral reconstruction with iliotibial band, and complete resection. Eight cadaveric hips with a mean age of 47.8 years (SD 4.3, range 41-51 years) were included. For each condition, the hip seal was broken by distracting the hip at a rate of 0.33 mm/s while the required force, energy, and negative intra-articular pressure were measured. For comparisons between labral conditions, measurements were normalized to the intact labral state (percent of intact). The relative contribution of the labrum to distractive stability was greatest at 1 and 2 mm of displacement, where it was significantly greater than the role of the capsule and accounted for 77 % (SD 27 %, p = 0.006) and 70 % (SD 7 %, p = 0.009) of total distractive stability, respectively. The relative contribution of the capsule to distractive stability increased with progressive displacement, providing 41 % (SD 49 %) and 52 % (SD 53 %) of distractive stability at 3 and 5 mm of distraction, respectively. The maximal distraction force required to break the hip seal in the intact labral state (capsule removed) varied from 124 to 150 N. Labral tear, partial resection, and complete resection resulted in average maximal distraction forces of 76 % (SD 34 %), 29 % (SD 26 %), and 27 % (SD 22 %), respectively, compared to the intact state. Through type labral repairs resulted in significantly greater improvements (from the labral tear state) in maximal negative pressure generated, compared to looped type repairs (median increase; +32 vs. -9 %, p

The efficacy of modified direct lateral versus posterior approach on gait function and hip muscle strength after primary total hip arthroplasty at 12months follow-up

DEFF Research Database (Denmark)

Rosenlund, Signe; Broeng, Leif; Overgaard, Søren

2016-01-01

-spatial parameters and range of motion. Isometric maximal hip muscle strength in abduction, flexion and extension was also tested. FINDINGS: Post-operatively, no between-group difference in gait function was observed. However, both hip abductor and flexor muscle strength improved more in the posterior approach group......BACKGROUND: The lateral and the posterior approach are the most commonly used procedures for total hip arthroplasty. Due to the detachment of the hip abductors, lateral approach is claimed to cause reduced hip muscle strength and altered gait pattern. However, this has not been investigated...... in a randomised controlled trial. The aim was to compare the efficacy of total hip arthroplasty performed by lateral or posterior approach on gait function and hip muscle strength up to 12months post-operatively. We hypothesised that posterior approach would be superior to lateral approach. METHODS: Forty...

Failure analysis of the cement mantle in total hip arthroplasty with an efficient probabilistic method.

Science.gov (United States)

Kaymaz, Irfan; Bayrak, Ozgu; Karsan, Orhan; Celik, Ayhan; Alsaran, Akgun

2014-04-01

Accurate prediction of long-term behaviour of cemented hip implants is very important not only for patient comfort but also for elimination of any revision operation due to failure of implants. Therefore, a more realistic computer model was generated and then used for both deterministic and probabilistic analyses of the hip implant in this study. The deterministic failure analysis was carried out for the most common failure states of the cement mantle. On the other hand, most of the design parameters of the cemented hip are inherently uncertain quantities. Therefore, the probabilistic failure analysis was also carried out considering the fatigue failure of the cement mantle since it is the most critical failure state. However, the probabilistic analysis generally requires large amount of time; thus, a response surface method proposed in this study was used to reduce the computation time for the analysis of the cemented hip implant. The results demonstrate that using an efficient probabilistic approach can significantly reduce the computation time for the failure probability of the cement from several hours to minutes. The results also show that even the deterministic failure analyses do not indicate any failure of the cement mantle with high safety factors, the probabilistic analysis predicts the failure probability of the cement mantle as 8%, which must be considered during the evaluation of the success of the cemented hip implants.

An ultrasonographic study on measurement of normal hip joint in Korean

International Nuclear Information System (INIS)

Lim, Hyo Keun; Choo, In Wook; Park, Soo Sung; Han, Man Chung

1989-01-01

The ultrasonography is very useful in evaluation of small amount of effusion in hip joint and has several advantages such as noninvasiveness, easiness, accuracy and no radiation hazard. The data of normal hip joint space and capsule is very important in ultrasonographic evaluation of inflammatory hip joint disease. However, normal ultrasonographic data of hip joint has not been reported except in pediatric age. The purpose of this study was to evaluate and measure normal hip joint space and capsule and to provide the basic data for the clinical application. Healthy 70 males and 70 females who have had no past history and present clinical symptom of hip joint were examined with real time sector scanner (5MHz transducer). Width of hip joint spaces and thickness of joint capsule were obtained and analysed by statistical analysis. The results were as follows: 1. The average width of the hip joint space were 2.6±0.5 mm (right), 2.5±0.5 mm (left) in males and 2.4±0.5 (right), 2.5±0.6 mm (left) in females. There was no significant difference by sex. 2. The widths of the hip joint space were increased with aging and decreased after 6th decade (male) and 5th decade (females). 3. The maximal difference of both hip joint space was 1.2 mm and there was no significant difference in both side by sex and age. 4. The average thicknesses of hip joint capsule were 1.9±0.3 mm (right), 1.8±0.2 mm (left) in males and 1.7±0.3 mm (right), 1.7±0.2 mm (left) in females. There was no significant difference by sex. 5. The thickness of the hip joint capsule were increased with aging and were in plateau after 5th decade (male and female). 6. The maximal difference of both hip joint capsules was 0.9 mm and there was no significant difference in both sides by sex and age. It is therefore, considered that ultrasonography could be a very useful modality in diagnosis of hip joint disease in which the hip joint space and the hip joint capsule are changed by various etiologies

Hip Ultrasonography in the Diagnosis of Developmental Dysplasia of the Hip: Bakırköy Experience

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Altuğ Duramaz

2014-12-01

Full Text Available Aim: The purpose of the study was to determine the prevalence, incidence, and etiology as well as the risk factors for developmental dysplasia of the hip in newborns in whom we performed ultrasonography for screening using Graff’s method in our clinic. Methods: We retrospectively evaluated 2632 hip ultrasonography records of 1316 babies performed between 2008 and 2013. We analyzed the questionnaires of the Turkish Pediatric Orthopaedic Society which were filled by the physician during examination. The babies were divided into two groups according to ultrasonographic hip angles as pathological and normal. Results: The study is made on 1316 babies [680 girls (51.6%, 636 boys (48.4%]. The risk for developmental dysplasia of the hip was higher in girls, babies with a family history, babies with metatarsus adductus and those have been swaddled before. The mean gestational age and gestational weight was statistically significantly lower in the pathological group (p=0.0011. Conclusion: In our cross-sectional study, the incidence of developmental dysplasia of the hip was 0.5%. Female gender, positive family history of developmental dysplasia of the hip,metatarsus adductus and swaddling are still risk factors. Researching risk factors carefully, patient education and adding hip ultrasonograpy to newborn routine screening program are important measures in preventing developmental dysplasia of the hip.

Hip instability: a review of hip dysplasia and other contributing factors

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Kraeutler, Matthew J.; Garabekyan, Tigran; Pascual-Garrido, Cecilia; Mei-Dan, Omer

2016-01-01

Summary Background 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. Purpose 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. Methods We reviewed the literature on the diagnosis and surgical management of hip dysplasia and other causes of hip instability. Conclusions 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. Level of evidence V. PMID:28066739

Epidemiology of hip fracture: Worldwide geographic variation

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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.

Second hip fractures at Chiang Mai University Hospital.

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Wongtriratanachai, Prasit; Chiewchantanakit, Siripong; Vaseenon, Tanawat; Rojanasthien, Sattaya; Leerapun, Taninnit

2015-02-01

Hip fractures are a major public health problem. Patients who have suffered a hip fracture have an increased risk of a subsequent hip fracture. This study examines the incidence ofsecondhip fractures and attempts to identify underlying risk factors. To examine the incidence ofsecond hip fractures in osteoporotic patients at Chiang Mai University Hospital and to identify risk factors related to second hip fractures. A retrospective review was conducted of all low-energy mechanism hip fracture patients admitted during 2008 and 2009. Analysis of second hip fractures was conducted using survival analysis and logistic regression analysis. A total of 191 patients were observed for 391.68 person-years (mean 2.05 person-years per patient). Among that group, nine second hip fractures were identified, an overall incidence rate of 0.023 second fractures per person-year. Second hip fractures tended to occur within the first year following an initial hip fracture. There were no significant differences related to either gender or comorbid medical conditions. Logistic regression analysis revealed that increased risk of a second hip fracture was associated with age (highest between 80 to 89 years) and patients who were not treated for osteoporosis following their initial fracture. The incidence of second hip fractures at Chiang Mai University Hospital was 0.023 per person-year Careful follow-up of older patients, especially those over 80, and treatment ofosteoporosis with bisphosphonate plus vitamin D and calcium supplements was correlated with a reduction in the incidence of second hip fractures.

Postoperative Delirium in Elderly Patients Undergoing Hip Fracture Surgery in the Sugammadex Era: A Retrospective Study

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Chung-Sik Oh

2016-01-01

Full Text Available Background. Residual neuromuscular block (NMB after general anesthesia has been associated with pulmonary dysfunction and hypoxia, which are both associated with postoperative delirium (POD. We evaluated the effects of sugammadex on POD in elderly patients who underwent hip fracture surgery. Methods. Medical records of 174 consecutive patients who underwent hip fracture surgery with general anesthesia were reviewed retrospectively to compare the perioperative incidence of POD, pulmonary complications, time to extubation, incidence of hypoxia, and laboratory findings between patients treated with sugammadex and those treated with a conventional cholinesterase inhibitor. Results. The incidence of POD was not significantly different between the two groups (33.3% versus 36.5%, resp.; P=0.750. Postoperative pulmonary complications and laboratory findings did not showed significant intergroup difference. However, time to extubation (6 ± 3 versus 8 ± 3 min; P<0.001 and the frequency of postoperative hypoxia were significantly lower (23% versus 43%; P=0.010 in the sugammadex group than in the conventional cholinesterase inhibitor group. Conclusion. Sugammadex did not reduce POD or pulmonary complications compared to conventional cholinesterase inhibitors, despite reducing time to extubation and postoperative hypoxia in elderly patients who underwent hip fracture surgery under general anesthesia.

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

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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

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

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 o...... for women than men, but is evident in both genders. In this 'viewpoint', we wish to draw attention to the emerging body of evidence and to encourage researchers to continue collecting measures of lower body size in their surveys....... 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...

The Influence of Backpack Weight and Hip Belt Tension on Movement and Loading in the Pelvis and Lower Limbs during Walking

Directory of Open Access Journals (Sweden)

Katja Oberhofer

2018-01-01

Full Text Available The introduction of hip belts to backpacks has caused a shift of loading from the spine to the hips with reported improvements in musculoskeletal comfort. Yet the effects of different hip belt tensions on gait biomechanics remain largely unknown. The goal of this study was to assess the influence of backpack weight and hip belt tension on gait biomechanics. Data from optical motion capture and ground reaction forces (GRF during walking were acquired in nine healthy male subjects (age 28.0 ± 3.9 years. Six configurations of a commercial backpack were analyzed, that is, 15 kg, 20 kg, and 25 kg loading with 30 N and 120 N hip belt tension. Joint ranges of motion (ROM, peak GRF, and joint moments during gait were analyzed for significant differences by repeated measures of ANOVA with Bonferroni post hoc comparison. Increased loading led to a significant reduction of knee flexion-extension ROM as well as pelvis rotational ROM. No statistically significant effect of hip belt tension magnitudes on gait dynamics was found at any backpack weight, yet there was a trend of increased pelvis ROM in the transverse plane with higher hip belt tension at 25 kg loading. Further research is needed to elucidate the optimum hip belt tension magnitudes for different loading weights to reduce the risks of injury especially with higher loading.

Reliability and Validity of the Hip Stability Isometric Test (HipSIT): A New Method to Assess Hip Posterolateral Muscle Strength.

Science.gov (United States)

Almeida, Gabriel Peixoto Leão; das Neves Rodrigues, Helena Larissa; de Freitas, Bruno Wesley; de Paula Lima, Pedro Olavo

2017-12-01

Study Design Cross-sectional study. Background The Hip Stability Isometric Test (HipSIT) evaluates the strength of the hip posterolateral stabilizers in a position that favors greater activation of the gluteus maximus and gluteus medius and lower activation of the tensor fascia lata. Objectives To check the validity and reliability of the HipSIT and to evaluate the HipSIT in women with patellofemoral pain (PFP). Methods The HipSIT was evaluated with a handheld dynamometer. During testing, the participants were sidelying, with their legs positioned at 45° of hip flexion and 90° of knee flexion. Participants were instructed to raise the knee of the upper leg while keeping the upper and lower heels in contact. To establish reliability and validity, 49 women were tested with the HipSIT by 2 different evaluators on day 1, and then again 7 days later. The strength of the hip extensors, abductors, and external rotators was also evaluated. Twenty women with unilateral PFP were also evaluated. Results The HipSIT has excellent intrarater and interrater reliability. The standard error of measurement was 0.01 kgf/kg, and the minimal detectable change was 0.036 kgf/kg. The HipSIT showed good validity in isolated hip abduction, external rotation, and extension (Pstrength deficits in women with PFP. J Orthop Sports Phys Ther 2017;47(12):906-913. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7274.

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

DEFF Research Database (Denmark)

Lauritzen, J B

1997-01-01

have a high risk of hip fracture (annual rate of 5-6%), and the incidence of falls is about 1,500 falls/1,000 persons/year. Most hip fractures are a result of a direct trauma against the hip. The incidence of falls on the hip among nursing home residents is about 290 falls/1,000 persons/year and about......%, corresponding to 9 out of 247 residents saved from sustaining a hip fracture. The review points to the essentials of the development of hip fracture, which constitutes; risk of fall, type of fall, type of impact, energy absorption, and lastly bone strength, which is the ultimate and last permissive factor......The present review summarizes the pathogenic mechanisms leading to hip fracture based on epidemiological, experimental, and controlled studies. The estimated lifetime risk of hip fracture is about 14% in postmenopausal women and 6% in men. The incidence of hip fractures increases exponentially...

Increasing hip and knee flexion during a drop-jump task reduces tibiofemoral shear and compressive forces: implications for ACL injury prevention training.

Science.gov (United States)

Tsai, Liang-Ching; Ko, Yi-An; Hammond, Kyle E; Xerogeanes, John W; Warren, Gordon L; Powers, Christopher M

2017-12-01

Although most ACL injury prevention programmes encourage greater hip and knee flexion during landing, it remains unknown how this technique influences tibiofemoral joint forces. We examined whether a landing strategy utilising greater hip and knee flexion decreases tibiofemoral anterior shear and compression. Twelve healthy women (25.9 ± 3.5 years) performed a drop-jump task before and after a training session (10-15 min) that emphasised greater hip and knee flexion. Peak tibiofemoral anterior shear and compressive forces were calculated using an electromyography (EMG)-driven knee model that incorporated joint kinematics, EMG and participant-specific muscle volumes and patella tendon orientation measured using magnetic resonance imaging (MRI). Participants demonstrated a decrease in peak anterior tibial shear forces (11.1 ± 3.3 vs. 9.6 ± 2.7 N · kg -1 ; P = 0.008) and peak tibiofemoral compressive forces (68.4 ± 7.6 vs. 62.0 ± 5.5 N · kg -1 ; P = 0.015) post-training. The decreased peak anterior tibial shear was accompanied by a decrease in the quadriceps anterior shear force, while the decreased peak compressive force was accompanied by decreased ground reaction force and hamstring forces. Our data provide justification for injury prevention programmes that encourage greater hip and knee flexion during landing to reduce tibiofemoral joint loading.

Imaging of sports-related hip and groin injuries.

Science.gov (United States)

Lischuk, Andrew W; Dorantes, Thomas M; Wong, William; Haims, Andrew H

2010-05-01

A normally functioning hip joint is imperative for athletes who use their lower extremities with running, jumping, or kicking activities. Sports-related injuries of the hip and groin are far less frequent than injuries to the more distal aspect of the extremity, accounting for less than 10% of lower extremity injuries. Despite the lower incidence, hip and groin injuries can lead to significant clinical and diagnostic challenges related to the complex anatomy and biomechanical considerations of this region. Loads up to 8 times normal body weight have been documented in the joint in common daily activities, such as jogging, with significantly greater force expected during competitive athletics. Additionally, treatment for hip and groin injuries can obviate the participation of medical and surgical specialties, with a multidisciplinary approach frequently required. Delay in diagnosis and triage of these injuries may cause loss of time from competition and, potentially, early onset of degenerative changes. Magnetic resonance imaging (MRI) of the hip has proven to be the gold standard for the diagnosis of sports-related hip and groin injuries in the setting of negative radiographs. With its exquisite soft tissue contrast, multiplanar capabilities, and lack of ionizing radiation, MRI is unmatched in the noninvasive diagnosis of intra-articular and extra-articular pathology, as well as intraosseous processes. This review focuses on MRI of common athletic injuries of the hip and groin, including acetabular labral tears, femoral acetabular impingement syndrome, muscle injuries around the hip and groin (including athletic pubalgia), and athletic osseous injuries.

Preoperative irradiation for prevention of heterotopic ossification following prosthetic total hip replacement. Results of a prospective study in 462 hips

Energy Technology Data Exchange (ETDEWEB)

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

2003-11-01

Background: The effectiveness of pre- or postoperative radiotherapy for prevention of heterotopic ossification (HO) following total hip replacement (THR) has already been demonstrated in the past. Thereby, in most studies using preoperative radiotherapy patients were irradiated < 6 h before surgery. The purpose of this prospective study was to analyze the effectiveness of preoperative irradiation on the evening before surgery and to identify risk factors for HO in a homogeneous collective of patients. Patients and Methods: From July 1997 to July 2001, 416 patients (462 hips; 235 males, 227 females) received preoperative radiotherapy of the hip on the evening before surgery with a 7-Gy single fraction. The patients' median age was 67.1 years. The most frequent indication for radiotherapy was hypertrophic osteoarthritis (383 hips, 82.9%). Treatment results were assessed by comparison of pre- and postoperative hip X-rays (immediately and 6 months after surgery). The analysis of radiographs was performed according to the Brooker score. Results: The overall incidence of HO was 18.1% (n = 84), Brooker score 1 12.3% (n = 57), score 2 3.9% (n = 18), score 3 1.5% (n = 7), and score 4 0.4% (n = 2). Sex, body height, hypertrophic osteoarthritis of higher degree, size of the femoral component of the prosthesis, previous ipsi- or contralateral HO, and short course of nonsteroidal anti-inflammatory drug (diclofenac) therapy significantly influenced the HO rate in univariate analysis. In multivariate analysis, an interdependence of prosthesis size, sex and patient's height was found. From these three variables, only prosthesis size was statistically significant in multivariate analysis. The cumulative dose of diclofenac ({<=} 300 mg or > 300 mg) within the first 7 postoperative days and previous ipsi- or contralateral HO influenced the incidence of HO in multivariate analysis. Conclusion: Preoperative radiotherapy on the evening before surgery is an effective treatment

Muscle-tendon-related pain in 100 patients with hip dysplasia: prevalence and associations with self-reported hip disability and muscle strength

DEFF Research Database (Denmark)

Jacobsen, Julie Sandell; Hølmich, Per; Thorborg, Kristian

2018-01-01

The primary aim was to identify muscle-tendon-related pain in 100 patients with hip dysplasia. The secondary aim was to test whether muscle-tendon-related pain is associated with self-reported hip disability and muscle strength in patient with hip dysplasia. One hundred patients (17 men......-tendon-related pain and hip extension a significant inverse linear association between muscle-tendon-related pain and muscle strength was found ranging from -0.11 to - 0.12 Nm/kg in the adjusted analysis (P hip dysplasia with a high prevalence......) with a mean age of 29 years (SD 9) were included. Clinical entity approach was carried out to identify muscle-tendon-related pain. Associations between muscle-tendon-related pain and self-reported hip disability and muscle strength were tested with multiple regression analysis, including adjustments for age...

Reduction of metallosis in hip implant using thin film coating

Science.gov (United States)

Rajeshshyam, R.; Chockalingam, K.; Gayathri, V.; Prakash, T.

2018-04-01

Hip implant finds its emerging attraction due to it continuous demand over the years. The hip implants (femoral head) and acetabulum cup) mainly fabricated by metals such as stainless steel, cobalt chrome and titanium alloys, other than that ceramics and polyethylene have been used. The metal-on-metal hip implant was found to be best implant material for most of the surgeons due to its high surface finish, low wear rate and low chance of dislocation from its position after implanting. Where in metal based hip implant shows less wear rate of 0.01mm3/year. Metal-on-metal implant finds its advantage over other materials both in its mechanical and physical stability against human load. In M-O-M Cobalt- chromium alloys induce metal allergy. The metal allergy (particulate debris) that is generated by wear, fretting, fragmentation and which is unavoidable when a prosthesis is implanted, can induce an inflammatory reaction in some circumstances. The objectives of this research to evaluate thin film coating with Nano particle additives to reduce the wear leads to regarding metal ion release. Experimental results reveals that thin film Sol-Gel coating with 4wt. % of specimen reduced the cobalt and chromium ion release and reduces the wear rate. Wear rate reduced by 98% for 4wt. % graphene in 20N and 95% for 4wt. % graphene in 10N.

Joint space width in dysplasia of the hip

DEFF Research Database (Denmark)

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

2005-01-01

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

The relative cost of bent-hip bent-knee walking is reduced in water.

Science.gov (United States)

Kuliukas, Algis V; Milne, Nick; Fournier, Paul

2009-01-01

The debate about how early hominids walked may be characterised as two competing hypotheses: They moved with a fully upright (FU) gait, like modern humans, or with a bent-hip, bent-knee (BK) gait, like apes. Both have assumed that this bipedalism was almost exclusively on land, in trees or a combination of the two. Recent findings favoured the FU hypothesis by showing that the BK gait is 50-60% more energetically costly than a FU human gait on land. We confirm these findings but show that in water this cost differential is markedly reduced, especially in deeper water, at slower speeds and with greater knee flexion. These data suggest that the controversy about australopithecine locomotion may be eased if it is assumed that wading was a component of their locomotor repertoire and supports the idea that shallow water might have been an environment favourable to the evolution of early forms of "non-optimal" hominid bipedalism.

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

Hip Implant Systems

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... Implants and Prosthetics Metal-on-Metal Hip Implants Hip Implants Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hip implants are medical devices intended to restore mobility ...

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

Schizophrenia, antipsychotics and risk of hip fracture

DEFF Research Database (Denmark)

Sørensen, Holger J; Jensen, Signe O W; Nielsen, Jimmi

2013-01-01

In a nationwide study using linkage of Danish hospital registers we examined predictors of hip fracture (ICD-10: S72) in 15,431 patients with schizophrenia (ICD-10: F20 or ICD-8: 295) and 3,807,597 population controls. Shorter education, disability pension, lifetime alcohol abuse, somatic co......-morbidity, antipsychotics (IRR=1.19; 95% CI 1.15-1.24), antidepressant (IRR=1.18; 95% CI 1.16-1.20), anticholinergics (IRR=1.29; 95% CI 1.22-1.36), benzodiazepines (IRR=1.06; 95% CI 1.04-1.08) and corticosteroids (IRR=1.44; 95% CI 1.36-1.53) were significant predictors. In 556 persons with schizophrenia and hip fracture...... (matched to 1:3 to schizophrenia controls without hip fracture), antipsychotic polypharmacy predicted hip fracture. Analyses among antipsychotic monotherapy patients showed no differential effect of individual antipsychotics. A dose-response relationship of hip fracture and lifetime antipsychotics...

Gluteal tendinopathy and hip osteoarthritis: Different pathologies, different hip biomechanics.

Science.gov (United States)

Allison, Kim; Hall, Michelle; Hodges, Paul W; Wrigley, Tim V; Vicenzino, Bill; Pua, Yong-Hao; Metcalf, Ben; Grimaldi, Alison; Bennell, Kim L

2018-03-01

Gluteal tendinopathy (GT) and hip osteoarthritis (OA) are the most common causes of hip pain and associated disability in older adults. Pain and altered walking biomechanics are common to both conditions. This study aimed to compare three-dimensional walking biomechanics between individuals with unilateral, symptomatic GT and HOA. Sixty individuals with symptomatic unilateral GT confirmed by magnetic-resonance-imaging and 73 individuals with symptomatic unilateral HOA (Kellgren-Lawrence Grade ≥ 2) underwent three-dimensional gait analysis. Maximum and minimum values of the external sagittal hip moment, the first peak, second peak and mid-stance minimum of the hip adduction moment (HAM), sagittal plane hip excursion and hip joint angles, pelvic obliquity and trunk lean, at the three HAM time points during stance phase of walking were compared between groups. Compared to individuals with HOA, those with GT exhibited a greater hip peak extension moment (P < 0.001) and greater HAM throughout the stance phase of walking (P = 0.01-P < 0.001), greater hip adduction (P < 0.001) and internal rotation (P < 0.01-P < 0.001) angles and lower hip flexion angles and excursion (P = 0.02 - P < 0.001). Individuals with HOA exhibited a greater forward trunk lean (P ≤ 0.001) throughout stance, and greater ipsilateral trunk lean in the frontal plane (P < 0.001) than those with GT. Despite presence of pain in both conditions, hip kinematics and kinetics differ between individuals with symptomatic unilateral GT and those with symptomatic unilateral HOA. These condition-specific impairments may be targets for optimization of management of HOA and GT. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparison of three methods to diagnose hip dysplasia in dogs

International Nuclear Information System (INIS)

Sharma, Vikas; Mohindroo, J.

2009-01-01

The present study was designed to compare the usefulness of goniometry, radiography and distraction index in diagnosis of hip dysplasia in dogs. During the study 25 clinical cases (50 joints) suspected for hip dysplasia were evaluated. Norberg angle was found to have a significant positive correlation with extension, flexion, abduction, and adduction angles and a significant negative correlation with distraction index (DI) measurements. It could be inferred that all the six parameters (NA, DI, extension, flexion, abduction, and adduction) were reliable indicators for early diagnosis of hip dysplasia.Goniometry could be used as a safe and easy method for preliminary suspicion of hip dysplasia

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...... Center-Copenhagen (SORC-C), Arthroscopic Centre Amager, Copenhagen University Hospital, Denmark. PARTICIPANTS: Twenty-four male soccer players with unilateral long-standing hip and groin pain. INTERVENTIONS: The soccer players performed 5 reliable hip muscle strength tests (isometric hip flexion...... strength (Spearman rho = -0.44, P = 0.016). CONCLUSIONS: Self-reported pain during testing does not seem to correlate with the majority of hip muscle strength tests used in soccer players with long-standing hip and groin pain....

Sonography for hip joint effusion in adults with hip pain

NARCIS (Netherlands)

Bierma-Zeinstra, S. M.; Bohnen, A. M.; Verhaar, J. A.; Prins, A.; Ginai-Karamat, A. Z.; Laméris, J. S.

2000-01-01

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

Brief concept of hip preservation

Directory of Open Access Journals (Sweden)

Sanjeev S. Madan

2017-12-01

Full Text Available Restoration of the anatomy of the hip joint and biomechanics across it, carry the immense importance to prevent future osteoarthritis of the joint. The aim of this review is to provide the brief concept of the methods to preserve the hip, especially in young adults. Attempts to preserve the hips start with the intense preoperative planning of the corrective procedure. Different parameters regarding the femur and acetabulum in all 3 dimensions need to be assessed. Especially, measurement of the anteversion of the femur and acetabulum is a significant step to avoid osteoarthritis. In addition, the suprapelvic and infrapelvic (spine and lower limb lengths alignment needs to be considered in the planning. Correction of the femoral side of the hip needs the understanding of the blood supply of the proximal femur which carries the risk of avascular necrosis more so with intracapsular osteotomies. Acetabular reorientation, to re-distribute the forces over the weight bearing part, can be carried out with re-directional osteotomy such as periacetabular osteotomy. It needs the understanding of the acetabular anatomy and the force distribution in it. To conclude, correction of both femoral and acetabular side parameters need to be considered in decision making depending on the alterations due to various etiologies causing the hip disorders.

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

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metallic cemented or... 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 implanted...

Analysis of rehabilitation activities within skilled nursing and inpatient rehabilitation facilities after hip replacement for acute hip fracture.

Science.gov (United States)

Munin, Michael C; Putman, Koen; Hsieh, Ching-Hui; Smout, Randall J; Tian, Wenqiang; DeJong, Gerben; Horn, Susan D

2010-07-01

To characterize rehabilitation services in two types of postacute facilities in patients who underwent hip replacement following a hip fracture. Multisite prospective observational cohort from 6 freestanding skilled nursing facilities and 11 inpatient rehabilitation facilities. Patients (n = 218) with hip fracture who had either hemiarthroplasty or total hip arthroplasty followed by rehabilitation at skilled nursing facilities or inpatient rehabilitation facilities were enrolled. Using a point-of-care methodology, we recorded data from actual physical therapy and occupational therapy sessions completed including functional outcomes during the postacute admission. Onset time from surgical repair to rehabilitation admission was not significantly different between sites. Average skilled nursing facilities length of stay was 24.7 +/- 13.6 days, whereas inpatient rehabilitation facilities was 13.0 +/- 5.7 days (P inpatient rehabilitation facilities. For weekdays only, these data changed to 1.6 in skilled nursing facilities and 2.6 hrs per patient in inpatient rehabilitation facilities (P inpatient rehabilitation facilities accrued more time for gait training and exercise in physical therapy, which was found to be 48% and 40% greater, respectively, through day 8. In occupational therapy, patients of inpatient rehabilitation facilities had more time allocated to lower body dressing and transfers. Significant differences in rehabilitation activities were observed, and intensity was notably different within the first 8 therapy days even though baseline demographics and medical complexity were comparable across facility types. Our data suggest that after more complex hip replacement surgery, hip fracture patients can tolerate more intensive therapy earlier within the rehabilitation program.

Sunlight exposure is important for preventing hip fractures in patients with Alzheimer's disease, Parkinson's disease, or stroke.

Science.gov (United States)

Iwamoto, J; Takeda, T; Matsumoto, H

2012-04-01

Hypovitaminosis D as a result of malnutrition or sunlight deprivation, increased bone resorption, low bone mineral density (BMD), or an increased risk of falls may contribute to an increased risk of hip fractures in patients with neurological diseases, including Alzheimer's disease, Parkinson's disease, and stroke. The purpose of this study was to clarify the efficacy of sunlight exposure for reducing the risk of hip fractures in patients with such neurological diseases. The English literature was searched using PubMed, and randomized controlled trials evaluating the efficacy of sunlight exposure for reducing the risk of hip fractures in patients with Alzheimer's disease, Parkinson's disease, and stroke were identified. The relative risk and the 95% confidence interval were calculated for individual randomized controlled trials, and a pooled data analysis (meta-analysis) was performed. Three randomized controlled trials were identified. Sunlight exposure improved hypovitaminosis D and increased the BMD. The relative risk (95% confidence interval) of hip fractures was 0.22 (0.05, 1.01) for Alzheimer's disease, 0.27 (0.08, 0.96) for Parkinson's disease, and 0.17 (0.02, 1.36) for stroke. The relative risk (95% confidence interval) calculated for the pooled data analysis was 0.23 (0.10, 0.56) (P = 0.0012), suggesting a significant risk reduction rate of 77%. The present meta-analysis added additional evidence indicating the efficacy of sunlight exposure for reducing the risk of hip fractures in patients with Alzheimer's disease, Parkinson's disease, and stroke. © 2011 John Wiley & Sons A/S.

Hip Replacement Surgery

Science.gov (United States)

... Outreach Initiative Breadcrumb Home Health Topics English Español Hip Replacement Surgery Basics In-Depth Download Download EPUB ... PDF What is it? Points To Remember About Hip Replacement Surgery Hip replacement surgery removes damaged or ...

Exercise for osteoarthritis of the hip.

Science.gov (United States)

Fransen, Marlene; McConnell, Sara; Hernandez-Molina, Gabriela; Reichenbach, Stephan

2014-04-22

Current international treatment guidelines recommending therapeutic exercise for people with symptomatic hip osteoarthritis (OA) report are based on limited evidence. To determine whether land-based therapeutic exercise is beneficial for people with hip OA in terms of reduced joint pain and improved physical function and quality of life. We searched five databases from inception up to February 2013. All randomised controlled trials (RCTs) recruiting people with hip OA and comparing some form of land-based therapeutic exercise (as opposed to exercises conducted in water) with a non-exercise group. Four review authors independently selected studies for inclusion. We resolved disagreements through consensus. Two review authors independently extracted data, assessed risk of bias and the quality of the body of evidence for each outcome using the GRADE approach. We conducted analyses on continuous outcomes (pain, physical function and quality of life) and dichotomous outcomes (proportion of study withdrawals). We considered that seven of the 10 included RCTs had a low risk of bias. However, the results may be vulnerable to performance and detection bias as none of the RCTs were able to blind participants to treatment allocation and, while most RCTs reported blinded outcome assessment, pain, physical function and quality of life were participant self reported. One of the 10 RCTs was only reported as a conference abstract and did not provide sufficient data for the evaluation of bias risk.High-quality evidence from nine trials (549 participants) indicated that exercise reduced pain (standardised mean difference (SMD) -0.38, 95% confidence interval (CI) -0.55 to -0.20) and improved physical function (SMD -0.38, 95% CI -0.54 to -0.05) immediately after treatment. Pain and physical function were estimated to be 29 points on a 0- to 100-point scale (0 was no pain or loss of physical function) in the control group; exercise reduced pain by an equivalent of 8 points (95% CI 4 to

High perceived caregiver burden for relatives of patients following hip fracture surgery

DEFF Research Database (Denmark)

Ariza-Vega, Patrocinio; Ortiz-Piña, Mariana; Kristensen, Morten Tange

2018-01-01

treatment strategies such as the support and training of the caregivers in patient handling during hospital stay could be carried out to reduce caregiver burden. Implications for rehabilitation The main caregiver of a hip fracture patient is usually a woman who is the daughter of the patient, and reducing...... her burden of care should be included as one of the objectives of rehabilitation treatment. The caregivers of hip fracture patients must be considered as part of the treatment during the patient's recovery period, and patient handling training should be provided to the caregivers of hip fracture......PURPOSE: To determine the profile of the main informal caregivers, the evolution of the caregiver burden, and the influencing factors of caregiver burden at 1-year after hip fracture surgery. METHODS: In this prospective cohort study, a total of 172 informal caregivers of patients were interviewed...

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.

3D printing technology used in severe hip deformity.

Science.gov (United States)

Wang, Shanshan; Wang, Li; Liu, Yan; Ren, Yongfang; Jiang, Li; Li, Yan; Zhou, Hao; Chen, Jie; Jia, Wenxiao; Li, Hui

2017-09-01

This study was designed to assess the use of a 3D printing technique in total hip arthroplasty (THA) for severe hip deformities, where new and improved approaches are needed. THAs were performed from January 2015 to December 2016. Bioprosthesis artificial hip joints were used in both conventional and 3D printing hip arthroplasties. A total of 74 patients (57 cases undergoing conventional hip replacements and 17 undergoing 3D printing hip replacements) were followed-up for an average of 24 months. The average age of the patients was 62.7 years. Clinical data between the patients treated with different approaches were compared. Results showed that the time to postoperative weight bearing and the Harris scores of the patients in the 3D printing group were better than those for patients in the conventional hip replacement group. Unfortunately, the postoperative infection and loosening rates were higher in the 3D printing group. However, there were no significant differences in femoral neck anteversion, neck shaft, acetabular or sharp angles between ipsilateral and contralateral sides in the 3D printing group (P>0.05). The femoral neck anteversion angle was significantly different between the two sides in the conventional hip replacement group (P3D printing approach provides a better short-term curative effect that is more consistent with the physiological structure and anatomical characteristics of the patient, and we anticipate that its use will help improve the lives of many patients.

Perceived loading and muscle activity during hip strengthening exercises

DEFF Research Database (Denmark)

Brandt, Mikkel; Jakobsen, Markus Due; Thorborg, Kristian

2013-01-01

hip muscle activity during hip abduction and hip adduction exercises using elastic resistance and isotonic machines, using electromyography (EMG). METHODS: EMG activity was recorded from 11 muscles at the hip, thigh and trunk during hip adduction and hip abduction exercises in 16 untrained women......, using elastic resistance and isotonic exercise machines. These recordings were normalized to maximal voluntary contraction (MVC) EMG (nEMG). The exercises were performed at four levels of perceived loading reported using the Borg CR10: light (Borg ≤2), moderate (Borg >2-... (r =0.62±0.54). The abduction exercise performed with elastic resistance displayed significantly higher gluteus medius nEMG recruitment than the in machine exercise. CONCLUSIONS: The results of this study show that the Borg CR10 scale can be a useful tool for estimating intensity levels during...

Improved 1-year mortality in elderly patients with a hip fracture following integrated orthogeriatric treatment

NARCIS (Netherlands)

Folbert, E. C.; Hegeman, J H; Vermeer, M; Regtuijt, E M; van der Velde, D; ten Duis, H. J.; Slaets, J. P.

To improve the quality of care and reduce the healthcare costs of elderly patients with a hip fracture, surgeons and geriatricians collaborated intensively due to the special needs of these patients. After treatment at the Centre for Geriatric Traumatology (CvGT), we found a significant decrease in

Comparison of hip function and quality of life of total hip arthroplasty and resurfacing arthroplasty in the treatment of young patients with arthritis of the hip joint at 5 years.

Science.gov (United States)

Costa, Matthew L; Achten, Juul; Foguet, Pedro; Parsons, Nicholas R

2018-03-12

To compare the medium-term clinical effectiveness of total hip arthroplasty and resurfacing arthroplasty. Single centre, two-arm, parallel group, assessor blinded, randomised controlled trial with 1:1 treatment allocation. A large teaching hospital in England. 122 patients older than 18 years with severe arthritis of the hip joint, suitable for resurfacing arthroplasty of the hip. Patients were excluded if they were considered to be unable to adhere to trial procedures or complete questionnaires. Total hip arthroplasty (replacement of entire femoral head and neck); hip resurfacing arthroplasty (replacement of the articular surface of femoral head only, femoral neck remains intact). Both procedures replaced the articular surface of the acetabulum. The outcome measures were hip function assessed using the Oxford Hip Score (OHS) and health-related quality of life assessed using the EuroQol (EQ-5D). Patients were followed up annually for a minimum of 5 years. Outcome data were modelled using the generalised estimating equation methodology to explore temporal variations during follow-up. 60 patients were randomly assigned to hip resurfacing arthroplasty and 62 to total hip arthroplasty. 95 (78%) of the 122 original study participants provided data at 5 years. There was a small decrease in both hip functions and quality of life in both groups of patients each year during the 5-year follow-up period. However, there was no evidence of a significant difference between treatments group in the OHS (P=0.333) or the EQ-5D (P=0.501). We previously reported no difference in outcome in the first year after surgery. The current medium-term results also show no evidence of a difference in hip function or health-related quality of life in the 5 years following a total hip arthroplasty versus resurfacing arthroplasty. ISRCTN33354155. UKCRN 4093. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use

Rheumatoid arthritis is associated with less optimal hip structural geometry.

Science.gov (United States)

Wright, Nicole C; Lisse, Jeffrey R; Beck, Thomas J; Sherrill, Duane L; Mohler, M Jane; Bassford, Tamsen; Cauley, Jane A; Lacroix, Andrea Z; Lewis, Cora E; Chen, Zhao

2012-01-01

The overall goal of this study was to assess the longitudinal changes in bone strength in women reporting rheumatoid arthritis (RA; n=78) compared with nonarthritic control participants (n=4779) of the Women's Health Initiative bone mineral density (WHI-BMD) subcohort. Hip structural analysis program was applied to archived dual-energy X-ray absorptiometry scans (baseline, years 3, 6, and 9) to estimate bone mineral density (BMD) and hip structural geometry parameters in 3 femoral regions: narrow neck (NN), intertrochanteric (IT), and shaft (S). The association between RA and hip structural geometry was tested using linear regression and random coefficient models. Compared with the nonarthritic control, the RA group had a lower BMD (p=0.061) and significantly lower outer diameter (p=0.017), cross-sectional area (p=0.004), and section modulus (p=0.035) at the NN region in the longitudinal models. No significant associations were seen at the IT regions or S regions, and the association was not modified by age, ethnicity, glucocorticoid use, or time. Within the WHI-BMD, women with RA group had reduced BMD and structural geometry at baseline, and this reduction was seen at a fixed rate throughout the 9 yr of study. Copyright © 2012 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

EVALUATION OF THE EFFICIENCY OF COMBINATION THERAPY WITH HYALURONATES IN PATIENTS WITH HIP OSTEOARTHROSIS

Directory of Open Access Journals (Sweden)

A G Shusharin

2011-01-01

Results. The developed treatment option could significantly reduce the clinical and functional WOMAC index and Leken's index, and inadequate joint function in the immediate period and a year after the treatment performed. It also considerably improved quality of life in patients with hip osteoarthrosis, which appeared as a significant increase of its rating according to eight SF-36 scales during more than a year.

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.

Ultrasound in the diagnosis and treatment of developmental dysplasia of the hip. Evaluation of a selective screening procedure

DEFF Research Database (Denmark)

Strandberg, C.; Konradsen, L.A.; Ellitsgaard, N.

2008-01-01

INTRODUCTION: With the intention of reducing the treatment frequency of Developmental Dysplasia of the Hip (DDH), two hospitals in Copenhagen implemented a screening and treatment procedure based on selective referral to ultrasonography of the hip (US). This paper describes and evaluates...... 0.03%. No relationship was seen between morphological parameters at the first US and the outcome of hips classified as minor dysplastic or not fully developed (NFD). A statistically significant relationship was seen between the degree of dysplasia and the time until US normalization of the hips (p......= 0.02). There was no relapse of dysplasia after treatment. The median duration of treatment was six, eight and nine weeks for mild, moderate and severe dysplasia respectively. CONCLUSION: The procedure resulted in a low rate of treatment and a small number of late diagnosed cases. Prediction...

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

DEFF Research Database (Denmark)

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

2017-01-01

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

Muscle-tendon-related pain in 100 patients with hip dysplasia: prevalence and associations with self-reported hip disability and muscle strength

DEFF Research Database (Denmark)

Jacobsen, Julie Sandell; Hölmich, Per; Thorborg, Kristian

2017-01-01

The primary aim was to identify muscle-tendon-related pain in 100 patients with hip dysplasia. The secondary aim was to test whether muscle-tendon-related pain is associated with self-reported hip disability and muscle strength in patient with hip dysplasia. One hundred patients (17 men......-tendon-related pain and hip extension a significant inverse linear association between muscletendon- related pain and muscle strength was found ranging from 0.11 to0.12 Nm/kg in the adjusted analysis (Phip dysplasia with a high prevalence......) with a mean age of 29 years (SD 9) were included. Clinical entity approach was carried out to identify muscle-tendon-related pain. Associations between muscle-tendon-related pain and self-reported hip disability and muscle strength were tested with multiple regression analysis, including adjustments for age...

Low revision rate after total hip arthroplasty in patients with pediatric hip diseases

DEFF Research Database (Denmark)

Engesæter, Lars B; Engesæter, Ingvild Ø; Fenstad, Anne Marie

2012-01-01

Background The results of primary total hip arthroplasties (THAs) after pediatric hip diseases such as developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), or Perthes' disease have been reported to be inferior to the results after primary osteoarthritis of the hip (OA.......9%) were operated due to pediatric hip diseases (3.1% for Denmark, 8.8% for Norway, and 1.9% for Sweden) and 288,435 THAs (77.8%) were operated due to OA. Unadjusted 10-year Kaplan-Meier survival of THAs after pediatric hip diseases (94.7% survival) was inferior to that after OA (96.6% survival......). Consequently, an increased risk of revision for hips with a previous pediatric hip disease was seen (risk ratio (RR) 1.4, 95% CI: 1.3-1.5). However, after adjustment for differences in sex and age of the patients, and in fixation of the prostheses, no difference in survival was found (93.6% after pediatric hip...

Muscle-tendon-related abnormalities detected by ultrasonography are common in symptomatic hip dysplasia

DEFF Research Database (Denmark)

Jacobsen, Julie Sandell; Bolvig, Lars; Hölmich, Per

2018-01-01

INTRODUCTION: Hip dysplasia is characterized by reduced acetabular coverage of the femoral head leading to an increased mechanical load on the hip joint and the acting hip muscles. Potentially, the muscles and tendons functioning close to the hip joint may present with overuse......-related ultrasonography findings. The primary aim was to report the prevalence of muscle-tendon-related abnormalities detected by ultrasonography in 100 patients with symptomatic hip dysplasia. The secondary aim was to investigate correlations between muscle-tendon-related abnormalities detected by ultrasonography......-tendon-related abnormalities detected by ultrasonography in the hip and groin region are common in patients with symptomatic hip dysplasia, and the ultrasonography findings of the iliopsoas and gluteus medius/minimus tendons are weakly to moderately correlated to pain related to muscles and tendons in these structures. Both...

Activation of the gluteus maximus and hamstring muscles during prone hip extension with knee flexion in three hip abduction positions.

Science.gov (United States)

Kang, Sun-Young; Jeon, Hye-Seon; Kwon, Ohyun; Cynn, Heon-Seock; Choi, Boram

2013-08-01

The direction of fiber alignment within a muscle is known to influence the effectiveness of muscle contraction. However, most of the commonly used clinical gluteus maximus (GM) exercises do not consider the direction of fiber alignment within the muscle. Therefore, the purpose of this study was to investigate the influence of hip abduction position on the EMG (electromyography) amplitude and onset time of the GM and hamstrings (HAM) during prone hip extension with knee flexion (PHEKF) exercise. Surface EMG signals were recorded from the GM and HAM during PHEKF exercise in three hip abduction positions: 0°, 15°, and 30°. Thirty healthy subjects voluntarily participated in this study. The results show that GM EMG amplitude was greatest in the 30° hip abduction position, followed by 15° and then 0° hip abduction during PHEKF exercise. On the other hand, the HAM EMG amplitude at 0° hip abduction was significantly greater than at 15° and 30° hip abduction. Additionally, GM EMG onset firing was delayed relative to that of the HAM at 0° hip abduction. On the contrary, the GM EMG onset occurred earlier than the HAM in the 15° and 30° hip abduction positions. These findings indicate that performing PHEKF exercise in the 30° hip abduction position may be recommended as an effective way to facilitate the GM muscle activity and advance the firing time of the GM muscle in asymptomatic individuals. This finding provides preliminary evidence that GM EMG amplitude and onset time can be modified by the degree of hip abduction. Copyright © 2012 Elsevier Ltd. All rights reserved.

Isometric hip muscle strength in posttraumatic below-knee amputees

Directory of Open Access Journals (Sweden)

Jandrić Slavica

2007-01-01

Full Text Available Background/Aim. Traumas and war injuries, next to chronic occlusive artery disease and diabetes mellitus-derived complications, are the most frequent cause of the lower limbs amputation. They affect mostly younger population that need a higher level of activities as compared with the elderly. Medical rehabilitation is very significant for the muscle performance improvement in this population providing their social reintegration. The aim of this study was to investigate the effect of below-knee amputation on the hip isometric muscle strength and effect of rehabilitation on improvement of hip muscle strength in below-knee amputees, secondary to war wounding. Methods. Forty below-knee amputees (after war wounding, average age 35.6±10.6 years, that were included in primary rehabilitation program with prosthetics, were examined. Objective parameters were used to evaluate therapeutical effects. Isometric muscle strength of hip flexors, extensors, abductors and adductors was measured by dynamometer and expressed in Newton (N at admission, control and discharge for each patient. Average length of the treatment was 51 ± 34.1 days. Results. For isometric hip flexors (t = - 1.99346, p < 0.05, extensors (t = -4.629073, p < 0.001, abductors (t = -4.9408, p < 0.001 and adductors (t = -2.00228, p < 0.05, muscle strength was significantly less on the amputated than on nonamputated side. The highest differences in muscle strength between amputated and nonamputated limbs were noted for hip abductors (26.6% and extensors (23.3%. There was significant improvement of mean values of strength for all examined hip muscles after rehabilitation and prosthetics for both legs in comparison to beginning of the therapy. The hip abductor on the amputated side was for 19.4% weaker after rehabilitation in comparison to the nonamputated limb. Conclusion. Decreases of isometric muscle strength in all examined hip muscles were observed, more in the amputated limb. Rehabilitation

Reference indices of hip structural analysis in Ukrainian women

Directory of Open Access Journals (Sweden)

N.V. Grygorieva

2017-10-01

Full Text Available Background. Nowadays, a comprehensive assessment of osteoporosis and the risk of osteoporotic fractures involves the combine use of bone mineral density (BMD, 10-year probability of major osteoporotic fractures (Fracture Risk Assessment Tool, Trabecular Bone Score, and parameters of hip structural ana­lysis. In recent years, reference data on the three above-mentioned methods have been developed for the Ukrainian population, but there are no data on the latest methodology. The objective of the study was to assess the age characteristics of hip structural analysis parameters in Ukrainian women and to offer their reference values for use in clinical practice. Materials and methods. Using the dual energy X-ray absorptiometry method, we examined 690 healthy women aged 20–89 years wi­thout osteoporosis and other clinically significant diseases and conditions affecting the bone metabolism, without other accompanying pathology of hip joint. Results. The results of the study showed a significant effect of age on femoral strength index (FSI, cross-sectional moment of inertia (CSMI, cross-sectional area (CSA, distance from center of femoral head to center of femoral neck (d1, distance from center of femoral head to inter-trochanteric line (d2, mean femoral neck dia­meter (d3, distance from center of mass of femoral neck to superior neck margin (y, shaft angle (a and hip axis length (HAL indices, but not on parameters of neck/shaft angle (q. A significant decrease of FSI with age was established on the background on increase of CSMI, CSA and HAL parameters. Indices of height and body weight were reliably related with parameters of CSMI, CSA and HAL. FSI was significantly related to the body weight, but not to the height. In addition, it reliably correlated with BMD measured at femoral neck and lesser at total hip and lumbar spine. The HAL did not significant correlate with any of the measured BMD, which confirms its independent role in prediction of

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

[Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis].

Science.gov (United States)

Medenica, Ivica; Luković, Milan; Radoicić, Dragan

2010-02-01

The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score--7.1). We performed total rearthroplasty by a custom-made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score--87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specificaly for a patient) and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

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

DEFF Research Database (Denmark)

Jacobsen, Steffen

2006-01-01

studies. To develop a comprehensible and reproducible radiographic discriminator of hip OA with as close an association to self reported hip pain as possible. To identify prevalences of hip OA and HD in a Caucasian, urban background population and investigate the influence of sex, age, physical...... to be a significant risk factor for hip OA in men. However, only obesity was found to determine an event of hip replacement surgery. In a longitudinal study of 81 subjects and with mild or moderate hip dysplasia followed for a decade we did not document a tendency for radiological degeneration compared to 136 control...

Primary total hip replacement versus hip resurfacing - hospital considerations.

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Ward, William G; Carter, Christina J; Barone, Marisa; Jinnah, Riyaz

2011-01-01

Multiple factors regarding surgical procedures and patient selection affect hospital staffing needs as well as hospital revenues. In order to better understand the potential impact on hospitals that hip arthroplasty device selection (standard total hip arthroplasty vs. resurfacing) creates, a review of all primary hip arthroplasties performed at one institution was designed to identify factors that impacted hospital staffing needs and revenue generation. All primary hip arthroplasties undertaken over three fiscal years (2008 to 2010) were reviewed, utilizing only hospital business office data and medical records data that had been previously extracted prior for billing purposes. Analysis confirmed differing demographics for two hip arthroplasty populations, with the resurfacing patients (compared to the conventional total hip arthroplasty population) consisting of younger patients (mean age, 50 vs. 61 years), who were more often male (75% vs. 45%), were more likely to have osteoarthritis as their primary diagnosis (83 vs. 67%) and were more often covered by managed care or commercial insurance (83 vs. 34%). They also had shorter hospital stays (mean length of stay, 2.3 vs. 4.1 days) and consequently provided a more favorable financial revenue stream to the hospital on a per patient basis. Several trends appeared during the study periods. There was a steady increase in all procedures in all groups except for the resurfacings, which decreased 26% in males and 53% in females between 2009 and 2010. Differences were observed in the demographics of patients presenting for resurfacing, compared to those presenting for conventional total hip arthroplasty. In addition to the revenue stream considerations, institutions undertaking a resurfacing program must commit the resources and planning in order to rehabilitate these patients more expeditiously than is usually required with conventional hip arthroplasty patients.

Bone Marrow Stem Cells Added to a Hydroxyapatite Scaffold Result in Better Outcomes after Surgical Treatment of Intertrochanteric Hip Fractures

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Joao Torres

2014-01-01

Full Text Available Introduction. Intertrochanteric hip fractures occur in the proximal femur. They are very common in the elderly and are responsible for high rates of morbidity and mortality. The authors hypothesized that adding an autologous bone marrow stem cells concentrate (ABMC to a hydroxyapatite scaffold and placing it in the fracture site would improve the outcome after surgical fixation of intertrochanteric hip fractures. Material and Methods. 30 patients were randomly selected and divided into 2 groups of 15 patients, to receive either the scaffold enriched with the ABMC (Group A during the surgical procedure, or fracture fixation alone (Group B. Results. There was a statistically significant difference in favor of group A at days 30, 60, and 90 for Harris Hip Scores (HHS, at days 30 and 60 for VAS pain scales, for bedridden period and time taken to start partial and total weight bearing (P<0.05. Discussion. These results show a significant benefit of adding a bone marrow enriched scaffold to surgical fixation in intertrochanteric hip fractures, which can significantly reduce the associated morbidity and mortality rates. Conclusion. Bone marrow stem cells added to a hydroxyapatite scaffold result in better outcomes after surgical treatment of intertrochanteric hip fractures.

Bone Marrow Stem Cells Added to a Hydroxyapatite Scaffold Result in Better Outcomes after Surgical Treatment of Intertrochanteric Hip Fractures

Science.gov (United States)

Gutierres, Manuel; Lopes, M. Ascenção; Santos, J. Domingos; Cabral, A. T.; Pinto, R.

2014-01-01

Introduction. Intertrochanteric hip fractures occur in the proximal femur. They are very common in the elderly and are responsible for high rates of morbidity and mortality. The authors hypothesized that adding an autologous bone marrow stem cells concentrate (ABMC) to a hydroxyapatite scaffold and placing it in the fracture site would improve the outcome after surgical fixation of intertrochanteric hip fractures. Material and Methods. 30 patients were randomly selected and divided into 2 groups of 15 patients, to receive either the scaffold enriched with the ABMC (Group A) during the surgical procedure, or fracture fixation alone (Group B). Results. There was a statistically significant difference in favor of group A at days 30, 60, and 90 for Harris Hip Scores (HHS), at days 30 and 60 for VAS pain scales, for bedridden period and time taken to start partial and total weight bearing (P < 0.05). Discussion. These results show a significant benefit of adding a bone marrow enriched scaffold to surgical fixation in intertrochanteric hip fractures, which can significantly reduce the associated morbidity and mortality rates. Conclusion. Bone marrow stem cells added to a hydroxyapatite scaffold result in better outcomes after surgical treatment of intertrochanteric hip fractures. PMID:24955356

Hip adductor muscle function in forward skating.

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Chang, Ryan; Turcotte, Rene; Pearsall, David

2009-09-01

Adductor strain injuries are prevalent in ice hockey. It has long been speculated that adductor muscular strains may be caused by repeated eccentric contractions which decelerate the leg during a stride. The purpose of this study was to investigate the relationship of skating speed with muscle activity and lower limb kinematics, with a particular focus on the role of the hip adductors. Seven collegiate ice hockey players consented to participate. Surface electromyography (EMG) and kinematics of the lower extremities were measured at three skating velocities 3.33 m/s (slow), 5.00 m/s (medium) and 6.66 m/s (fast). The adductor magnus muscle exhibited disproportionately larger increases in peak muscle activation and significantly prolonged activation with increased speed. Stride rate and stride length also increased significantly with skating velocity, in contrast, hip, knee and ankle total ranges of motion did not. To accommodate for the increased stride rate with higher skating speeds, the rate of hip abduction increased significantly in concert with activations of adductor magnus indicating a substantial eccentric contraction. In conclusion, these findings highlight the functional importance of the adductor muscle group and hip abduction-adduction in skating performance as well as indirectly support the notion that groin strain injury potential increases with skating speed.

Effect of Mulligan's and Kinesio knee taping on adolescent ballet dancers knee and hip biomechanics during landing.

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Hendry, D; Campbell, A; Ng, L; Grisbrook, T L; Hopper, D M

2015-12-01

Taping is often used to manage the high rate of knee injuries in ballet dancers; however, little is known about the effect of taping on lower-limb biomechanics during ballet landings in the turnout position. This study investigated the effects of Kinesiotape (KT), Mulligan's tape (MT) and no tape (NT) on knee and hip kinetics during landing in three turnout positions. The effect of taping on the esthetic execution of ballet jumps was also assessed. Eighteen pain-free 12-15-year-old female ballet dancers performed ballet jumps in three turnout positions, under the three knee taping conditions. A Vicon Motion Analysis system (Vicon Oxford, Oxford, UK) and Advanced Mechanical Technology, Inc. (Watertown, Massa chusetts, USA) force plate collected lower-limb mechanics. The results demonstrated that MT significantly reduced peak posterior knee shear forces (P = 0.025) and peak posterior (P = 0.005), medial (P = 0.022) and lateral (P = 0.014) hip shear forces compared with NT when landing in first position. KT had no effect on knee or hip forces. No significant differences existed between taping conditions in all landing positions for the esthetic measures. MT was able to reduce knee and the hip forces without affecting the esthetic performance of ballet jumps, which may have implications for preventing and managing knee injuries in ballet dancers. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Bilateral hip arthroplasty: is 1-week staging the optimum strategy?

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Willis-Owen Charles A

2010-11-01

Full Text Available Abstract Seventy-nine patients underwent bilateral hip arthroplasty staged either at 1 week (Group 1 or after greater intervals (as suggested by the patients, mean 44 weeks, range 16-88 weeks (Group 2, over a five year period at one Institution. Sixty-eight patients (29 bilateral hip resurfacings and 39 total hip replacements completed questionnaires regarding their post-operative recovery, complications and overall satisfaction with the staging of their surgery. There was no significant age or ASA grade difference between the patient groups. Complication rates in the two groups were similar and overall satisfaction rates were 84% in Group 1 (n = 32 and 89% in Group 2 (n = 36. Cumulative hospital lengths of stay were significantly longer in Group 1 patients (11.9 days vs 9.1 days(p The mean time to return to part-time work was 16.4 weeks for Group 1, and a cumulative 17.2 weeks (8.8 and 8.4 weeks for Group 2. The time to return to full-time work was significantly shorter for Group 1 patients (21.0 weeks, compared with a cumulative 29.7 weeks for Group 2(p Hip resurfacing patients in Group 2 had significantly shorter durations of postoperative pain and were able to return to part-time and full time work sooner than total hip arthroplasty patients. There was a general trend towards a faster recovery and resumption of normal activities following the second operation in Group 2 patients, compared with the first operation. Bilateral hip arthroplasty staged at a 1-week interval resulted in an earlier resolution of hip pain, and an earlier return to full-time work (particularly following total hip replacement surgery, with high levels of patient satisfaction and no increased risk in complications; however the hospital length of stay was significantly longer. The decision for the timing of staged bilateral surgery should be made in conjunction with the patient, making adjustments to accommodate their occupational needs and functional demands.

Outcomes of Hip Arthroscopy in Competitive Athletes.

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Perets, Itay; Hartigan, David E; Chaharbakhshi, Edwin O; Ashberg, Lyall; Ortiz-Declet, Victor; Domb, Benjamin G

2017-08-01

To evaluate the minimum 2-year postoperative clinical outcomes and the rate of return to sports in athletes who underwent capsular plication for the treatment of ligamentous laxity and/or borderline dysplasia during hip arthroscopy for the treatment of femoroacetabular impingement and labral pathology. Since 2008, data were prospectively collected on patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears. Inclusion criteria were as follows: athlete at the high school, collegiate, or professional levels preoperatively, underwent capsular plication, and preoperatively recorded patient-reported outcome scores including modified Harris hip score (mHHS), nonarthritic athletic hip score (NAHS), hip outcome score-sports-specific subscale (HOS-SSS), and visual analog scale (VAS). Exclusion criteria were as follows: 1, and previous hip conditions. Sports activity and competitive levels were collected at a minimum of 2 years postoperatively. Fifty-one hips (49 patients) met the inclusion criteria, and 41 hips (39 patients) had minimum 2-year follow-up (80.4% follow-up). Mean mHHS increased from 67.1 preoperatively to 83.5 (P arthroscopies allowed the patients to return to sports at follow-up. Thirty-four (82.9%) hip arthroscopies allowed the patients to maintain their competitive physical abilities at follow-up. Patient-reported outcomes and VAS in athletes significantly improved at a minimum of 2 years after capsular plication as a part of hip arthroscopy addressing varying pathologies. In addition, most patients returned to sports at similar or higher competitive levels. These results suggest that capsular plication is a favorable treatment option in athletes with ligamentous laxity and/or borderline dysplasia. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Hip biomechanics during stair ascent and descent in people with and without hip osteoarthritis.

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Hall, Michelle; Wrigley, Tim V; Kean, Crystal O; Metcalf, Ben R; Bennell, Kim L

2017-07-01

Hip osteoarthritis (OA) is often associated with pain and impaired function. Understanding biomechanical alterations in patients with hip OA during challenging activities such as stair use is important to inform treatments. The aim of this study was to determine whether kinematics and kinetics during stair ambulation differed between people with hip OA and healthy controls. Fifteen participants with symptomatic and radiographic hip OA and 15 asymptomatic healthy controls underwent 3-D motion analysis during stair ascent and descent. Trunk, pelvis, and hip kinematics as well as hip kinetics were evaluated. Analyses were performed unadjusted and adjusted for speed and leg length. In both the unadjusted and adjusted analyses, participants with hip OA ascended stairs with less hip range of motion in all three planes and a lower peak external rotation moment compared to controls. In the unadjusted analysis, hip OA participants descended stairs with greater ipsilateral trunk lean, less sagittal plane range of motion, lower peak extension moment, lower peak external rotation moment, and greater hip adduction moment impulse compared to controls. In the adjusted results, peak internal rotation moment and hip adduction moment impulse were greater in hip OA participants compared to controls. Findings show that individuals with hip OA display limited range of hip joint movement, particularly during stair ascent, and overall indicate the use of strategies (e.g., trunk lean; lower peak external rotation moment; higher adduction moment impulse) that implicate altered hip abductor function. Future research is required to further understand the implications of these findings on hip OA. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1505-1514, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Dialysis-related amyloidosis of the hip joints in long-term hemodialysis patients. MRI findings of hip joints in twelve female hemodialysis patients

International Nuclear Information System (INIS)

Suzuki, Hitoe; Shibuya, Asuka; Ando, Minoru; Akiba, Takashi; Nitta, Kosaku

2007-01-01

We report a female with amyloid arthropathy of the hip joints. She was a 67-year-old woman who had been treated by hemodialysis for 22 years. She had demonstrated a 5-month history of continuous low-grade fever and pain in her left hip and she was finally unable to walk by herself. Findings on X-ray films and MRI of the hip joints suggested avascular necrosis in both femur heads. To palliate symptoms, bipolar surgery on the left hip joint was performed. Pathological examination of bone tissue specimen demonstrated that there was some , β 2 -microglobulin (β 2 -MG)-related amyloid accumulation in the femur head. Based on this clinical experience, we performed MRI screening for amyloid lesions of the hip joints in another 11 asymptomatic female patients undergoing hemodialysis for 20 years or more. Cystic lesions of the hip joints were observed in 8 patients, amyloid arthropathy in 2 patients, and fluid trapped in the joint in 1 patient. Patients with amyloidosis had significantly lower serum β 2 -MG levels than patients without amyloidosis (28.6 mg/L versus 41.4 mg/L; p=0.0339). Our findings show that dialysis-related amyloidosis of the hip joints is one of the potential and significant problems in female patients on long-term hemodialysis therapy. It may be important to screen for this pathological condition in long-term hemodialysis patients. (author)

Efficacy of alendronate, a bisphosphonate, in the treatment of AVN of the hip. A prospective open-label study.

Science.gov (United States)

Agarwala, S; Jain, D; Joshi, V R; Sule, A

2005-03-01

To study the efficacy of alendronate, in the treatment of avascular necrosis (AVN) of the hip. Sixty patients with AVN of the hip (100 hips with AVN) were studied. The follow-up period ranged from 3 months to 5 yr. The most common cause of AVN was steroids. Parameters studied were walking time, standing time, pain and disability on a visual analogue scale (VAS), range of motion of the hip, X-ray and MRI of the hip. All patients were treated with alendronate 10 mg/day (or 70 mg/week) along with 500-1000 mg of daily calcium and vitamin D supplements, and were advised to avoid weight-bearing. NSAIDs and analgesics were permitted as needed and were recorded. Forty-one patients (71 AVN hips) with AVN have been followed up for a minimum of 1 yr, 24 patients (42 AVN hips) for 2 yr and 21 patients (37 AVN hips) for more than 2 yr (average 37 month). Fourteen patients have been followed up for less than 1 yr (3-9 months). Significant reduction in pain and disability scores (P 0.001). Radiologically, the hips either stabilized in the same grade or progressed by one grade. MRI showed a decrease in marrow oedema in most cases at the 1-yr follow-up. Six patients (10 hips) required surgery and there were two (three hips) dropouts. The drug was well tolerated and there was a reduction in NSAID requirement. Alendronate reduces pain, improves function and retards AVN progression. Early surgical intervention can be avoided in most patients.

Evaluation of hip internal and external rotation range of motion as an injury risk factor for hip, abdominal and groin injuries in professional baseball players

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Xinning Li

2015-12-01

Full Text Available Normal hip range of motion (ROM is essential in running and transfer of energy from lower to upper extremities during overhead throwing. Dysfunctional hip ROM may alter lower extremity kinematics and predispose athletes to hip and groin injuries. The purpose of this study is characterize hip internal/external ROM (Arc and its effect on the risk of hip, hamstring, and groin injuries in professional baseball players. Bilateral hip internal and external ROM was measured on all baseball players (N=201 in one professional organization (major and minor league during spring training. Players were organized according to their respective positions. All injuries were documented prospectively for an entire MLB season (2010 to 2011. Data was analyzed according to position and injuries during the season. Total number of players (N=201 with an average age of 24±3.6 (range=17-37. Both pitchers (N=93 and catchers (N=22 had significantly decreased mean hip internal rotation and overall hip arc of motion compared to the positional players (N=86. Players with hip, groin, and hamstring injury also had decreased hip rotation arc when compared to the normal group. Overall, there is a correlation between decreased hip internal rotation and total arc of motion with hip, hamstring, and groin injuries.

Athletic Hip Injuries.

Science.gov (United States)

Lynch, T Sean; Bedi, Asheesh; Larson, Christopher M

2017-04-01

Historically, athletic hip injuries have garnered little attention; however, these injuries account for approximately 6% of all sports injuries and their prevalence is increasing. At times, the diagnosis and management of hip injuries can be challenging and elusive for the team physician. Hip injuries are seen in high-level athletes who participate in cutting and pivoting sports that require rapid acceleration and deceleration. Described previously as the "sports hip triad," these injuries consist of adductor strains, osteitis pubis, athletic pubalgia, or core muscle injury, often with underlying range-of-motion limitations secondary to femoroacetabular impingement. These disorders can happen in isolation but frequently occur in combination. To add to the diagnostic challenge, numerous intra-articular disorders and extra-articular soft-tissue restraints about the hip can serve as pain generators, in addition to referred pain from the lumbar spine, bowel, bladder, and reproductive organs. Athletic hip conditions can be debilitating and often require a timely diagnosis to provide appropriate intervention.

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

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metal/polymer... § 888.3390 Hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis is a two-part...

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

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) trunnion-bearing... Devices § 888.3380 Hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis is a two...

Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis

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Medenica Ivica

2010-01-01

Full Text Available Background. The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. Case report. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score - 7.1. We performed total rearthroplasty by a custom- made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score - 87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Conclusion. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specifically for a patient and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

Interventions for Hip Pain in the Maturing Athlete

Science.gov (United States)

Gomberawalla, M. Mustafa; Kelly, Bryan T.; Bedi, Asheesh

2014-01-01

long-term results. Improvements in hip arthroscopy have led to outcomes equivalent to open surgery while utilizing significantly less invasive techniques. However, outcomes may ultimately depend on the degree of underlying OA. When counseling the mature athlete with hip pain, an understanding of the underlying anatomy, degree of arthritis, and expectations will help guide the treating surgeon in offering appropriate treatment options. PMID:24427445

3.0 T conventional hip MR and hip MR arthrography for the acetabular labral tears confirmed by arthroscopy

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Tian, Chun-Yan [Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191 (China); Wang, Jian-Quan [Department of Sports Medicine, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191,PR China (China); Zheng, Zhuo-Zhao, E-mail: zzhuozhao@aliyun.com [Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191 (China); Ren, A.-Hong [Department of Radiology, Beijing Daxing Hospital, 26 West Huangcun Road, Daxing District, Beijing 102600 (China)

2014-10-15

Highlights: • MR is the preferred imaging modality for diagnosing acetabular labral tears. • The diagnostic performance of MR arthrography are superior than conventional hip MR. • The hip MR arthrography is recommended for diagnosing acetabular labral lesions. - Abstract: Objective: To evaluate the value of hip MR for diagnosing acetabular labrum tears, and to further compare the diagnostic performances of conventional MR with MR arthrography in acetabular labrum tears. Methods: 90 patients undergoing both hip MR examination and subsequent hip arthroscopy were retrospectively evaluated. Of these patients, 34 accepted both conventional MR and MR arthrography; while the other 56 only underwent conventional MR examination. All hip MR images were independently reviewed by two radiologists, and further compared with the results of hip arthroscopy. Results: 59 of 90 patients were confirmed with acetabular labral tears by hip arthroscopy and 31 without tears. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of conventional MR for evaluating the acetabular labral tears were 61.0%, 77.4%, 83.7% and 51.1% (radiologist A), and 66.1%, 74.2%, 82.9% and 53.4% (radiologist B), respectively, with good consistency between the two observers (K = 0.645). The sensitivity, specificity, PPV and NPV of MR arthrography for assessing the acetabular labral tears were 90.5%, 84.6%, 90.5% and 84.6% (radiologist A), and 95.2%, 84.6%, 90.9% and 91.7% (radiologist B), respectively, with excellent good consistency between the two observers (K = 0.810). The sensitivity and NPV of MR arthrography for diagnosing the acetabular labral tears were significantly higher than those of conventional MR (both P < 0.05). Conclusion: Hip MR arthrography is a reliable evaluation modality for diagnosing the acetabular labral tears, and its diagnostic performance is superior to that of conventional MR at 3.0 T.

Femoral Geometry in Male Patients with Atraumatic Hip Fracture - Original Investigation

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Gülten Tan

2007-03-01

Full Text Available Aims: Hip fracture is the most serious complication of osteoporosis and the most disabling type of fracture. In this study, we aimed to compare femoral geometry in hip fractured male patients aged more than 65 years old with age matched controls. Patients and Methods: 20 male patients with a history of nontraumatic hip fracture and 19 age-matched healthy controls were included in this study. Bone mineral density of neck and trochanter of hip were measured by DEXA. In addition to BMD, an experienced radiologist measured proximal femur geometric parameters potentially involved in bone strength. Results: Mean BMDs of trochanteric region were not significantly different between groups, but mean BMDs of neck region were statistically significantly lower in the hip fractured group. Neck shaft angle and femur shaft width were the geometric parameters found to be significantly higher in the hip fractured group. The correlation between femur geometric and the anthropometric measurements was present only in the kontrol group. Conclusion: We concluded that besides femur geometric measurements, correlation between these measurements might be an important factors for the fracture risk. (From the World of Osteoporosis 2007;13:15-8

Reduction of metal artifacts from hip prostheses on CT images of the pelvis: value of iterative reconstructions.

Science.gov (United States)

Morsbach, Fabian; Bickelhaupt, Sebastian; Wanner, Guido A; Krauss, Andreas; Schmidt, Bernhard; Alkadhi, Hatem

2013-07-01

To assess the value of iterative frequency split-normalized (IFS) metal artifact reduction (MAR) for computed tomography (CT) of hip prostheses. This study had institutional review board and local ethics committee approval. First, a hip phantom with steel and titanium prostheses that had inlays of water, fat, and contrast media in the pelvis was used to optimize the IFS algorithm. Second, 41 consecutive patients with hip prostheses who were undergoing CT were included. Data sets were reconstructed with filtered back projection, the IFS algorithm, and a linear interpolation MAR algorithm. Two blinded, independent readers evaluated axial, coronal, and sagittal CT reformations for overall image quality, image quality of pelvic organs, and assessment of pelvic abnormalities. CT attenuation and image noise were measured. Statistical analysis included the Friedman test, Wilcoxon signed-rank test, and Levene test. Ex vivo experiments demonstrated an optimized IFS algorithm by using a threshold of 2200 HU with four iterations for both steel and titanium prostheses. Measurements of CT attenuation of the inlays were significantly (P algorithm for CT image reconstruction significantly reduces metal artifacts from hip prostheses, improves the reliability of CT number measurements, and improves the confidence for depicting pelvic abnormalities.

Sucralfate significantly reduces ciprofloxacin concentrations in serum.

OpenAIRE

Garrelts, J C; Godley, P J; Peterie, J D; Gerlach, E H; Yakshe, C C

1990-01-01

The effect of sucralfate on the bioavailability of ciprofloxacin was evaluated in eight healthy subjects utilizing a randomized, crossover design. The area under the concentration-time curve from 0 to 12 h was reduced from 8.8 to 1.1 micrograms.h/ml by sucralfate (P less than 0.005). Similarly, the maximum concentration of ciprofloxacin in serum was reduced from 2.0 to 0.2 micrograms/ml (P less than 0.005). We conclude that concurrent ingestion of sucralfate significantly reduces the concentr...

Strategy for prevention of hip fractures in patients with Parkinson's disease.

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Iwamoto, Jun; Sato, Yoshihiro; Takeda, Tsuyoshi; Matsumoto, Hideo

2012-09-18

Hypovitaminosis D and K due to malnutrition or sunlight deprivation, increased bone resorption due to immobilization, low bone mineral density (BMD) and an increased risk of falls may contribute to an increased risk of hip fractures in patients with Parkinson's disease. The purpose of the present study was to clarify the efficacy of interventions intended to prevent hip fractures in elderly patients with Parkinson's disease. PubMed was used to search the literature for randomized controlled trials (RCTs) regarding Parkinson's disease and hip fractures. The inclusion criteria were 50 or more subjects per group and a study period of 1 year or longer. Five RCTs were identified and the relative risk and 95% confidence interval were calculated for individual RCTs. Sunlight exposure increased serum hydroxyvitamin D [25(OH)D] concentration, improved motor function, decreased bone resorption and increased BMD. Alendronate or risedronate with vitamin D supplementation increased serum 25(OH)D concentration, strongly decreased bone resorption and increased BMD. Menatetrenone (vitamin K(2)) decreased serum undercarboxylated osteocalcin concentration, decreased bone resorption and increased BMD. Sunlight exposure (men and women), menatetrenone (women), alendronate and risedronate with vitamin D supplementation (women) significantly reduced the incidence of hip fractures. The respective RRs (95% confidence intervals) according to the intention-to-treat analysis were 0.27 (0.08, 0.96), 0.13 (0.02, 0.97), 0.29 (0.10, 0.85) and 0.20 (0.06, 0.68). Interventions, including sunlight exposure, menatetrenone and oral bisphosphonates with vitamin D supplementation, have a protective effect against hip fractures elderly patients with Parkinson's disease.

[Multidisciplinary approach of hip fractures based on Hungarian data].

Science.gov (United States)

Juhász, Krisztina; Turchányi, Béla; Mintál, Tibor; Somogyi, Péter

2016-09-01

Hip fractures are described by increased mortality, loss of quality of life, functional decline and burden of diseases. They show a growing number worldwide. The aim of the present study is to summarise the existing data on the incidence, mortality, complications and rehabilitation of hip fractures, which relevance is reported only by few studies. To reduce mortality and complications of hip fractures the authors emphasize the importance of primary treatment within 12 hours, appropriate selection of surgical methods corresponding to the fracture type after the assessment of femoral head viability, vitamin D supplementation, same conditions for primary treatment during everyday of the week, and an adequate acute treatment and rehabilitation for patient's general health status. In the future integrated processing of multidisciplinary results of hip fractures based on Hungarian data can support the development of efficient treatment and prevention strategies, which can be advantageous for the patient, families, health care system, and the society, too, by the reduction of costly complications of hip fracture healing and mortality. Orv. Hetil., 2016, 157(37), 1469-1475.

Hip pain

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... from a chair, walking, climbing stairs, and driving Hamstring strain Iliotibial band syndrome Hip flexor strain Hip ... and cool down afterward. Stretch your quadriceps and hamstrings. Avoid running straight down hills. Walk down instead. ...

Center of Mass Compensation during Gait in Hip Arthroplasty Patients: Comparison between Large Diameter Head Total Hip Arthroplasty and Hip Resurfacing

Directory of Open Access Journals (Sweden)

Vicky Bouffard

2011-01-01

Full Text Available Objective. To compare center of mass (COM compensation in the frontal and sagittal plane during gait in patients with large diameter head total hip arthroplasty (LDH-THA and hip resurfacing (HR. Design. Observational study. Setting. Outpatient biomechanical laboratory. Participants. Two groups of 12 patients with LDH-THA and HR recruited from a larger randomized study and 11 healthy controls. Interventions. Not applicable. Main Outcome Measures. To compare the distance between the hip prosthetic joint center (HPJC and the COM. The ratio (RHPJC-COM and the variability (CVHPJC-COM were compared between groups. Hip flexor, abductor, and adductor muscle strength was also correlated between groups while radiographic measurements were correlated with the outcome measures. Results. In the frontal plane, HR shows less variability than healthy controls at push-off and toe-off and RHPJC-COM is correlated with the muscle strength ratios (FRABD at heel contact, maximal weight acceptance, and mid stance. In the sagittal plane, LDH-THA has a higher RHPJC-COM than healthy controls at push-off, and CVHPJC-COM is significantly correlated with FRFLEX. Conclusions. One year after surgery, both groups of patients, LDH-THA and HR, demonstrate minor compensations at some specific instant of the gait cycle, in both frontal and sagittal planes. However, their locomotion pattern is similar to the healthy controls.

Hip supporting device

DEFF Research Database (Denmark)

2011-01-01

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

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).

THE ASSOCIATIONS BETWEEN HIP STRENGTH AND HIP KINEMATICS DURING A SINGLE LEG HOP IN RECREATIONAL ATHLETES POST ACL RECONSTRUCTION COMPARED TO HEALTHY CONTROLS.

Science.gov (United States)

Tate, Jeremiah; Suckut, Tell; Wages, Jensen; Lyles, Heather; Perrin, Benjamin

2017-06-01

Only a small amount of evidence exists linking hip abductor weakness to dynamic knee valgus during static and dynamic activities. The associations of hip extensor strength and hip kinematics during the landing of a single leg hop are not known. Purpose: To determine if relationships exist between hip extensor and abductor strength and hip kinematics in both involved and uninvolved limb during the landing phase of a single leg hop in recreational athletes post anterior cruciate ligament (ACL) reconstruction. The presence of similar associations was also evaluated in healthy recreational athletes. Controlled Laboratory Study; Cross-sectional. Twenty-four recreational college-aged athletes participated in the study (12 post ACL reconstruction; 12 healthy controls). Sagittal and frontal plane hip kinematic data were collected for five trials during the landing of a single leg hop. Hip extensor and abductor isometric force production was measured using a hand-held dynamometer and normalized to participants' height and weight. Dependent and independent t-tests were used to analyze for any potential differences in hip strength or kinematics within and between groups, respectively. Pearson's r was used to demonstrate potential associations between hip strength and hip kinematics for both limbs in the ACL group and the right limb in the healthy control group. Independent t-tests revealed that participants post ACL reconstruction exhibited less hip extensor strength (0.18 N/Ht*BW vs. 0.25 N/Ht*BW, p=hip adduction (9.0 º vs. 0.8 º, p=hip extensor strength and maximum hip abduction/adduction angle in the involved limb. A moderate and direct relationship between hip abductor strength and maximum hip flexion angle was demonstrated in the both the involved ( r =.62) and uninvolved limb ( r =.65, p=.02). No significant associations were demonstrated between hip extensor or abductor strength and hip flexion and/or abduction/adduction angles in the healthy group. The

Reduced bone mineral density is not associated with significantly reduced bone quality in men and women practicing long-term calorie restriction with adequate nutrition.

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Villareal, Dennis T; Kotyk, John J; Armamento-Villareal, Reina C; Kenguva, Venkata; Seaman, Pamela; Shahar, Allon; Wald, Michael J; Kleerekoper, Michael; Fontana, Luigi

2011-02-01

Calorie restriction (CR) reduces bone quantity but not bone quality in rodents. Nothing is known regarding the long-term effects of CR with adequate intake of vitamin and minerals on bone quantity and quality in middle-aged lean individuals. In this study, we evaluated body composition, bone mineral density (BMD), and serum markers of bone turnover and inflammation in 32 volunteers who had been eating a CR diet (approximately 35% less calories than controls) for an average of 6.8 ± 5.2 years (mean age 52.7 ± 10.3 years) and 32 age- and sex-matched sedentary controls eating Western diets (WD). In a subgroup of 10 CR and 10 WD volunteers, we also measured trabecular bone (TB) microarchitecture of the distal radius using high-resolution magnetic resonance imaging. We found that the CR volunteers had significantly lower body mass index than the WD volunteers (18.9 ± 1.2 vs. 26.5 ± 2.2 kg m(-2) ; P = 0.0001). BMD of the lumbar spine (0.870 ± 0.11 vs. 1.138 ± 0.12 g cm(-2) , P = 0.0001) and hip (0.806 ± 0.12 vs. 1.047 ± 0.12 g cm(-2) , P = 0.0001) was also lower in the CR than in the WD group. Serum C-terminal telopeptide and bone-specific alkaline phosphatase concentration were similar between groups, while serum C-reactive protein (0.19 ± 0.26 vs. 1.46 ± 1.56 mg L(-1) , P = 0.0001) was lower in the CR group. Trabecular bone microarchitecture parameters such as the erosion index (0.916 ± 0.087 vs. 0.877 ± 0.088; P = 0.739) and surface-to-curve ratio (10.3 ± 1.4 vs. 12.1 ± 2.1, P = 0.440) were not significantly different between groups. These findings suggest that markedly reduced BMD is not associated with significantly reduced bone quality in middle-aged men and women practicing long-term calorie restriction with adequate nutrition.

Unipedal standing exercise and hip bone mineral density in postmenopausal women: a randomized controlled trial.

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Sakai, Akinori; Oshige, Toshihisa; Zenke, Yukichi; Yamanaka, Yoshiaki; Nagaishi, Hitoshi; Nakamura, Toshitaka

2010-01-01

The aim of this study was to test the effect of unipedal standing exercise on bone mineral density (BMD) of the hip in postmenopausal women. Japanese postmenopausal women (n = 94) were assigned at random to an exercise or control group (no exercise). The 6-month exercise program consisted of standing on a single foot for 1 min per leg 3 times per day. BMD of the hip was measured by dual-energy X-ray absorptiometry. There was no significant difference in age and baseline hip BMD between the exercise group (n = 49) and control group (n = 45). Exercise did not improve hip BMD compared with the control group. Stepwise regression analysis identified old age as a significant determinant (p = 0.034) of increased hip total BMD at 6 months after exercise. In 31 participants aged >/=70 years, the exercise group (n = 20) showed significant increase in the values of hip BMD at the areas of total (p = 0.008), intertrochanteric (p = 0.023), and Ward's triangle (p = 0.032). The same parameters were decreased in the control group (n = 11). The percent changes in hip BMD of the exercise group were not significantly different from those of the control group either in the participants with low baseline hip total BMD ( or =80% of the young adult mean). In conclusion, unipedal standing exercise for 6 months did not improve hip BMD in Japanese postmenopausal women. Effect of exercise on hip total BMD was age dependent. In participants aged > or =70 years, the exercise significantly increased hip total BMD.

Sports Activity Following Cementless Metaphyseal Hip Joint Arthroplasty

Directory of Open Access Journals (Sweden)

Czech Szymon

2017-12-01

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

Sports Activity Following Cementless Metaphyseal Hip Joint Arthroplasty.

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

2017-12-01

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

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

Science.gov (United States)

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

2017-07-01

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

Experimentally induced cam impingement in the sheep hip.

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Siebenrock, Klaus A; Fiechter, Ruth; Tannast, Moritz; Mamisch, Tallal C; von Rechenberg, Brigitte

2013-04-01

Sheep hips have a natural non-spherical femoral head similar to a cam-type deformity in human beings. By performing an intertrochanteric varus osteotomy, cam-type femoro-acetabular impingement (FAI) during flexion can be created. We tested the hypotheses that macroscopic lesions of the articular cartilage and an increased Mankin score (MS) can be reproduced by an experimentally induced cam-type FAI in this ovine in vivo model. Furthermore, we hypothesized that the MS increases with longer ambulatory periods. Sixteen sheep underwent unilateral intertrochanteric varus osteotomy of the hip with the non-operated hip as a control. Four sheep were sacrificed after 14, 22, 30, and 38-weeks postoperatively. We evaluated macroscopic chondrolabral alterations, and recorded the MS, based on histochemical staining, for each ambulatory period. A significantly higher prevalence of macroscopic chondrolabral lesions was found in the impingement zone of the operated hips. The MS was significantly higher in the acetabular/femoral cartilage of the operated hips. Furthermore, these scores increased as the length of the ambulatory period increased. Cam-type FAI can be induced in an ovine in vivo model. Localized chondrolabral degeneration of the hip, similar to that seen in humans (Tannast et al., Clin Orthop Relat Res 2008; 466: 273-280; Beck et al., J Bone Joint Surg Br 2005; 87: 1012-1018), can be reproduced. This experimental sheep model can be used to study cam-type FAI. Copyright © 2012 Orthopaedic Research Society.

The High Value Healthcare Collaborative: Observational Analyses of Care Episodes for Hip and Knee Arthroplasty Surgery.

Science.gov (United States)

Weeks, William B; Schoellkopf, William J; Sorensen, Lyle S; Masica, Andrew L; Nesse, Robert E; Weinstein, James N

2017-03-01

Broader use of value-based reimbursement models will require providers to transparently demonstrate health care value. We sought to determine and report cost and quality data for episodes of hip and knee arthroplasty surgery among 13 members of the High Value Healthcare Collaborative (HVHC), a consortium of health care systems interested in improving health care value. We conducted a retrospective, cross-sectional observational cohort study of 30-day episodes of care for hip and knee arthroplasty in fee-for-service Medicare beneficiaries aged 65 or older who had hip or knee osteoarthritis and used 1 of 13 HVHC member systems for uncomplicated primary hip arthroplasty (N = 8853) or knee arthroplasty (N = 16,434), respectively, in 2012 or 2013. At the system level, we calculated: per-capita utilization rates; postoperative complication rates; standardized total, acute, and postacute care Medicare expenditures for 30-day episodes of care; and the modeled impact of reducing episode expenditures or per-capita utilization rates. Adjusted per-capita utilization rates varied across HVHC systems and postacute care reimbursements varied more than 3-fold for both types of arthroplasty in both years. Regression analysis confirmed that total episode and postacute care reimbursements significantly differed across HVHC members after considering patient demographic differences. Potential Medicare cost savings were greatest for knee arthroplasty surgery and when lower total reimbursement targets were achieved. The substantial variation that we found offers opportunities for learning and collaboration to collectively improve outcomes, reduce costs, and enhance value. Ceteris paribus, reducing per-episode reimbursements would achieve greater Medicare cost savings than reducing per-capita rates. Copyright © 2016 Elsevier Inc. All rights reserved.

Acute cognitive dysfunction after hip fracture

DEFF Research Database (Denmark)

Bitsch, M S; Foss, N B; Kristensen, B B

2006-01-01

hip fracture surgery in an optimized, multimodal, peri-operative rehabilitation regimen. METHODS: One hundred unselected hip fracture patients treated in a well-defined, optimized, multimodal, peri-operative rehabilitation regimen were included. Patients were tested upon admission and on the second......BACKGROUND: Patients undergoing hip fracture surgery often experience acute post-operative cognitive dysfunction (APOCD). The pathogenesis of APOCD is probably multifactorial, and no single intervention has been successful in its prevention. No studies have investigated the incidence of APOCD after......, fourth and seventh post-operative days with the Mini Mental State Examination (MMSE) score. RESULTS: Thirty-two per cent of patients developed a significant post-operative cognitive decline, which was associated with several pre-fracture patient characteristics, including age and cognitive function...

External Snapping Hip Syndrome: Emphasis on the MR Imaging

International Nuclear Information System (INIS)

Choi, Jung Eun; Lee, Bae Young; Sung, Mi Sook; Lee, Ki Haeng; Yoo, Won Jong; Lim, Hyun Wook; Chung, Myung Hee; Park, Jeong Mi; Kim, Jee Young

2010-01-01

The aim of this study is to evaluate the MR imaging features of patients with external snapping hip syndrome. We retrospectively reviewed 63 hip MR images. The images were analyzed according to the thickness and contour of the iliotibial band and the gluteus maximus, the presence of bone marrow edema, bursitis, joint effusion and other associated findings. The MR imaging of 22 hips with snapping hip syndrome depicted the causes of external snapping hip syndrome in twenty cases (90%). The MR imaging features of the snapping hip included thickening of the iliotibial band in twelve cases (55%) and/or thickening of the anterior band of the gluteus maximus in nineteen (86%), and a wavy contour of the iliotibial band or the anterior band of the gluteus maximus in ten cases (45%). These findings show a significant p value (<0.01). The majority of patients with snapping hip syndrome revealed thickening of the iliotibial band, thickening of the anterior band of the gluteus maximus and wavy contour of the those structures on MR imaging

External Snapping Hip Syndrome: Emphasis on the MR Imaging

Energy Technology Data Exchange (ETDEWEB)

Choi, Jung Eun; Lee, Bae Young [Catholic University St. Paul' s Hospital, Seoul (Korea, Republic of); Sung, Mi Sook; Lee, Ki Haeng; Yoo, Won Jong; Lim, Hyun Wook; Chung, Myung Hee [Catholic University Bucheon St. Mary' s Hospital, Bucheon (Korea, Republic of); Park, Jeong Mi [Catholic University St. Mary' s Hospital, Seoul (Korea, Republic of); Kim, Jee Young [Catholic University St. Vincent' s Hospital, Suwon (Korea, Republic of)

2010-02-15

The aim of this study is to evaluate the MR imaging features of patients with external snapping hip syndrome. We retrospectively reviewed 63 hip MR images. The images were analyzed according to the thickness and contour of the iliotibial band and the gluteus maximus, the presence of bone marrow edema, bursitis, joint effusion and other associated findings. The MR imaging of 22 hips with snapping hip syndrome depicted the causes of external snapping hip syndrome in twenty cases (90%). The MR imaging features of the snapping hip included thickening of the iliotibial band in twelve cases (55%) and/or thickening of the anterior band of the gluteus maximus in nineteen (86%), and a wavy contour of the iliotibial band or the anterior band of the gluteus maximus in ten cases (45%). These findings show a significant p value (<0.01). The majority of patients with snapping hip syndrome revealed thickening of the iliotibial band, thickening of the anterior band of the gluteus maximus and wavy contour of the those structures on MR imaging.

Hip adductor activations during run-to-cut maneuvers in compression shorts: Implications for return to sport after groin injury

Science.gov (United States)

CHAUDHARI, AJIT M. W.; JAMISON, STEVEN T.; MCNALLY, MICHAEL P.; PAN, XUELIANG; SCHMITT, LAURA C.

2014-01-01

Athletes at high risk of groin strains in sports such as hockey and soccer often choose to wear shorts with directional compression to aid in prevention or recovery from hip adductor strains. Large eccentric contractions are known to result in or exacerbate strain injuries, but it is unknown if these shorts have a beneficial effect on hip adductor muscle activity. In this study, surface electromyography of the adductor longus and ground reaction force (GRF) data were obtained simultaneously on 29 healthy individuals without previous history of serious injury while performing unanticipated 45° run-to-cut maneuvers in a laboratory setting wearing shorts with non-directional compression (control, HeatGear, Under Armour, USA) or shorts with directional compression (directional, CoreShort PRO, Under Armour, USA), in random order. Average adductor activity in the stance leg was significantly lower in the directional condition than in the control condition during all parts of stance phase (all pshorts appears to be associated with reduced stance limb hip adductor activity. Athletes seeking to reduce demand on the hip adductors as they approach full return to activities may benefit from the use of directional compression shorts. PMID:24669858

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....

Let Me Blow Your Mind: Hip Hop Feminist Futures in Theory and Praxis

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Lindsey, Treva B.

2015-01-01

This essay brings together key theoretical interventions in hip-hop feminism to explore the continued, but undervalued, significance of hip-hop feminism in urban education. More specifically, the essay challenges narrow conceptualizations of the "hip hop subject" as Black and male by using hip-hop feminist theory to incorporate the lived…

Rethinking Pedagogy in Urban Spaces: Implementing Hip-Hop Pedagogy in the Urban Science Classroom

Science.gov (United States)

Adjapong, Edmund S.; Emdin, Christopher

2015-01-01

A significant amount of research regarding Hip-Hop Based Education (HHBE) fails to provide insight on how to incorporate elements of Hip-Hop into daily teaching practices; rather Hip-Hop based educators focus mainly on incorporating Hip-Hop culture into curricula. This study explores the benefits of using two specific Hip-Hop pedagogical practices…

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

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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

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.

Hip Arthroscopy in High-Level Baseball Players.

Science.gov (United States)

Byrd, J W Thomas; Jones, Kay S

2015-08-01

To report the results of hip arthroscopy among high-level baseball players as recorded by outcome scores and return to baseball. All patients undergoing hip arthroscopy were prospectively assessed with the modified Harris Hip Score. On review of all procedures performed over a 12-year period, 44 hips were identified among 41 intercollegiate or professional baseball players who had achieved 2-year follow-up. Among the 41 players, follow-up averaged 45 months (range, 24 to 120 months), with a mean age of 23 years (range, 18 to 34 years). There were 23 collegiate (1 bilateral) and 18 professional (2 bilateral) baseball players, including 10 Major League Baseball players. Of the 8 Major League Baseball pitchers, 6 (75%) also underwent ulnar collateral ligament elbow surgery. Improvement in the modified Harris Hip Score averaged 13 points (from 81 points preoperatively to 94 points postoperatively); a paired-samples t test determined that this mean improvement of 13 points was statistically significant (P arthroscopy. This study supports the idea that arthroscopic treatment for a variety of hip pathologies in high-level baseball players provides a successful return to sport and improvement in functional outcome scores. Level IV, therapeutic case series. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

The incidence of primary hip osteoarthritis in active duty US military servicemembers.

Science.gov (United States)

Scher, Danielle L; Belmont, Philip J; Mountcastle, Sally; Owens, Brett D

2009-04-15

Although multiple studies have reported the prevalence of primary hip osteoarthritis (OA), little has been reported on incidence rates of hip OA. We sought to determine the incidence rate and demographic risk factors of hip OA in an ethnically diverse and physically active population of US military servicemembers. A query was performed using the US Defense Medical Epidemiology Database for the International Classification of Diseases, Ninth Revision, Clinical Modification code for hip OA (715.95). Multivariate Poisson regression analysis was used to estimate the rate of hip OA per 100,000 person-years, controlling for sex, race, age, rank, and service. The overall unadjusted incidence rate of hip OA was 35 per 100,000 person-years. Women, compared with men, had a significantly increased adjusted incidence rate ratio for hip OA of 1.87 (95% confidence interval [95% CI] 1.73-2.01). The adjusted incidence rate ratio for black servicemembers when compared with white servicemembers was 1.32 (95% CI 1.23-1.41). The adjusted incidence rate ratio for the > or =40-year-old age group compared with the 20-year-old group was 22.21 (95% CI 17.54-28.14). With junior officers as the referent category, junior enlisted, senior enlisted, and senior officers rank groups had a significantly increased adjusted incidence rate ratio for hip OA. With the Air Force as the referent category, each service had a significantly increased adjusted incidence rate ratio for hip OA. Female sex; black race; age > or =40 years; junior enlisted, senior enlisted, and senior officer rank groups; and military service in the Navy, Army, or Marines were all risk factors for hip OA.

HIPs at Ten

Science.gov (United States)

Kuh, George; O'Donnell, Ken; Schneider, Carol Geary

2017-01-01

2017 is the anniversary of the introduction of what are now commonly known as high-impact practices (HIPs). Many of the specific activities pursued under the HIPs acronym have been around in some form for decades, such as study abroad, internships, and student-faculty research. It was about ten years ago that, after conferring HIPs at Ten with…

Neuromuscular Activation of the Vastus Intermedius Muscle during Isometric Hip Flexion.

Directory of Open Access Journals (Sweden)

Akira Saito

Full Text Available Although activity of the rectus femoris (RF differs from that of the other synergists in quadriceps femoris muscle group during physical activities in humans, it has been suggested that the activation pattern of the vastus intermedius (VI is similar to that of the RF. The purpose of present study was to examine activation of the VI during isometric hip flexion. Ten healthy men performed isometric hip flexion contractions at 25%, 50%, 75%, and 100% of maximal voluntary contraction at hip joint angles of 90°, 110° and 130°. Surface electromyography (EMG was used to record activity of the four quadriceps femoris muscles and EMG signals were root mean square processed and normalized to EMG amplitude during an isometric knee extension with maximal voluntary contraction. The normalized EMG was significantly higher for the VI than for the vastus medialis during hip flexion at 100% of maximal voluntary contraction at hip joint angles of 110° and 130° (P < 0.05. The onset of VI activation was 230-240 ms later than the onset of RF activation during hip flexion at each hip joint angle, which was significantly later than during knee extension at 100% of maximal voluntary contraction (P < 0.05. These results suggest that the VI is activated later than the RF during hip flexion. Activity of the VI during hip flexion might contribute to stabilize the knee joint as an antagonist and might help to smooth knee joint motion, such as in the transition from hip flexion to knee extension during walking, running and pedaling.

Assessment of adult hip dysplasia and the outcome of surgical treatment

DEFF Research Database (Denmark)

Troelsen, Anders

2012-01-01

Hip dysplasia and hip joint deformities in general are recognized as possible precursors of osteoarthritic development. Early and correct identification of hip dysplasia is important in order to offer timely joint preserving treatment. In the contemporary literature, several controversies exist......, and some of these were the focus of this doctoral thesis. Categorized into subjects, the major findings and their possible importance are listed below. DIAGNOSTIC ASSESSMENT OF HIP DYSPLASIA: A multi-observer study quantified the variability of different methods for diagnostic assessment of hip dysplasia...... and osteoarthritis and resulted in general recommendations regarding diagnostic assessment of hip dysplasia. Pelvic tilt was shown to differ significantly between the supine and weight-bearing positions in patients with dysplastic hip joints. This is a finding that adds controversy to the application of neutral...

Revision Hip Arthroscopy: A Systematic Review of Diagnoses, Operative Findings, and Outcomes.

Science.gov (United States)

Cvetanovich, Gregory L; Harris, Joshua D; Erickson, Brandon J; Bach, Bernard R; Bush-Joseph, Charles A; Nho, Shane J

2015-07-01

To determine indications for, operative findings of, and outcomes of revision hip arthroscopy. A systematic review was registered with PROSPERO and performed based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Therapeutic clinical outcome studies reporting the indications for, operative findings of, and outcomes of revision hip arthroscopy were eligible for inclusion. All study-, patient-, and hip-specific data were extracted and analyzed. The Modified Coleman Methodology Score was used to assess study quality. Five studies were included (348 revision hip arthroscopies; 333 patients; mean age, 31.4 ± 4.2 years; 60% female patients). All 5 studies were either Level III or IV evidence. The surgeon performing revision hip arthroscopy was the same as the primary hip surgeon in only 25% of cases. The mean time between primary and revision hip arthroscopy was 27.8 ± 7.0 months (range, 2 to 193 months). Residual femoroacetabular impingement was the most common indication for and operative finding of revision hip arthroscopy (81% of cases). The most commonly reported revision procedures were femoral osteochondroplasty (24%) and acetabuloplasty (18%). The modified Harris Hip Score was used in all 5 analyzed studies, with significant (P arthroscopy, subsequent reported operations were hip arthroplasty in 11 patients and re-revision hip arthroscopy in 8 patients (5% total reoperation rate). Revision hip arthroscopy is most commonly performed for residual femoroacetabular impingement, with statistically significant and clinically relevant improvements shown in multiple patient-reported clinical outcome scores at short-term follow-up. The reoperation rate after revision hip arthroscopy is 5% within 2 years, including further arthroscopy or conversion to hip arthroplasty. Level IV, systematic review of Level III and IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Evaluating healthcare resource utilization and outcomes for surgical hip dislocation and hip arthroscopy for femoroacetabular impingement.

Science.gov (United States)

de Sa, Darren; Horner, Nolan S; MacDonald, Austin; Simunovic, Nicole; Slobogean, Gerard; Philippon, Marc J; Belzile, Etienne L; Karlsson, Jon; Ayeni, Olufemi R

2016-12-01

Surgical hip dislocation (SHD) and hip arthroscopy are surgical methods used to correct deformity associated with femoroacetabular impingement (FAI). Though both of these approaches appear to benefit patients, no studies exist comparing healthcare resource utilization of the two surgical approaches. This systematic review examines the literature and the records of two surgeons to evaluate the resource utilization associated with treating symptomatic FAI via these two methods. EMBASE, MEDLINE and PubMed were searched for relevant articles. The articles were systematically screened, and data was abstracted in duplicate. To further supplement resource utilization data, a retrospective chart review of two surgeon's patient data (one using SHD and another using an arthroscopic approach) was completed. Experts in pharmacy, physiotherapy, radiology, anaesthesia, physiatry and the local hospital finance department were also consulted. There were 52 studies included with a total of 460 patients (535 hips) and 3886 patients (4147 hips) who underwent SHD and arthroscopic surgery for FAI, respectively. Regardless of approach, most patients treated for symptomatic FAI improved across various outcomes measures with low complication rates. Surgical time across all approaches was similar, averaging 118 ± 2 min. On a per patient basis, hip arthroscopy ($10,976) uses approximately 41 % of the resources of SHD ($24,379). There were no significant differences in outcomes for FAI treated with SHD or arthroscopy. However, with regard to healthcare resource utilization based on the OHIP healthcare system, hip arthroscopy uses substantially less resources than SHD within the first post-operative year. Systematic Review of Level IV Studies, Level IV.

Cementless Hip Stem Anteversion in the Dysplastic Hip: A Comparison of Tapered Wedge vs Metaphyseal Filling.

Science.gov (United States)

Taniguchi, Naofumi; Jinno, Tetsuya; Koga, Daisuke; Hagino, Tetsuo; Okawa, Atsushi; Haro, Hirotaka

2017-05-01

Appropriate stem anteversion is important for achieving stability of the prosthetic joint in total hip arthroplasty. Anteversion of a cementless femoral stem is affected by the femoral canal morphology and varies according to stem geometry. We investigated the difference and variation of the increase in anteversion between 2 types of cementless stems, and the correlation between each stem and the preoperative femoral anteversion. We retrospectively compared 2 groups of hips that underwent total hip arthroplasty using a metaphyseal filling stem (78 hips) or a tapered wedge stem (83 hips). All the patients had osteoarthritis due to hip dysplasia. Computed tomography was used to measure preoperative femoral anteversion at 5 levels and postoperative stem anteversion. The increase in anteversion of the tapered wedge stem group (22.7° ± 11.6°) was more than that of the metaphyseal filling stem group (17.2° ± 8.3°; P = .0007). The variation of the increase in the tapered wedge stem group was significantly larger than that in the metaphyseal filling stem group (P = .0016). The metaphyseal filling stem group was more highly and positively correlated with femoral anteversion than the tapered wedge stem group. Femoral anteversion affects stem anteversion differently according to stem geometry. The tapered wedge stems had greater variation of the increase in anteversion than did the metaphyseal filling stems. Based on the results of this study, it is difficult to preoperatively estimate the increase in stem anteversion for tapered wedge stems. Copyright © 2016 Elsevier Inc. All rights reserved.

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

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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

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.

[Effect of abducens orthosis combined with walker on developmental dysplasia of the hip].

Science.gov (United States)

Hu, Zhiyong; Xu, Yongqiang; Liang, Jieyu; Li, Kanghua; Liao, Qiande

2009-07-01

To evaluate the effect of abducens orthosis combined with walker on developmental dysplasia of the hip (DDH). A total of 126 patients (224 hips) with DDH aged 6-36 months in Xiangya Hospital was randomly divided into 2 groups: an orthosis combined with walker group and an improved hip frog cast fixation group. Seventy patients (130 hips) were treated by the orthosis combined with walker and 56 patients (94 hips) were treated by the improved hip frog cast fixation. We compared the effect and complications of the 2 groups. The fineness rates of the orthosis combined with walker group and the improved hip frog cast fixation group were 89.2% and 90.4%, respectively, with no significant difference (P>0.05). The rate of femoral head osteonecrosis in the orthosis combined with walker group was significantly lower than that in the improved hip frog cast fixation group (1.5% vs. 5.3%,Pwalker has a lower proportion of femoral head osteonecrosis, but a higher proportion of re-dislocation.

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

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

DEFF Research Database (Denmark)

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

2004-01-01

OBJECTIVES: (1) To evaluate the effect of pelvic orientation on measurements of hip joint space widths (JSW) in cadaver pelvic radiographs, thereby validating the pelvic radiographs of the Copenhagen City Heart Study: The Osteoarthritis Substudy (CCHS III) cohort of 4.152 subjects, and (2...... was significantly associated to self reported pain in or around the hip joint in both sexes. CONCLUSION: Measurements of minimum hip JSW did not seem to be significantly influenced by varying spatial orientation of the pelvis during X-ray recordings. An inclusion criteria of minimum JSW

Hip morphology predicts posterior hip impingement in a cadaveric model.

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Morris, William Z; Fowers, Cody A; Weinberg, Douglas S; Millis, Michael B; Tu, Leigh-Anne; Liu, Raymond W

2018-05-01

Posterior hip impingement is a recently-identified cause of hip pain. The purpose of this study is to characterise posterior femoroacetabular and ischiofemoral impingement and identify its predisposing morphologic traits. Two hundred and six cadaveric hips were randomly selected and taken through controlled motion in two pure axes associated with posterior hip impingement: external rotation (through the mechanical axis) and adduction (coronal plane). The range of motion and location of impingement was noted for each specimen. Morphologic traits including femoral/acetabular version, and true neck-shaft angle (TNSA) were also measured. External rotation impingement occurred between the femoral neck and acetabulum in 83.0% of hips, and between the lesser trochanter and ischial tuberosity in 17.0%. Adduction impingement occurred between the lesser trochanter and ischial tuberosity in 78.6% of hips, and between the femoral neck and acetabulum in 21.4%. Multiple regression revealed that increased femoral/acetabular version predicted earlier external rotation and adduction impingement. Unstandardised betas ranging from -0.39 to -0.64 reflect that each degree of increased femoral/acetabular version individually accounts for a loss of external rotation or adduction of approximately half a degree before impingement ( p < 0.001 for each). Increased TNSA was associated with earlier adduction impingement only (unstandardised beta -0.35, p = 0.005). Relative femoral/acetabular anteversion was associated with earlier posterior hip impingement. Coxa valga was associated with earlier adduction impingement, but protective against external rotation impingement. These findings highlight the importance of monitoring correction during femoral/acetabular osteotomies, as overcorrection of retroversion may predispose to earlier posterior impingement.

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

Once-yearly zoledronic acid in hip fracture prevention

Science.gov (United States)

Demontiero, Oddom; Duque, Gustavo

2009-01-01

Osteoporosis is an escalating global problem. Hip fractures, the most catastrophic complication of osteoporosis, continue to cause significant mortality and morbidity despite increasing availability of effective preventative agents. Among these agents, oral bisphosphonates have been the first choice for the treatment and prevention of osteoporotic fractures. However, the use of oral bisphosphonates, especially in the older population, has been limited by their side effects and method of administration thus compromising their persistent use. The resultant low adherence by patients has undermined their full potential and has been associated with an increase in the incidence of fragility fractures. Recently, annual intravenous zoledronic acid (ZOL) has been approved for osteoporosis. Randomized controlled trials have demonstrated ZOL to be safe, have good tolerability and produce significant effect on bone mass and microarchitecture. Adherence has also been shown to be better with ZOL. Furthermore two large trials firmly demonstrated significant anti-osteoporotic effect (∼59% relative risk reduction of hip fractures) and mortality benefit (28% reduction in mortality) of ZOL in older persons with recent hip fractures. In this review, we report the current evidence on the use of ZOL for the prevention of hip fractures in the elderly. We also report the pharmacological characteristics and the advantages and disadvantages of ZOL in this particular group. PMID:19503777

Finite element simulation of HIP-process to produce 3d near net shape parts

International Nuclear Information System (INIS)

Zadeh, M.K.

1996-01-01

One of the major problems when producing powder metallurgy parts through hot isostatic pressing (HIP) is the non homogeneous shrinkage of HIP-capsule during the process. This leads to time and cost consuming machining of the HIP parts. In order to reduce the machining to a minimum, one can try to simulate the HIP-process by means of numerical methods. Hereby, the part distortion can be predicted, and hence a new HIP-capsule can be designed in such a way to prevent the distortion partly or even completely. In the following, a finite element method is used, on one hand, to simulate part shrinkage during HIP process; on the other hand a method is integrated in this simulation to optimize the HIP-capsule geometry. For the determination of material dependent parameters, a mixture of theoretical and experimental methods is used. Results of simulation are verified for a complex 3d HIP part out of TiAl6V4

Fear of falling in patients with hip fractures: prevalence and related psychological factors.

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Visschedijk, Jan; van Balen, Romke; Hertogh, Cees; Achterberg, Wilco

2013-03-01

To determine the prevalence of fear of falling (FoF) in patients after a hip fracture, to investigate the relation with time after fracture, and to assess associations between FoF and other psychological factors. Cross-sectional study performed between September 2010 and March 2011 in elderly patients after a hip fracture. Ten postacute geriatric rehabilitation wards in Dutch nursing homes. A total of 100 patients aged ≥65 years with a hip fracture admitted to a geriatric rehabilitation ward. FoF and related concepts such as falls-related self-efficacy, depression, and anxiety were measured by means of self-assessment instruments. Of all patients, 36% had a little FoF and 27% had quite a bit or very much FoF. Scores on the Falls Efficacy Scale-International were 30.6 in the first 4 weeks after hip fracture, 35.6 in the second 4 weeks, and 29.4 in the period ≥8 weeks after fracture. In these 3 periods, the prevalence rates of FoF were 62%, 68%, and 59%, respectively. Significant correlations were found between FoF and anxiety (P falls-related self-efficacy. During rehabilitation, FoF is greatest in the second 4 weeks after hip fracture. More studies are needed to explore the determinants of FoF and develop interventions to reduce FoF and improve outcome after rehabilitation. Copyright © 2013. Published by Elsevier Inc.

Effects of HIP and forging on fracture behaviour in cast iron with spheroidal vanadium carbides dispersed within martensitic-matrix microstructure

International Nuclear Information System (INIS)

Uematsu, Y.; Tokaji, K.; Nishigaki, K.; Okajima, D.; Ogasawara, M.

2010-01-01

The cast iron with spheroidal vanadium carbides dispersed within martensitic-matrix microstructure was developed as a die material due to its high hardness. In order to achieve high performances of dies, not only the hardness but also the mechanical properties such as fracture toughness and fatigue crack propagation (FCP) resistance should be improved. In this paper, hot isostatic pressing (HIP) or forging was applied to the cast iron to improve mechanical properties, and the fracture behaviour, such as flexural strength, fracture toughness and FCP, was studied. The average flexural strength was reduced by forging because of the enhanced notch sensitivity due to the increase in the hardness. The fracture toughness was not affected by HIP nor forging while its scatter was significantly reduced by both post-treatments. The intrinsic FCP resistance taking account of crack closure was the same regardless of the application of HIP or forging, indicating that a slight change in the microstructure resulting from both treatments and the presence of casting defects exerted little influence on FCP behaviour. It could be concluded that both HIP and forging could improve the hardness of the material, while fracture toughness and FCP resistance were maintained.

Fragility non-hip fracture patients are at risk.

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Gosch, M; Druml, T; Nicholas, J A; Hoffmann-Weltin, Y; Roth, T; Zegg, M; Blauth, M; Kammerlander, C

2015-01-01

Fragility fractures are a growing worldwide health care problem. Hip fractures have been clearly associated with poor outcomes. Fragility fractures of other bones are common reasons for hospital admission and short-term disability, but specific long-term outcome studies of non-hip fragility fractures are rare. The aim of our trial was to evaluate the 1-year outcomes of non-hip fragility fracture patients. This study is a retrospective cohort review of 307 consecutive older inpatient non-hip fracture patients. Patient data for analysis included fracture location, comorbidity prevalence, pre-fracture functional status, osteoporosis treatments and sociodemographic characteristics. The main outcomes evaluated were 1-year mortality and post-fracture functional status. As compared to the expected mortality, the observed 1-year mortality was increased in the study group (17.6 vs. 12.2 %, P = 0.005). After logistic regression, three variables remained as independent risk factors for 1-year mortality among non-hip fracture patients: malnutrition (OR 3.3, CI 1.5-7.1), Charlson comorbidity index (CCI) (OR 1.3, CI 1.1-1.5) and the Parker Mobility Score (PMS) (OR 0.85, CI 0.74-0.98). CCI and PMS were independent risk factors for a high grade of dependency after 1 year. Management of osteoporosis did not significantly improve after hospitalization due to a non-hip fragility fracture. The outcomes of older non-hip fracture patients are comparable to the poor outcomes of older hip fracture patients, and appear to be primarily related to comorbidities, pre-fracture function and nutritional status. The low rate of patients on osteoporosis medications likely reflects the insufficient recognition of the importance of osteoporosis assessment and treatment in non-hip fracture patients. Increased clinical and academic attention to non-hip fracture patients is needed.

Study of the variations of fall induced hip fracture risk between right and left femurs using CT-based FEA.

Science.gov (United States)

Faisal, Tanvir R; Luo, Yunhua

2017-10-03

Hip fracture of elderly people-suffering from osteoporosis-is a severe public health concern, which can be reduced by providing a prior assessment of hip fracture risk. Image-based finite element analysis (FEA) has been considered an effective computational tool to assess the hip fracture risk. Considering the femoral neck region is the weakest, fracture risk indicators (FRI) are evaluated for both single-legged stance and sideways fall configurations and are compared between left and right femurs of each subject. Quantitative Computed Tomography (QCT) scan datasets of thirty anonymous patients' left and right femora have been considered for the FE models, which have been simulated with an equal magnitude of load applied to the aforementioned configurations. The requirement of bilateral hip assessment in predicting the fracture risk has been explored in this study. Comparing the sideways fall and single-legged stance, the FRI varies by 64 to 74% at the superior aspects and by 14 to 19% at the inferior surfaces of both the femora. The results of this in vivo analysis clearly substantiate that the fracture is expected to initiate at the superior surface of femoral neck region if a patient falls from his/her standing height. The distributions of FRI between the femurs vary considerably, and the variability is significant at the superior aspects. The p value (= 0.02) obtained from paired sample t-Test yields p value ≤ 0.05, which shows the evidence of variability of the FRI distribution between left and right femurs. Moreover, the comparison of FRIs between the left and right femur of men and women shows that women are more susceptible to hip fracture than men. The results and statistical variation clearly signify a need for bilateral hip scanning in predicting hip fracture risk, which is clinically conducted, at present, based on one hip chosen randomly and may lead to inaccurate fracture prediction. This study, although preliminary, may play a crucial role in

Hip and upper extremity kinematics in youth baseball pitchers.

Science.gov (United States)

Holt, Taylor; Oliver, Gretchen D

2016-01-01

The purpose of this study was to examine the relationship between dynamic hip rotational range of motion and upper extremity kinematics during baseball pitching. Thirty-one youth baseball pitchers (10.87 ± 0.92 years; 150.03 ± 5.48 cm; 44.83 ± 8.04 kg) participated. A strong correlation was found between stance hip rotation and scapular upward rotation at maximum shoulder external rotation (r = 0.531, P = 0.002) and at ball release (r = 0.536, P = 0.002). No statistically significant correlations were found between dynamic hip rotational range of motion and passive hip range of motion. Hip range of motion deficits can constrain pelvis rotation and limit energy generation in the lower extremities. Shoulder pathomechanics can then develop as greater responsibility is placed on the shoulder to generate the energy lost from the proximal segments, increasing risk of upper extremity injury. Additionally, it appears that passive seated measurements of hip range of motion may not accurately reflect the dynamic range of motion of the hips through the progression of the pitch cycle.

Increased body mass index is a predisposition for treatment by total hip replacement

DEFF Research Database (Denmark)

Jacobsen, Steffen; Sonne-Holm, Stig

2005-01-01

-joint degeneration and dysplasia. Sequential body mass index (BMI) measurements from 1976 to 1992, age, exposure to daily lifting and hip dysplasia were entered into logistic regression analyses. The prevalence of hip dysplasia ranged from 5.4% to 12.8% depending on the radiographical index used. Radiological hip OA...... prevalence was 1.0--2.5% in subjects or=60 years of age. While radiological OA was significantly influenced by hip dysplasia in men and hip dysplasia and age in women, the risk of THR being performed was only influenced by BMI assessed in 1976. Hip......We investigated the radiological and epidemiological data of 4,151 subjects followed up from 1976 to 2003 to determine individual risk factors for hip osteoarthritis (OA), hip pain and/or treatment by total hip replacement (THR). Pelvic radiographs recorded in 1992 were assessed for evidence of hip...

Evaluation of a multidisciplinary rehabilitation programme for elderly patients with hip fracture: A prospective cohort study

Directory of Open Access Journals (Sweden)

Wing-Hoi Cheung

2017-12-01

Full Text Available Objective: To investigate the effectiveness and cost of an 18-month multi-disciplinary Comprehensive Fragility Fracture Management Program (CFFMP for fragility hip fracture patients. Design: Prospective cohort study. Patients: Elderly patients with hip fracture were recruited at their first postoperative follow-up in 2 district hospitals. The intervention group comprised patients from the hospital undergoing CFFMP, and the control group comprised patients from another hospital undergoing conventional care. CFFMP provided geri-orthopaedic co-management, physician consultations, group-exercise and vibration-therapy. Timed-up-and-go test (TUG, Elderly Mobility Scale (EMS, Berg Balance Scale (BBS and fall risk screening (FS were used to assess functional performance. Incidences of falls and secondary fractures, the cost of the programme and related healthcare resources were recorded. Results: A total of 76 patients were included in the intervention group (mean age 77.9 years ((standard deviation; SD 6.1 and 77 in the control group (79.9 (SD 7.2, respectively. The re-fracture rate in the control group (10.39% was significantly higher than in the intervention group (1.32% (p = 0.034. The intervention group improved significantly in TUG, EMS and FS after a 1-year programme. The overall healthcare costs per patient in the intervention and control groups were US$22,450 and US$25,313, respectively. Conclusion: Multi-disciplinary CFFMP is effective, with reduced overall cost, reduced length of hospital stay and reduced secondary fracture rate. The rehabilitation community service favours rehabilitation and improved quality of life of hip fracture patients.

Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties

DEFF Research Database (Denmark)

Jørgensen, Christoffer Calov; Kjærsgaard-Andersen, Per; Kehlet, Henrik

2014-01-01

STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To investigate the incidence of hip dislocation 90 days after total hip arthroplasty in relation to time after surgery, mechanism of dislocation and predisposing factors. METHODS: Prospective data on preoperative patient.......31-3.40)] but not hospital stay of hip...

Innovations in the management of hip fractures.

Science.gov (United States)

Teasdall, Robert D; Webb, Lawrence X

2003-08-01

Hip fractures include fractures of the head, neck, intertrochanteric, and subtrochanteric regions. Head fractures commonly accompany dislocations. Neck fractures and intertrochanteric fractures occur with greatest frequency in elderly patients with a low bone mineral density and are produced by low-energy mechanisms. Subtrochanteric fractures occur in a predominantly strong cortical osseous region that is exposed to large compressive stresses. Implants used to address these fractures must accommodate significant loads while the fractures consolidate. Complications secondary to hip fractures produce significant morbidity and include infection, nonunion, malunion, decubitus ulcers, fat emboli, deep venous thrombosis, pulmonary embolus, pneumonia, myocardial infarction, stroke, and death.

Characteristics of children with hip displacement in cerebral palsy

Directory of Open Access Journals (Sweden)

Wagner Philippe

2007-10-01

Full Text Available Abstract Background Hip dislocation in children with cerebral palsy (CP is a common and severe problem. The dislocation can be avoided, by screening and preventive treatment of children with hips at risk. The aim of this study was to analyse the characteristics of children with CP who develop hip displacement, in order to optimise a hip surveillance programme. Methods In a total population of children with CP a standardised clinical and radiological follow-up of the hips was carried out as a part of a hip prevention programme. The present study is based on 212 children followed until 9–16 years of age. Results Of the 212 children, 38 (18% developed displacement with Migration Percentage (MP >40% and further 19 (9% MP between 33 and 39%. Mean age at first registration of hip displacement was 4 years, but some hips showed MP > 40% already at two years of age. The passive range of hip motion at the time of first registration of hip displacement did not differ significantly from the findings in hips without displacement. The risk of hip displacement varied according to CP-subtype, from 0% in children with pure ataxia to 79% in children with spastic tetraplegia. The risk of displacement (MP > 40% was directly related to the level of gross motor function, classified according to the gross motor function classification system, GMFCS, from 0% in children in GMFCS level I to 64% in GMFCS level V. Conclusion Hip displacement in CP often occurs already at 2–3 years of age. Range of motion is a poor indicator of hips at risk. Thus early identification and early radiographic examination of children at risk is of great importance. The risk of hip displacement varies according to both CP-subtype and GMFCS. It is sometimes not possible to determine subtype before 4 years of age, and at present several definitions and classification systems are used. GMFCS is valid and reliable from 2 years of age, and it is internationally accepted. We recommend a hip

Investigating Cultural Collision: Educators' Perceptions of Hip-Hop Culture

Science.gov (United States)

Beachum, Floyd D.

2013-01-01

Hip-hop music has been embraced worldwide by youth, pummeled in the media for supposedly increasing social misery and hailed as a significant musical breakthrough. Hip-hop culture has transcended musical boundaries and now impacts speech, clothing, mannerisms, movies, websites, television programming, magazines, and energy drinks (Dyson, 2007;…

Normative values of eccentric hip abduction strength in novice runners

DEFF Research Database (Denmark)

Jørgensen, Daniel Ramskov; Pedersen, Mette Broen; Kastrup, Kristrian

2014-01-01

.354) Nm/kg. CONCLUSION: Normative values for maximal eccentric hip abduction strength in novice runners can be calculated by taking into account the differences in strength across genders and the decline in strength that occurs with increasing age. Age and gender were associated with maximal eccentric hip...... associated with maximal eccentric hip abduction strength from a univariate analysis were included in a multivariate linear regression model. Based on the results from the regression model, a regression equation for normative hip abduction strength is presented. RESULTS: A SIGNIFICANT DIFFERENCE IN MAXIMAL...... was found, p gender. Based on this, the equation to calculate normative values for relative eccentric hip abduction strength became: (1.600 + (age * -0.005) + (gender (1 = male / 0 = female) * 0.215) ± 1 or 2 * 0...

Surgical hip dislocation in treatment of slipped capital femoral epiphysis

Directory of Open Access Journals (Sweden)

Elmarghany Mohammed

2017-01-01

Full Text Available Background: Most surgeons advocate in situ fixation of the slipped epiphysis with acceptance of any persistent deformity in the proximal femur [Aronsson DD, Loder RT, Breur GJ, Weinstein SL (2006 Slipped capital femoral epiphysis: current concepts. J Am Acad Orthop Surg 14, 666–679]. This residual deformity can lead to osteoarthritis due to femoroacetabular cam impingement (FAI [Leunig M, Slongo T, Ganz R (2008 Subcapital realignment in slipped capital femoral epiphysis: surgical hip dislocation and trimming of the stable trochanter to protect the perfusion of the epiphysis. Instr Course Lect 57, 499–507]. Objective: The primary aim of our study was to report the results of the technique of capital realignment with Ganz surgical hip dislocation and its reproducibility to restore hip anatomy and function. Patients and methods: This prospective case series study included 30 patients (32 hips, 13 left (Lt hips, 19 right (Rt hips with stable chronic slipped capital femoral epiphysis (SCFE after surgical correction with a modified Dunn procedure. This study included 22 males and eight females. The mean age of our patients was 14 years (10–18 years. The mean follow-up period was 14.5 months (6–36 months. Results: Thirty hips had excellent and good clinical and radiographic outcomes with respect to hip function and radiographic parameters. Two patients had fair to poor clinical outcome including three patients who developed Avascular Necrosis (AVN. The difference between those who developed AVN and those who did not develop AVN was statistically significant in postoperative clinical scores (p = 0.0000. The mean slip angle of the femoral head was 52.5° ± 14.6 preoperatively and was corrected to a mean value of 5.6° ± 8.2° with mean correction of 46.85° ± 14.9° (p = 0.0000. The mean postoperative alpha angle was 51.15° ± 4.2° with mean correction of 46.70 ± 14.20 (p = 0.0000. In our series, the mean postoperative

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.

Hip Injuries and Disorders

Science.gov (United States)

Your hip is the joint where your femur (thigh bone) meets your pelvis (hip bone). There are two main parts: a ball ... fits in a socket in the pelvis. Your hip is known as a ball-and-socket joint. ...

Milk consumption during teenage years and risk of hip fractures in older adults.

Science.gov (United States)

Feskanich, Diane; Bischoff-Ferrari, Heike A; Frazier, A Lindsay; Willett, Walter C

2014-01-01

Milk consumption during adolescence is recommended to promote peak bone mass and thereby reduce fracture risk in later life. However, its role in hip fracture prevention is not established and high consumption may adversely influence risk by increasing height. To determine whether milk consumption during teenage years influences risk of hip fracture in older adults and to investigate the role of attained height in this association. Prospective cohort study over 22 years of follow-up in more than 96,000 white postmenopausal women from the Nurses' Health Study and men aged 50 years and older from the Health Professionals Follow-up Study in the United States. Frequency of consumption of milk and other foods during ages 13 to 18 years and attained height were reported at baseline. Current diet, weight, smoking, physical activity, medication use, and other risk factors for hip fractures were reported on biennial questionnaires. Cox proportional hazards models were used to calculate relative risks (RRs) of first incidence of hip fracture from low-trauma events per glass (8 fl oz or 240 mL) of milk consumed per day during teenage years. During follow-up, 1226 hip fractures were identified in women and 490 in men. After controlling for known risk factors and current milk consumption, each additional glass of milk per day during teenage years was associated with a significant 9% higher risk of hip fracture in men (RR = 1.09; 95% CI, 1.01-1.17). The association was attenuated when height was added to the model (RR = 1.06; 95% CI, 0.98-1.14). Teenage milk consumption was not associated with hip fractures in women (RR = 1.00 per glass per day; 95% CI, 0.95-1.05). Greater milk consumption during teenage years was not associated with a lower risk of hip fracture in older adults. The positive association observed in men was partially mediated through attained height.

Increasing incidence of hip fracture in Chiang Mai, Thailand.

Science.gov (United States)

Wongtriratanachai, Prasit; Luevitoonvechkij, Sirichai; Songpatanasilp, Thawee; Sribunditkul, Siripoj; Leerapun, Taninnit; Phadungkiat, Sompant; Rojanasthien, Sattaya

2013-01-01

Hip fracture is a major health problem in Thailand. This study attempted to examine the incidence, related factors, and trends of hip fracture in Chiang Mai, Thailand. All hip fracture data among patients aged 50 yr or older were collected from hospitals in Chiang Mai, Thailand from August 1, 2006 to July 3, 2007. Data from the 1997 Chiang Mai hip fracture study were used for comparison. In the study period, 690 hip fractures were reported: 203 males and 487 females (male to female ratio was 1 to 2.4), with a mean age of 76.7 yr. The estimated cumulative incidence was 181.0 per 100,000, and the adjusted incidence was 253.3 (males: 135.9; females: 367.9). A simple fall was the most common mechanism (79%) of fracture, and 80% of the hip fractures occurred in patients aged 70 yr or older. The highest incidence of hip fracture was observed in patients older than 85 yr (1239). At 6 mo postfracture, most patients (61%) used a walking aid. Compared with the 1997 data, hip fracture incidence had increased by an average of 2% per yr, and the incidence of hip fracture had increased significantly from August 1, 2006 to July 31, 2007, especially in patients older than 75 yr. In patients older than 84 yr, the incidence increased by a factor of 2. Urgent strategies for the prevention and treatment of osteoporosis, and hence hip fracture, are needed. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Bone mineral density difference between right and left hip during ageing

DEFF Research Database (Denmark)

Schwarz, P.; Jørgensen, Niklas Rye; Jensen, L.T.

2011-01-01

be affected by significant left-right difference in hip BMD, especially in the old. The purpose of our study was to ascertain the difference in BMD measurement of the two hips in a population of Caucasian community dwelling women older than 65 years invited for screening. We found that bilateral BMD...... found an increasing difference between the hips with increasing age and this difference was up to 9.1% in the women older than 70 years when evaluating femoral neck, meaning that the diagnosis of osteoporosis in a subset of patients would depend on whether the left or right hip was scanned. When...... measurements were only moderately correlated at the femoral neck and total hip. In a significant number of the screened elderly women, we found that the DXA differences changed the diagnosis of each woman from either normal BMD to osteopenia or visa versa or from osteopenia to osteoporosis or visa versa. We...

Bone Mineral Density difference between Right and Left Hip during Ageing

DEFF Research Database (Denmark)

Schwarz, P; Jørgensen, NR; Jensen, LT

2011-01-01

be affected by significant left-right difference in hip BMD, especially in the old. The purpose of our study was to ascertain the difference in BMD measurement of the two hips in a population of Caucasian community dwelling women older than 65 years invited for screening. We found that bilateral BMD...... found an increasing difference between the hips with increasing age and this difference was up to 9.1% in the women older than 70 years when evaluating femoral neck, meaning that the diagnosis of osteoporosis in a subset of patients would depend on whether the left or right hip was scanned. When...... measurements were only moderately correlated at the femoral neck and total hip. In a significant number of the screened elderly women, we found that the DXA differences changed the diagnosis of each woman from either normal BMD to osteopenia or visa versa or from osteopenia to osteoporosis or visa versa. We...

Pyrolysis and catalytic pyrolysis as a recycling method of waste CDs originating from polycarbonate and HIPS

Energy Technology Data Exchange (ETDEWEB)

Antonakou, E.V. [Department of Chemistry, Aristotle University of Thessaloniki, 54124 Thessaloniki (Greece); Kalogiannis, K.G.; Stephanidis, S.D. [Chemical Process Engineering Research Institute, 57001 Thermi, Thessaloniki (Greece); Triantafyllidis, K.S. [Department of Chemistry, Aristotle University of Thessaloniki, 54124 Thessaloniki (Greece); Chemical Process Engineering Research Institute, 57001 Thermi, Thessaloniki (Greece); Lappas, A.A. [Chemical Process Engineering Research Institute, 57001 Thermi, Thessaloniki (Greece); Achilias, D.S., E-mail: axilias@chem.auth.gr [Department of Chemistry, Aristotle University of Thessaloniki, 54124 Thessaloniki (Greece)

2014-12-15

Highlights: • Thermal and catalytic pyrolysis is a powerful method for recycling of WEEEs. • Liquid products obtained from the pyrolysis of PC or HIPS found in waste CDs are very different. • Mainly phenols are obtained from pyrolysis PC based wastes while aromatics from HIPS. • Use of MgO catalyst increases the amount of phenols from CD recycling compared to ZSM-5. • Use of MgO or ZSM-5 catalysts reduces the amount of styrene recovered from HIPS. - Abstract: Pyrolysis appears to be a promising recycling process since it could convert the disposed polymers to hydrocarbon based fuels or various useful chemicals. In the current study, two model polymers found in WEEEs, namely polycarbonate (PC) and high impact polystyrene (HIPS) and their counterparts found in waste commercial Compact Discs (CDs) were pyrolysed in a bench scale reactor. Both, thermal pyrolysis and pyrolysis in the presence of two catalytic materials (basic MgO and acidic ZSM-5 zeolite) was performed for all four types of polymers. Results have shown significant recovery of the monomers and valuable chemicals (phenols in the case of PC and aromatic hydrocarbons in the case of HIPS), while catalysts seem to decrease the selectivity towards the monomers and enhance the selectivity towards other desirable compounds.

Transient osteoporosis of the hip

International Nuclear Information System (INIS)

McWalter, Patricia; Hassan Ahmed

2007-01-01

Transient osteoporosis of the hip is an uncommon cause of hip pain, mostly affecting healthy middle-aged men and also women in the third trimester of pregnancy. We present a case of transient osteoporosis of the hip in a 33-year-old non-pregnant female patient. This case highlights the importance of considering a diagnosis of transient osteoporosis of the hip in patients who present with hip pain. (author)

Bilateral, Misalignment-Compensating, Full-DOF Hip Exoskeleton: Design and Kinematic Validation

Directory of Open Access Journals (Sweden)

Karen Junius

2017-01-01

Full Text Available A shared design goal for most robotic lower limb exoskeletons is to reduce the metabolic cost of locomotion for the user. Despite this, only a limited amount of devices was able to actually reduce user metabolic consumption. Preservation of the natural motion kinematics was defined as an important requirement for a device to be metabolically beneficial. This requires the inclusion of all human degrees of freedom (DOF in a design, as well as perfect alignment of the rotation axes. As perfect alignment is impossible, compensation for misalignment effects should be provided. A misalignment compensation mechanism for a 3-DOF system is presented in this paper. It is validated by the implementation in a bilateral hip exoskeleton, resulting in a compact and lightweight device that can be donned fast and autonomously, with a minimum of required adaptations. Extensive testing of the prototype has shown that hip range of motion of the user is maintained while wearing the device and this for all three hip DOFs. This allowed the users to maintain their natural motion patterns when they are walking with the novel hip exoskeleton.

Bilateral, Misalignment-Compensating, Full-DOF Hip Exoskeleton: Design and Kinematic Validation

Science.gov (United States)

Degelaen, Marc; Lefeber, Nina; Swinnen, Eva; Vanderborght, Bram; Lefeber, Dirk

2017-01-01

A shared design goal for most robotic lower limb exoskeletons is to reduce the metabolic cost of locomotion for the user. Despite this, only a limited amount of devices was able to actually reduce user metabolic consumption. Preservation of the natural motion kinematics was defined as an important requirement for a device to be metabolically beneficial. This requires the inclusion of all human degrees of freedom (DOF) in a design, as well as perfect alignment of the rotation axes. As perfect alignment is impossible, compensation for misalignment effects should be provided. A misalignment compensation mechanism for a 3-DOF system is presented in this paper. It is validated by the implementation in a bilateral hip exoskeleton, resulting in a compact and lightweight device that can be donned fast and autonomously, with a minimum of required adaptations. Extensive testing of the prototype has shown that hip range of motion of the user is maintained while wearing the device and this for all three hip DOFs. This allowed the users to maintain their natural motion patterns when they are walking with the novel hip exoskeleton. PMID:28790799

Hip arthroscopy: prevalence of intra-articular pathologic findings after traumatic injury of the hip.

Science.gov (United States)

Khanna, Vickas; Harris, Adam; Farrokhyar, Forough; Choudur, Hema N; Wong, Ivan H

2014-03-01

The purpose of this study was to document and compare the incidence of intra-articular hip pathologic findings identified using arthroscopy versus conventional imaging in patients with acute trauma to the hip. This was a blinded prospective case series study designed to review the incidence of intra-articular pathologic disorders in patients with post-traumatic injury between the ages of 18 and 65 years who were referred to a single surgeon. Injuries included hip dislocation, proximal femur fracture, pelvic ring fracture, acetabular fracture, penetrating injury (gunshot wound), and soft tissue injury. Preoperative radiographs, computed tomographic (CT) scans, or magnetic resonance imaging/magnetic resonance angiography (MRI/MRA) scans (or a combination of these) were obtained. Findings were documented and compared with intraoperative findings. A total of 29 post-traumatic hips were enrolled in this study. Hip arthroscopy identified 17 of 29 hips (59%) as having loose bodies, 11 of 29 (38%) hips as having an intra-articular step deformity, 14 of 29 (49%) hips as having an osteochondral lesion, and 27 of 29 (93%) hips as having a labral tear. Plain radiographs and CT scans yielded low sensitivity when compared with arthroscopy for the identification of loose bodies and step deformities. MRI/MRA comparison with arthroscopic findings suggest that MRI/MRA is an accurate tool for identification of labral tears, because 91% of tears seen on arthroscopy were also identified by MRI/MRA. In 4 hips, however, MRI/MRA failed to identify osteochondral lesions that were subsequently identified by arthroscopy. Traumatic injuries of the hip result in substantial intra-articular pathologic findings, including loose bodies, labral tears, step deformities, and osteochondral lesions. The arthroscope is a powerful tool in identifying these injuries. Plain radiographs and CT scans appear to underestimate the true incidence of loose bodies and step deformities within the joint when

ASSOCIATION OF ISOMETRIC STRENGTH OF HIP AND KNEE MUSCLES WITH INJURY RISK IN HIGH SCHOOL CROSS COUNTRY RUNNERS.

Science.gov (United States)

Luedke, Lace E; Heiderscheit, Bryan C; Williams, D S Blaise; Rauh, Mitchell J

2015-11-01

High school cross country runners have a high incidence of overuse injuries, particularly to the knee and shin. As lower extremity strength is modifiable, identification of strength attributes that contribute to anterior knee pain (AKP) and shin injuries may influence prevention and management of these injuries. To determine if a relationship existed between isometric hip abductor, knee extensor and flexor strength and the incidence of AKP and shin injury in high school cross country runners. Sixty-eight high school cross country runners (47 girls, 21 boys) participated in the study. Isometric strength tests of hip abductors, knee extensors and flexors were performed with a handheld dynamometer. Runners were prospectively followed during the 2014 interscholastic cross country season for occurrences of AKP and shin injury. Bivariate logistic regression was used to examine risk relationships between strength values and occurrence of AKP and shin injury. During the season, three (4.4%) runners experienced AKP and 13 (19.1%) runners incurred a shin injury. Runners in the tertiles indicating weakest hip abductor (chi-square = 6.140; p=0.046), knee extensor (chi-square = 6.562; p=0.038), and knee flexor (chi-square = 6.140; p=0.046) muscle strength had a significantly higher incidence of AKP. Hip and knee muscle strength was not significantly associated with shin injury. High school cross country runners with weaker hip abductor, knee extensor and flexor muscle strength had a higher incidence of AKP. Increasing hip and knee muscle strength may reduce the likelihood of AKP in high school cross country runners. 2b.

TREATMENT OF HIP DYSPLASIA

OpenAIRE

Iulian ICLEANU; Mariana CORDUN

2015-01-01

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 (g...

Hip-hop to prevent substance use and HIV among African-American youth: a preliminary investigation.

Science.gov (United States)

Turner-Musa, Jocelyn O; Rhodes, Warren A; Harper, P Thandi Hicks; Quinton, Sylvia L

2008-01-01

Substance use and HIV risk behaviors are increasing among African-American youth. Interventions that incorporate youth values and beliefs are needed to reduce this trajectory. Hip-hop plays an important role in the lives of many African-American youth and provides a context within which to prevent risky behaviors. The current study examines the efficacy of a hip-hop based substance use and HIV preventive intervention that targets African-American middle-school youth. The sample consists of 68 middle-school students who completed baseline and 6-month follow-up assessments. Findings suggest that students in the intervention group were significantly more likely to have higher knowledge of perception of drug risk and more knowledge about HIV/AIDS compared to students in the comparison group at the 6-month post-intervention assessment. Discussion is centered on implications of hip-hop as a viable approach for preventing substance use and HIV within a high-risk group.

Is cortical bone hip? What determines cortical bone properties?

Science.gov (United States)

Epstein, Sol

2007-07-01

Increased bone turnover may produce a disturbance in bone structure which may result in fracture. In cortical bone, both reduction in turnover and increase in hip bone mineral density (BMD) may be necessary to decrease hip fracture risk and may require relatively greater proportionate changes than for trabecular bone. It should also be noted that increased porosity produces disproportionate reduction in bone strength, and studies have shown that increased cortical porosity and decreased cortical thickness are associated with hip fracture. Continued studies for determining the causes of bone strength and deterioration show distinct promise. Osteocyte viability has been observed to be an indicator of bone strength, with viability as the result of maintaining physiological levels of loading and osteocyte apoptosis as the result of a decrease in loading. Osteocyte apoptosis and decrease are major factors in the bone loss and fracture associated with aging. Both the osteocyte and periosteal cell layer are assuming greater importance in the process of maintaining skeletal integrity as our knowledge of these cells expand, as well being a target for pharmacological agents to reduce fracture especially in cortical bone. The bisphosphonate alendronate has been seen to have a positive effect on cortical bone by allowing customary periosteal growth, while reducing the rate of endocortical bone remodeling and slowing bone loss from the endocortical surface. Risedronate treatment effects were attributed to decrease in bone resorption and thus a decrease in fracture risk. Ibandronate has been seen to increase BMD as the spine and femur as well as a reduced incidence of new vertebral fractures and non vertebral on subset post hoc analysis. And treatment with the anabolic agent PTH(1-34) documented modeling and remodelling of quiescent and active bone surfaces. Receptor activator of nuclear factor kappa B ligand (RANKL) plays a key role in bone destruction, and the human monoclonal

Drinking water fluoridation: bone mineral density and hip fracture incidence.

Science.gov (United States)

Lehmann, R; Wapniarz, M; Hofmann, B; Pieper, B; Haubitz, I; Allolio, B

1998-03-01

The role of drinking water fluoride content for prevention of osteoporosis remains controversial. Therefore, we analyzed the influence of drinking water fluoridation on the incidence of osteoporotic hip fractures and bone mineral density (BMD) in two different communities in eastern Germany: in Chemnitz, drinking water was fluoridated (1 mg/L) over a period of 30 years; in Halle, the water was not fluoridated. BMD was measured in healthy hospital employees aged 20-60 years (Halle: 214 women, 98 men; Chemnitz: 201 women, 43 men, respectively) using dual-energy X-ray absorptiometry. Hip fractures in patients > or = 35 years admitted to the local hospitals in the years 1987-1989 were collected from the clinic registers. There was no difference in age, anthropometric, hormonal, or lifestyle variables between the two groups. Mean fluoride exposure in Chemnitz was 25.2 +/- 7.3 years. No correlation was found between fluoride exposure and age-adjusted BMD. We found no significant difference in spinal or femoral BMD between subjects living in Halle and Chemnitz [lumbar spine: 0.997 +/- 0.129 (g/cm2) vs. 1.045 + 0.171 (g/cm2), p = 0.08, for men; 1.055 +/- 0.112 (g/cm2) vs. 1.046 +/- 0.117 (g/cm2), p = 0.47, for women]. The fracture incidence showed an exponential increase with aging in men and women with an incidence about 3.5 times higher for women. In Chemnitz, we calculated an age-adjusted annual incidence of 142.2 per 100,000 for women and 72.5 per 100,000 for men, respectively. In Halle, the incidences were 178.5 per 100,000 for women and 89.2 per 100,000 for men. There was a lower hip fracture incidence after the age of 85 in women in Chemnitz (1391 per 100,000 in Chemnitz vs. 1957 per 100,000) in Halle, p = 0.006). Using the age-adjusted incidences, significantly fewer hip fractures occurred in Chemnitz in both men and women. In conclusion, our study suggests that optimal drinking water fluoridation (1 mg/L), which is advocated for prevention of dental caries, does

Age-related hip fractures in men: clinical spectrum and short-term outcomes.

Science.gov (United States)

Poór, G; Atkinson, E J; Lewallen, D G; O'Fallon, W M; Melton, L J

1995-01-01

Clinical spectrum, treatment and short-term outcomes were assessed among the 131 Rochester, Minnesota, men who contracted an initial hip fracture due to moderate trauma during 1978-89. Three-fourths of falls leading to hip fracture occurred indoors with little seasonality, and 91% of fractures were in men 65 years of age or older. The ratio of cervical to intertrochanteric femur fractures was 1.4:1, and there was a tendency toward more neurological conditions among the patients with cervical fractures. Hemiarthroplasty and total hip replacement were mostly performed for cervical fractures, while internal fixation was preferred for intertrochanteric fractures. In-hospital mortality was 11.5%, and the 30-day case fatality rate was 16.0%. Age and postoperative deterioration of mental status significantly increased the risk of early death, the latter even after adjustment in a multivariate model, while comorbidity had a suggestive but not statistically significant influence on mortality. More than half the men were discharged to nursing homes, and 79% of the patients who survived at 1 year resided in nursing homes or intermediate care facilities or were attended by home care. Only 41% of survivors recovered their prefracture level of functioning and nearly 60% of patients limped and required a cane or walker. After implementation of the prospective payment system in 1984, the length of hospital stay was reduced, but there was no change in early mortality rates, in the duration of physical therapy following fracture or in attendance at nursing homes. The results of this population-based study demonstrate the strong impact of hip fractures on short-term outcomes in men.

Structural differences between hip endoprostheses, and implications on a hip kinetics

Directory of Open Access Journals (Sweden)

Mirza Biščević

2005-11-01

Full Text Available We compared kinetic characteristic of unipolar, bipolar and total hip endoprostheses, implanted after dislocated femoral neck fracture. Ninety patients were divided into three groups (30 patients in each group; a group with unipolar partial hip endoprosthesis (UPEP, a group with bipolar partial hip endoprosthesis (BPEP and a group with total hip endoprosthesis (TEP. The patients from different groups were paired by parameters which could influence the long term functional result: follow up period, comorbidities, functional capabilities before injury, etc. After the average follow up 3.8 +/- 1.9 years, a measuring of range of hip motions (ROM was conducted. The largest mean amplitudes in flexion (104 degrees, extension (13 degrees, abduction (35 degrees and external rotation (38 degrees was achieved BPEP, the largest adduction (14 degrees was achieved UPEP, and internal rotation (34 degrees TEP. Differences in ROMs are partially related to the clinical parameters such as: level of the hip pain, gait pattern, age and rehabilitation period (P < 0.05. Measuring of ROMs is the most reliable part of the clinical exam and it does not depend on subjectivity of patient, as opposed to other clinical parameters (level of pain, walking distance, aids usage, etc. The results obtained are favorable for the bipolar hip endoprosthesis, and they can be related to the biomechanical differences between the three types of hip endoprostheses. Kinetic advantages of the BPEP as compared to the UPEP, can be explained by the BPEP's structure: two-level mobility and a thinner neck which delays impingement in the late motion phase. In comparison to the TEP, clinical advantages of the BPEP can be attributed to less extensive surgery and scarring.

X-Ray Exam: Hip

Science.gov (United States)

... for Educators Search English Español X-Ray Exam: Hip KidsHealth / For Parents / X-Ray Exam: Hip What's in this article? What It Is Why ... You Have Questions Print What It Is A hip X-ray is a safe and painless test ...

Bursitis of the Hip

Science.gov (United States)

... difficile (C. diff.) InfectionHerpes Home Diseases and Conditions Bursitis of the Hip Condition Bursitis of the Hip Share Print Table of Contents1. ... Prevention5. Treatment6. Everyday Life7. Questions8. Resources What is bursitis of the hip? Bursitis is the painful swelling ...

Cranberry juice concentrate does not significantly decrease the incidence of acquired bacteriuria in female hip fracture patients receiving urine catheter: a double-blind randomized trial

Directory of Open Access Journals (Sweden)

Gunnarsson AK

2017-01-01

Full Text Available Anna-Karin Gunnarsson,1 Lena Gunningberg,2 Sune Larsson,1 Kenneth B Jonsson1 1Institution of Surgical Sciences, Uppsala University, Uppsala, Sweden; 2Institution of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden Background: Urinary tract infection (UTI is a common complication among patients with hip fractures. Receiving an indwelling urinary catheter is a risk factor for developing UTIs. Treatment of symptomatic UTIs with antibiotics is expensive and can result in the development of antimicrobial resistance. Cranberries are thought to prevent UTI. There is no previous research on this potential effect in patients with hip fracture who receive urinary catheters. Aim: The aim of this study is to investigate whether intake of cranberry juice concentrate preoperatively decreases the incidence of postoperative UTIs in hip fracture patients that received a urinary catheter. Design: This study employed a randomized, placebo-controlled double-blind trial. Method: Female patients, aged 60 years and older, with hip fracture (n=227 were randomized to receive cranberry or placebo capsules daily, from admission, until 5 days postoperatively. Urine cultures were obtained at admission, 5 and 14 days postoperatively. In addition, Euro Qual five Dimensions assessments were performed and patients were screened for UTI symptoms. Result: In the intention-to-treat analysis, there was no difference between the groups in the proportion of patients with hospital-acquired postoperative positive urine cultures at any time point. When limiting the analysis to patients that ingested at least 80% of the prescribed capsules, 13 of 33 (39% in the placebo group and 13 of 47 (28% in the cranberry group (P=0.270 had a positive urine culture at 5 days postoperatively. However, this difference was not statistically significant (P=0.270. Conclusion: Cranberry concentrate does not seem to effectively prevent UTIs in female patients with hip fracture and

Validity and reliability of isometric muscle strength measurements of hip abduction and abduction with external hip rotation in a bent-hip position using a handheld dynamometer with a belt.

Science.gov (United States)

Aramaki, Hidefumi; Katoh, Munenori; Hiiragi, Yukinobu; Kawasaki, Tsubasa; Kurihara, Tomohisa; Ohmi, Yorikatsu

2016-07-01

[Purpose] This study aimed to investigate the relatedness, reliability, and validity of isometric muscle strength measurements of hip abduction and abduction with an external hip rotation in a bent-hip position using a handheld dynamometer with a belt. [Subjects and Methods] Twenty healthy young adults, with a mean age of 21.5 ± 0.6 years were included. Isometric hip muscle strength in the subjects' right legs was measured under two posture positions using two devices: a handheld dynamometer with a belt and an isokinetic dynamometer. Reliability was evaluated using an intra-class correlation coefficient (ICC); relatedness and validity were evaluated using Pearson's product moment correlation coefficient. Differences in measurements of devices were assessed by two-way ANOVA. [Results] ICC (1, 1) was ≥0.9; significant positive correlations in measurements were found between the two devices under both conditions. No main effect was found between the measurement values. [Conclusion] Our findings revealed that there was relatedness, reliability, and validity of this method for isometric muscle strength measurements using a handheld dynamometer with a belt.

Hip fracture - discharge

Science.gov (United States)

... neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge ... in the hospital for surgery to repair a hip fracture, a break in the upper part of ...

Effect of tranexamic acid administration on bleeding in primary total hip arthroplasty.

Science.gov (United States)

Fernández-Cortiñas, A B; Quintáns-Vázquez, J M; Gómez-Suárez, F; Murillo, O Simón; Sánchez-López, B R; Pena-Gracía, J M

To study the efficacy of tranexamic acid to decrease perioperative bleeding in patients who have undergone a total hip arthroplasty operation and to evaluate drug safety. Observational, prospective, controlled and randomized study on the efficacy of tranexamic acid as a method to reduce bleeding in primary hip replacement surgery. We included 134 patients operated during 2014 in our centre, who were divided into 2 groups according to whether or not they had received tranexamic acid. The main study variables were haemoglobin and haematocrit levels, the amount of blood collected from the post-operative drain in the first 12, 24 and 48hours and transfusion requirements. Post-operative haemoglobin and haematocrit levels were statistically higher (Ptranexamic acid. Statistically significant differences (P=.001) were found as to the need for transfusion according to group, more transfusions were performed in the cohort that had not received tranexamic acid: 25.37% compared to 4.48% for the group with tranexamic acid. No adverse events related to administration of tranexamic acid were recorded. Administration of tranexamic acid has proved to be an effective and safe method to reduce peri-operative bleeding in patients who underwent total hip arthroplasty and avoids allogenic blood transfusion. Therefore, tranexamic acid treatment could entail a financial saving for the healthcare system and expose the patient to less risk. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

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.

Hip adductor activations during run-to-cut manoeuvres in compression shorts: implications for return to sport after groin injury.

Science.gov (United States)

Chaudhari, Ajit M W; Jamison, Steven T; McNally, Michael P; Pan, Xueliang; Schmitt, Laura C

2014-01-01

Athletes at high risk of groin strains in sports such as hockey and soccer often choose to wear shorts with directional compression to aid in prevention of or recovery from hip adductor strains. Large, eccentric contractions are known to result in or exacerbate strain injuries, but it is unknown if these shorts have a beneficial effect on hip adductor muscle activity. In this study, surface electromyography (EMG) of the adductor longus and ground reaction force (GRF) data were obtained simultaneously on 29 healthy individuals without previous history of serious injury while performing unanticipated 45° run-to-cut manoeuvres in a laboratory setting wearing shorts with non-directional compression (control, HeatGear, Under Armour, USA) or shorts with directional compression (directional, CoreShort PRO, Under Armour, USA), in random order. Average adductor activity in the stance leg was significantly lower in the directional condition than in the control condition during all parts of stance phase (all P < 0.042). From this preliminary analysis, wearing directional compression shorts appears to be associated with reduced stance limb hip adductor activity. Athletes seeking to reduce demand on the hip adductors as they approach full return to activities may benefit from the use of directional compression shorts.

The epidemic of hip fractures: are we on the right track?

Directory of Open Access Journals (Sweden)

Klaas A Hartholt

Full Text Available BACKGROUND: Hip fractures are a public health problem, leading to hospitalization, long-term rehabilitation, reduced quality of life, large healthcare expenses, and a high 1-year mortality. Especially older adults are at greater risk of fractures than the general population, due to the combination of an increased fall risk and osteoporosis. The aim of this study was to determine time trends in numbers and incidence rates of hip fracture-related hospitalizations and admission duration in the older Dutch population. METHODS AND FINDINGS: Secular trend analysis of all hospitalizations in the older Dutch population (≥65 years from 1981 throughout 2008, using the National Hospital Discharge Registry. Numbers, age-specific and age-adjusted incidence rates (per 10,000 persons of hospital admissions and hospital days due to a hip fracture were used as outcome measures in each year of the study. Between 1981 and 2008, the absolute number of hip fractures doubled in the older Dutch population. Incidence rates of hip fracture-related hospital admissions increased with age, and were higher in women than in men. The age-adjusted incidence rate increased from 52.0 to 67.6 per 10,000 older persons. However, since 1994 the incidence rate decreased (percentage annual change -0.5%, 95% CI: -0.7; -0.3, compared with the period 1981-1993 (percentage annual change 2.3%, 95% CI: 2.0; 2.7. The total number of hospital days was reduced by a fifth, due to a reduced admission duration in all age groups. A possible limitation was that data were obtained from a linked administrative database, which did not include information on medication use or co-morbidities. CONCLUSIONS: A trend break in the incidence rates of hip fracture-related hospitalizations was observed in the Netherlands around 1994, possibly as a first result of efforts to prevent falls and fractures. However, the true cause of the observation is unknown.

[Is Mapuche ethnicity a risk factor for hip fracture in aged?].

Science.gov (United States)

Sapunar, Jorge; Bravo, Paulina; Schneider, Hermann; Jiménez, Marcela

2003-10-01

Ethnic factors are involved in the risk for osteoporosis and hip fracture. To assess the effect of Mapuche ethnicity on the risk of hip fracture. A case control study. Cases were subjects over 55 years of age admitted, during one year, for hip fracture not associated to major trauma or tumors. Controls were randomly chosen from other hospital services and paired for age with cases. The magnitude of the association between ethnicity and hip fracture was expressed as odds ratio in a logistic regression model. In the study period, 156 cases with hip fracture were admitted. The proportion of subjects with Mapuche origin was significantly lower among cases than controls (11.8 and 26.5% respectively, p Mapuche ethnicity was associated with hip fracture with an odds radio of 0.14 (p = 0.03, 95% CI 0.03-0.8). In this sample, Mapuche ethnicity is a protective factor for hip fracture.

Ethamsylate and blood loss in total hip replacement.

Science.gov (United States)

Keith, I

1979-01-01

Nineteen consecutive patients undergoing total hip replacement under epidural anaesthesia were randomly divided into two groups. The treatment group received 1000 mg of ethamsylate intravenously before induction of anaesthesia. Blood lost during surgery was measured by a colorimetric technique. Closed suction drains were used and all blood lost after operation collected for measurement. Ethamsylate did not decrease the average volumes of blood lost during or after the operation. Neither did it reduce the requirements for blood transfusion. Although there were no side-effects attributable to ethamyslate, there seems to be no indication for its use in total hip replacement under epidural anaesthesia.

The incidence of total hip arthroplasty after hip arthroscopy in osteoarthritic patients

Directory of Open Access Journals (Sweden)

Haviv Barak

2010-07-01

Full Text Available Abstract Objective To assess the incidence of total hip arthroplasty (THA in osteoarthritic patients who were treated by arthroscopic debridement and to evaluate factors that might influence the time interval from the first hip arthroscopy to THA. Design Retrospective clinical series Methods Follow-up data and surgical reports were retrieved from 564 records of osteoarthritic patients that have had hip arthroscopy between the years 2002 to 2009 with a mean follow-up time of 3.2 years (range, 1-6.4 years. The time interval between the first hip arthroscopy to THA was modelled as a function of patient age; level of cartilage damage; procedures performed and repeated arthroscopies with the use of multivariate regression analysis. Results Ninety (16% of all participants eventually required THA. The awaiting time from the first arthroscopy to a hip replacement was found to be longer in patients younger than 55 years and in a milder osteoarthritic stage. Patients that experienced repeated hip scopes had a longer time to THA than those with only a single procedure. Procedures performed concomitant with debridement and lavage did not affect the time interval to THA. Conclusions In our series of arthroscopic treatment of hip osteoarthritis, 16% required THA over a period of 7 years. Factors that influence the time to arthroplasty were age, degree of osteoarthritis and recurrent procedures.

The incidence of total hip arthroplasty after hip arthroscopy in osteoarthritic patients

Science.gov (United States)

2010-01-01

Objective To assess the incidence of total hip arthroplasty (THA) in osteoarthritic patients who were treated by arthroscopic debridement and to evaluate factors that might influence the time interval from the first hip arthroscopy to THA. Design Retrospective clinical series Methods Follow-up data and surgical reports were retrieved from 564 records of osteoarthritic patients that have had hip arthroscopy between the years 2002 to 2009 with a mean follow-up time of 3.2 years (range, 1-6.4 years). The time interval between the first hip arthroscopy to THA was modelled as a function of patient age; level of cartilage damage; procedures performed and repeated arthroscopies with the use of multivariate regression analysis. Results Ninety (16%) of all participants eventually required THA. The awaiting time from the first arthroscopy to a hip replacement was found to be longer in patients younger than 55 years and in a milder osteoarthritic stage. Patients that experienced repeated hip scopes had a longer time to THA than those with only a single procedure. Procedures performed concomitant with debridement and lavage did not affect the time interval to THA. Conclusions In our series of arthroscopic treatment of hip osteoarthritis, 16% required THA over a period of 7 years. Factors that influence the time to arthroplasty were age, degree of osteoarthritis and recurrent procedures. PMID:20670440

Hip Arthroscopy in Patients Age 40 or Older: A Systematic Review.

Science.gov (United States)

Horner, Nolan S; Ekhtiari, Seper; Simunovic, Nicole; Safran, Marc R; Philippon, Marc J; Ayeni, Olufemi R

2017-02-01

To (1) report clinical outcomes, complication rates, and total hip arthroplasty (THA) conversion rates for patients age 40 or older who underwent hip arthroscopy, and (2) report any age-related predictors of outcome identified in the literature. MEDLINE, EMBASE, and PubMed were searched for relevant studies and pertinent data were abstracted from eligible studies. No meta-analysis was performed because of heterogeneity amongst studies. Seventeen studies were included in this review comprising 16,327 patients, including 9,954 patients age 40 or older. All studies reported statistically significant improvements in outcomes after hip arthroscopy for femoral osteochondroplasty, labral repair, or unspecified indications. In patients 40 or older who underwent labral debridement, these improvements were not clinically significant. Obesity and osteoarthritic changes predicted poorer outcomes. Only 1 of 3 studies directly comparing the 2 groups found that patients 40 or older had a significantly less improvement in a standardized hip outcome score than patients under 40 after hip arthroscopy, but all found that patients 40 or older had significantly higher rates of THA conversion. The rate of conversion to THA was 18.1% for patients 40 or older, 23.1% for patients over 50, and 25.2% for patients over 60 with a mean of 25.0 months to THA. Indications for hip arthroscopy including femoral osteochondroplasty and labral repair resulted in clinically significant improvements in patients 40 or older in most research studies examined in this review, whereas labral debridement did not produce clinically significant improvements postoperatively in the same studies. In these studies, the rate of conversion to THA is higher than in patients under 40 and increases with each decade of life, with many individual studies showing a significant increase in the rate of THA conversion. Hip arthroscopy may be suitable for some patients 40 or older, but patient selection is key and patients

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

Science.gov (United States)

Harakeh, Zeena; Bogt, Tom F M Ter

2018-02-16

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

Improving time to surgery for hip fracture patients. Impact of the introduction of an emergency theatre

LENUS (Irish Health Repository)

French-O’Carroll, F

2017-01-01

Hip fractures are a major cause of morbidity and mortality1. Surgery performed on the day of or after admission is associated with improved outcome2,3. An audit cycle was performed examining time to surgery for hip fracture patients. Our initial audit identified lack of theatre space as one factor delaying surgery. A dedicated daytime emergency theatre was subsequently opened and a re-audit was performed to assess its impact on time to surgery. Following the opening of the theatre, the proportion of patients with a delay to hip fracture surgery greater than 36 hours was reduced from 49% to 26% with lack of theatre space accounting for 23% (3 of 13) of delayed cases versus 28.6% (9 of 32) previously. 44% of hip fracture surgeries were performed in the emergency theatre during daytime hours, whilst in-hospital mortality rose from 4.6% to 6%. We conclude that access to an emergency theatre during daytime hours reduced inappropriate delays to hip fracture surgery.

Risk factors for hip fracture among institutionalised older people.

Science.gov (United States)

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

2009-07-01

risk factors for hip fracture in community-dwelling individuals have been extensively studied, but there have been fewer studies of institutionalised older people. a total of 1,894 older people (1,433 females, 461 males; mean age 86 years, SD 7.1 years) were recruited from 52 nursing homes and 30 intermediate-care nursing care facilities in Australia during March 1999 and February 2003. We assessed clinical risk factors for hip fracture and skeletal fragility by calcaneus broadband ultrasound attenuation (BUA) at baseline and then followed up for fracture for 4 years. Hip fractures were validated by x-ray reports. Survival analysis with age as a time-dependent covariate was used to analyse the data. during a mean follow-up period of 2.65 years (SD 1.38), 201 hip fractures in 191 residents were recorded, giving an overall hip fracture incidence rate of 4.0% per person year (males 3.6% and females 4.1%). Residents living in intermediate-care hostels had a higher crude hip fracture rate (4.6% vs. 3.0%) than those living in high-care nursing homes. In multivariate analysis, an increased risk of hip fracture was significantly associated with older age, cognitive impairment, a history of fracture since age 50, lower body weight, longer lower leg length and poorer balance in intermediate-care hostel residents, but not with lower BUA. institutionalised older people, who are at a higher risk of hip fracture than community-dwelling individuals, have differences in some risk factors for hip fracture that should be considered in targeting intervention programs.

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.

Arthroscopic Labral Base Repair in the Hip: 5-Year Minimum Clinical Outcomes.

Science.gov (United States)

Domb, Benjamin G; Yuen, Leslie C; Ortiz-Declet, Victor; Litrenta, Jody; Perets, Itay; Chen, Austin W

2017-10-01

Arthroscopic labral base repair (LBR) in the hip is a previously described technique designed to restore the native functional anatomy of the labrum by reproducing its seal against the femoral head. LBR has been shown to have good short-term outcomes. Hypothesis/Purpose: The purpose was to evaluate clinical outcomes of an LBR cohort with a minimum 5-year follow-up. It was hypothesized that patients who underwent LBR would continue to have significant improvement from their preoperative scores and maintain scores similar to their 2-year outcomes. Case series; Level of evidence, 4. Data for patients undergoing primary hip arthroscopic surgery with LBR from February 2008 to May 2011 with a minimum 5-year follow-up were prospectively collected and retrospectively reviewed. Patients with preoperative Tonnis osteoarthritis grade ≥2, previous hip conditions (slipped capital femoral epiphysis, avascular necrosis, Legg-Calv-Perthes disease), severe dysplasia (lateral center-edge angle hip surgery were excluded. Statistical equivalence tests evaluated patient-reported outcomes (PROs) including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), visual analog scale (VAS) for pain, and patient satisfaction (0-10 scale; 10 = very satisfied). Of the 70 patients (74 hips) who met inclusion and exclusion criteria, 60 (85.7%) patients (64 hips) were available at a minimum 5-year follow-up. All PRO scores significantly improved from preoperative values with a mean follow-up of 67.8 ± 7.4 months (range, 60.0-89.7 months). The mean mHHS increased from 64.4 ±13.8 to 85.3 ± 17.7 ( P hip arthroscopic surgery has yet to be determined; however, these midterm results demonstrate the rates of additional procedures (both secondary arthroscopic surgery and conversion to total hip arthroplasty), that may be necessary after 2 years.

The population attributable risk of nutrition and lifestyle on hip fractures.

Science.gov (United States)

Pripp, Are Hugo; Dahl, Ola E

2015-01-01

Norway is among the countries with the highest incidence of hip fractures, and how to reduce this incidence is a major public health concern. The population attributable risk (PAR), which measures the portion of hip fracture incidences in the population that can be attributed to an exposure if there is a causal relationship, was assessed for the exposure to excessive alcohol consumption, being underweight, low calcium from dairy products, low physical activity and current tobacco smoking. The risk ratio (RR) of the exposures summarized from systematic reviews and meta-analyses, as well as their prevalence from national statistics or Norwegian population-based studies, were used to estimate PARs. Low physical activity and current tobacco smoking had the highest RR for hip fractures, with 1.65 (95% CI 1.50-1.81) and 1.52 (95% CI 1.41-1.63). Low physical activity had the highest prevalence in the population (27.4%) and the highest PAR (0.151), followed by tobacco smoking (PAR = 0.081) and excessive alcohol consumption (PAR = 0.01). By comparison, being underweight and low calcium from dairy products had negligible PAR estimates. From a public health perspective, increased daily physical activity is the most promising intervention to reduce the incidence of hip fractures. Reduced smoking and alcohol consumption are of relevance, but other health risks related to these exposures are of greater public health concern. Low body weight and nutritional calcium from dairy products seem to be of less importance.

Quantifying metal artefact reduction using virtual monochromatic dual-layer detector spectral CT imaging in unilateral and bilateral total hip prostheses

Energy Technology Data Exchange (ETDEWEB)

Wellenberg, R.H.H., E-mail: r.h.wellenberg@amc.uva.nl [Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands); Boomsma, M.F., E-mail: m.f.boomsma@isala.nl [Department of Radiology, Isala, Zwolle (Netherlands); Osch, J.A.C. van, E-mail: j.a.c.van.osch@isala.nl [Department of Radiology, Isala, Zwolle (Netherlands); Vlassenbroek, A., E-mail: alain.vlassenbroek@philips.com [Philips Medical Systems, Brussels (Belgium); Milles, J., E-mail: julien.milles@philips.com [Philips Medical Systems, Eindhoven (Netherlands); Edens, M.A., E-mail: m.a.edens@isala.nl [Department of Innovation and Science, Isala, Zwolle (Netherlands); Streekstra, G.J., E-mail: g.j.streekstra@amc.uva.nl [Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands); Slump, C.H., E-mail: c.h.slump@utwente.nl [MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede (Netherlands); Maas, M., E-mail: m.maas@amc.uva.nl [Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands)

2017-03-15

, only mild/moderate metal artefacts were significantly reduced compared to 70 and 74 keV images. Deviations in CT numbers, noise, SNRs and CNRs due to metal artefacts were decreased with respectively 64%, 57%, 62% and 63% (p < 0.001) compared to unaffected pellets. Optimal keVs, based on CNRs, for different unilateral and bilateral metal hip prostheses consisting of different metal alloys varied from 74 to 150 keV. The Titanium alloy resulted in less severe artefacts and were reduced more effectively compared to the Cobalt alloy. Conclusions: Virtual monochromatic dual-layer Spectral CT imaging results in a significant reduction of streak artefacts produced by beam-hardening in mild and moderate artefacts by improving CT number accuracy, SNRs and CNRs, while decreasing noise values in a total hip arthroplasty phantom. An optimal monochromatic energy of 130 keV was found ranging from 74 keV to 150 keV for different unilateral and bilateral hip prostheses consisting of different metal alloys.

The efficiency of risedronate in reducing bone resorption after total hip arthroplasty: a meta-analysis of randomized control trials at a minimum of 6 months' follow-up.

Science.gov (United States)

Yang, Liqing

2018-04-17

Recently risedronate is suggested to be effective for the prevention and treatment of for osteoporosis in total hip arthroplasty. This meta-analysis aimes to evaluate the efficacy of risedronate in reducing femoral periprosthetic bone mineral density loss in patients undergoing primary total hip arthroplasty. A systematic search was performed in Medline (1966-31 October 2017), PubMed (1966-31 October 2017), Embase (1980-31 October 2017), ScienceDirect (1985-31 October 2017) and the Cochrane Library. Only randomized controlled trial (RCT) were included. Fixed/random effect model was used according to the heterogeneity tested by I2 statistic. Meta-analysis was performed using Stata 11.0 software. The outcome measures included periprosthetic bone mineral density, length of stay and adverse effects. Four RCTs including 198 patients met the inclusion criteria. The present meta-analysis showed that there were significant differences between treatment groups in terms of periprosthetic bone mineral density in Gruen zones 1 (standard mean difference (SMD) = 0.758, 95% CI 0.469 to 1.047, P = 0.000), 2 (SMD = 0.814, 95% CI 0.523 to 1.106, P = 0.000), 3 (SMD = 0.340, 95% CI 0.059 to 0.622, P = 0.018), 6 (SMD = 2.400, 95% CI 2.029 to 2.771, P = 0.000), and 7 (SMD = 2.400, 95% CI 2.029 to 2.771, P = 0.000). Oral risedronate could significantly reduce periprosthetic bone resorption around an uncemented femoral stem (Gruen zones 1, 2, 3, 6, and 7) up to 6 months after THA. In addition, no severe adverse events were identified. Future trials of risedronate treatment after THA should focus on clinically relevant end points such as the risks of fracture and revision arthroplasty.

Hip arthroscopy with labral repair for femoroacetabular impingement

DEFF Research Database (Denmark)

Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto

2014-01-01

PURPOSE: The purpose of this study was to examine the progression of clinical outcomes 3, 6 and 12 months after hip arthroscopy with labral repair for femoroacetabular impingement (FAI). METHODS: From May 2009 to December 2011, 87 consecutive patients [55 females (median age 38, range 17-63) and 32...... males (median age 38, range 15-59)] underwent hip arthroscopy and labral repair, by the same experienced surgeon. Standardised, but unstructured, post-operative rehabilitation instructions were provided. Function and pain were evaluated using modified Harris Hip Score (mHHS) and visual analogue scale...... months with no additional changes from 6 to 12 months [22.6 (2.6)-27.9 (2.6), (n.s.)]. CONCLUSIONS: Improvements in function (mHHS) and pain (VAS) were seen in patients after hip arthroscopy with labral repair for FAI at 3, 6, and 12 months. While significant improvements occurred from 3 to 6 months...

Concomitant Hip Arthroscopy and Periacetabular Osteotomy.

Science.gov (United States)

Domb, Benjamin G; LaReau, Justin M; Hammarstedt, Jon E; Gupta, Asheesh; Stake, Christine E; Redmond, John M

2015-11-01

To detail our early experience using concomitant hip arthroscopy and periacetabular osteotomy (PAO) for the treatment of acetabular dysplasia. We prospectively collected and retrospectively reviewed the surgical and outcome data of 17 patients who underwent concomitant hip arthroscopy and PAO between October 2010 and July 2013. Preoperative and postoperative range of motion, outcome and pain scores, and radiographic data were collected. Intraoperative arthroscopic findings and postoperative complications were recorded. The group consisted of 3 male and 14 female patients with a mean follow-up period of 2.4 years. Three patients had undergone previous surgery on the affected hip. Chondrolabral pathology was identified in all 17 patients. Twelve patients underwent labral repair, and five patients underwent partial labral debridement. No patient was converted to total hip arthroplasty or required revision surgery at short-term follow-up. All 4 patient-reported outcome scores showed statistically significant changes from baseline to latest follow-up (P arthroscopy and PAO has been favorable. We noted that all our patients have evidence of chondrolabral damage at the time of PAO when the joint is distracted and evaluated. All patients in this series had intra-articular pathology treated arthroscopically and showed satisfactory mean clinical improvement. Hip arthroscopy with PAO did not appear to introduce complications beyond the PAO alone. Level IV, therapeutic case series. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Efficient radiological assessment of the internal snapping hip syndrome

International Nuclear Information System (INIS)

Wunderbaldinger, P.; Bremer, C.; Matuszewski, L.; Marten, K.; Turetschek, K.; Rand, T.

2001-01-01

The aim of this study was to evaluate the diagnostic value/significance of various imaging techniques for demonstrating the underlying causative pathology of clinically suspected internal snapping hip syndrome. We intended to define the most efficient diagnostic imaging algorithm that leads to a specific definite therapy for this rare hip disorder. The imaging studies of 54 patients (43 women, 11 men, average age 58 years) with the clinical suspicion of internal snapping hip syndrome were compared for their diagnostic value/significance for finding the underlying pathology. Radiological workup included plain radiographs of the pelvis and hip joints (n=54), ultrasound (US) of the hip joints (n=29), computed tomography (CT) of the pelvis and proximal femur (n=17), and magnetic resonance imaging (MRI) of the pelvis/hip joint (n=21). In order to establish an efficient diagnostic algorithm we compared the diagnostic value of each imaging technique alone and in combination with the other methods. The underlying causative pathology could be established in 37% of patients (n=20) by the use of conventional radiographs alone and in 46% of the patients (n=25) by US alone, and in combination in 83% of the patients (n=45). By adding CT to the radiological workup, we established final diagnosis in 88% (in combination with X-ray; n=15/17) and 94% (together with X-ray and US; n=16/17) of the patients. Whenever MR imaging was used a causative pathology was found in all patients (100%; n=21). The most efficient radiological algorithm in the assessment of patients with internal snapping hip syndrome is the combination of plain radiography and US. MR imaging can be retained for unresolved and difficult cases. (orig.)

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

Hip-Hop to Health Jr. for Latino preschool children.

Science.gov (United States)

Fitzgibbon, Marian L; Stolley, Melinda R; Schiffer, Linda; Van Horn, Linda; KauferChristoffel, Katherine; Dyer, Alan

2006-09-01

Hip-Hop to Health Jr. was a diet/physical activity intervention designed to reduce gains in BMI (kilograms per meter squared) in preschool minority children. Twelve predominantly Latino Head Start centers participated in a group-randomized trial conducted between Fall 2001 and Winter 2003. Six centers were randomized to a culturally proficient 14-week (three times weekly) diet/physical activity intervention. Parents participated by completing weekly homework assignments. The children in the other six centers received a general health intervention that did not address either diet or physical activity. The primary outcome was change in BMI, and secondary outcomes were changes in dietary intake and physical activity. Measures were collected at baseline, post-intervention, and at Years 1 and 2 follow-up. There were no significant differences between intervention and control schools in either primary or secondary outcomes at post-intervention, Year 1, or Year 2 follow-ups. When Hip-Hop to Health Jr. was conducted in predominantly black Head Start centers, it was effective in reducing subsequent increases in BMI in preschool children. In contrast, when the program was conducted in Latino centers, it was not effective. Although the intervention did not prevent excessive weight gain in Latino children, it was very well received. Future interventions with this population may require further cultural tailoring and a more robust parent intervention.

Cytokines as a predictor of clinical response following hip arthroscopy: minimum 2-year follow-up.

Science.gov (United States)

Shapiro, Lauren M; Safran, Marc R; Maloney, William J; Goodman, Stuart B; Huddleston, James I; Bellino, Michael J; Scuderi, Gaetano J; Abrams, Geoffrey D

2016-08-01

Hip arthroscopy in patients with osteoarthritis has been shown to have suboptimal outcomes. Elevated cytokine concentrations in hip synovial fluid have previously been shown to be associated with cartilage pathology. The purpose of this study was to determine whether a relationship exists between hip synovial fluid cytokine concentration and clinical outcomes at a minimum of 2 years following hip arthroscopy. Seventeen patients without radiographic evidence of osteoarthritis had synovial fluid aspirated at time of portal establishment during hip arthroscopy. Analytes included fibronectin-aggrecan complex as well as a multiplex cytokine array. Patients completed the modified Harris Hip Score, Western Ontario and McMaster Universities Arthritis Index and the International Hip Outcomes Tool pre-operatively and at a minimum of 2 years following surgery. Pre and post-operative scores were compared with a paired t-test, and the association between cytokine values and clinical outcome scores was performed with Pearson's correlation coefficient with an alpha value of 0.05 set as significant. Sixteen of seventeen patients completed 2-year follow-up questionnaires (94%). There was a significant increase in pre-operative to post-operative score for each clinical outcome measure. No statistically significant correlation was seen between any of the intra-operative cytokine values and either the 2-year follow-up scores or the change from pre-operative to final follow-up outcome values. No statistically significant associations were seen between hip synovial fluid cytokine concentrations and 2-year follow-up clinical outcome assessment scores for those undergoing hip arthroscopy.

The effectiveness of a de-implementation strategy to reduce low-value blood management techniques in primary hip and knee arthroplasty: a pragmatic cluster-randomized controlled trial.

Science.gov (United States)

Voorn, Veronique M A; Marang-van de Mheen, Perla J; van der Hout, Anja; Hofstede, Stefanie N; So-Osman, Cynthia; van den Akker-van Marle, M Elske; Kaptein, Ad A; Stijnen, Theo; Koopman-van Gemert, Ankie W M M; Dahan, Albert; Vliet Vlieland, Thea P M M; Nelissen, Rob G H H; van Bodegom-Vos, Leti

2017-05-30

Perioperative autologous blood salvage and preoperative erythropoietin are not (cost) effective to reduce allogeneic transfusion in primary hip and knee arthroplasty, but are still used. This study aimed to evaluate the effectiveness of a theoretically informed multifaceted strategy to de-implement these low-value blood management techniques. Twenty-one Dutch hospitals participated in this pragmatic cluster-randomized trial. At baseline, data were gathered for 924 patients from 10 intervention and 1040 patients from 11 control hospitals undergoing hip or knee arthroplasty. The intervention included a multifaceted de-implementation strategy which consisted of interactive education, feedback on blood management performance, and a comparison with benchmark hospitals, aimed at orthopedic surgeons and anesthesiologists. After the intervention, data were gathered for 997 patients from the intervention and 1096 patients from the control hospitals. The randomization outcome was revealed after the baseline measurement. Primary outcomes were use of blood salvage and erythropoietin. Secondary outcomes included postoperative hemoglobin, length of stay, allogeneic transfusions, and use of local infiltration analgesia (LIA) and tranexamic acid (TXA). The use of blood salvage (OR 0.08, 95% CI 0.02 to 0.30) and erythropoietin (OR 0.30, 95% CI 0.09 to 0.97) reduced significantly over time, but did not differ between intervention and control hospitals (blood salvage OR 1.74 95% CI 0.27 to 11.39, erythropoietin OR 1.33, 95% CI 0.26 to 6.84). Postoperative hemoglobin levels were significantly higher (β 0.21, 95% CI 0.08 to 0.34) and length of stay shorter (β -0.36, 95% CI -0.64 to -0.09) in hospitals receiving the multifaceted strategy, compared with control hospitals and after adjustment for baseline. Transfusions did not differ between the intervention and control hospitals (OR 1.06, 95% CI 0.63 to 1.78). Both LIA (OR 0.0, 95% CI 0.0 to 0.0) and TXA (OR 0.3, 95% CI 0.2 to 0

Activity and Quality of Life after Total Hip Arthroplasty.

Science.gov (United States)

Świtoń, Anna; Wodka-Natkaniec, Ewa; Niedźwiedzki, Łukasz; Gaździk, Tadeusz; Niedźwiedzki, Tadeusz

2017-10-31

Coxarthrosis is a chronic musculoskeletal condition that causes severe pain and considerable limi-tation of the patient's motor performance. Total hip arthroplasty is one of the most common and effective methods used in the treatment of advanced degenerative changes. The aim of the present study was to evaluate the activity and quality of life of patients after unilateral total hip arthroplasty. The study was conducted in a group of 189 patients who had undergone unilateral total hip arthroplasty. Goniometry was used to determine the range of motion of both hip joints. Patients' physical ability and pain severity were assessed based on the Harris Hip Score (HHS) questionnaire. The examination of the range of motion in the lower extremities revealed statistically significant diffe-rences in flexion (p<0.01), abduction (p=<0.01), adduction (p<0.01) and external rotation (p<0.01) between the operated and the healthy extremity. The greatest limitation of motion was demonstrated for external rotation (<14°). Approximately 14% of the patients were not able to perform this motion in their healthy hip joint, while 17.5% of them could not do so in the affected hip joint. Analysis of HHS results (mean = 79 pts) revealed that more than 50% of the patients described their functional ability and quality of life as good and excellent. It was demonstrated that 54% of patients did not suffer from pain, whereas minor or mild pain was noted in 35%. 1. A subjective clinical assessment of patients after total hip arthroplasty showed that their quality of life had improved. 2. It is necessary to perform physiotherapy after total hip arthroplasty, on both the operated and healthy side. 3. Exacerbation of pain and impaired activity in patients after total hip arthroplasty were associated with the female sex to a considerable extent.

Osteoarthritis of the hip

International Nuclear Information System (INIS)

Kokubo, Takashi; Takatori, Yoshio; Sasaki, Yasuhito

1993-01-01

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

3D Printing Aids Acetabular Reconstruction in Complex Revision Hip Arthroplasty

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Andrew J. Hughes

2017-01-01

Full Text Available Revision hip arthroplasty requires comprehensive appreciation of abnormal bony anatomy. Advances in radiology and manufacturing technology have made three-dimensional (3D representation of osseous anatomy obtainable, which provide visual and tactile feedback. Such life-size 3D models were manufactured from computed tomography scans of three hip joints in two patients. The first patient had undergone multiple previous hip arthroplasties for bilateral hip infections, resulting in right-sided pelvic discontinuity and a severe left-sided posterosuperior acetabular deficiency. The second patient had a first-stage revision for infection and recurrent dislocations. Specific metal reduction protocols were used to reduce artefact. The images were imported into Materialise MIMICS 14.12®. The models were manufactured using selective laser sintering. Accurate templating was performed preoperatively. Acetabular cup, augment, buttress, and cage sizes were trialled using the models, before being adjusted, and resterilised, enhancing the preoperative decision-making process. Screw trajectory simulation was carried out, reducing the risk of neurovascular injury. With 3D printing technology, complex pelvic deformities were better evaluated and treated with improved precision. Life-size models allowed accurate surgical simulation, thus improving anatomical appreciation and preoperative planning. The accuracy and cost-effectiveness of the technique should prove invaluable as a tool to aid clinical practice.

Operative Trends in the Treatment of Hip Fractures and the Role of Arthroplasty

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Grau, Luis; Summers, Spencer; Rosas, Samuel; Ong, Alvin; Hernandez, Victor Hugo

2018-01-01

Introduction: There is a projected exponential increase in the number of hip fractures in the United States. Trends in patient demographics and the role of total hip arthroplasty (THA) and its associated outcomes following hip fractures surgery have not been well studied. Methods: Patients with proximal femur fractures between 1990 and 2007 were identified in the National Hospital Discharge Survey database. Demographics, comorbidities, perioperative complications, and discharge status for patients undergoing THA, hemiarthroplasty, or internal fixation were examined. Multivariable regression was performed to determine independent risk factors for perioperative complications. Results: Between 1990 and 2007, there was a statistically significant increase in patient age, adverse events, medical comorbidities, surgical complications, medical complications, and nonroutine discharge across all surgical treatment modalities. In the same time period, the utilization of THA for all fracture types decreased significantly. Discussion: Total hip arthroplasty was found to be an independent risk factor for perioperative complications. Orthopedic surgeons should be aware that the hip fracture population continues to get older, with more medical comorbidities and are at higher risk for perioperative complications. Conclusion: Total hip arthroplasty is associated with a higher rate of perioperative complications in the hip fracture population. PMID:29619275

The Epidemiology of Hip and Groin Injuries in Professional Baseball Players.

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Coleman, Struan H; Mayer, Stephanie W; Tyson, Jared J; Pollack, Keshia M; Curriero, Frank C

2016-01-01

Injuries of the hip and groin among professional baseball players can result in a significant number of disabled list days. The epidemiology of these injuries has not been delineated. The purpose of this study is to describe the incidence, mechanism, type, and rehabilitation course of hip and groin injuries among Major League Baseball (MLB) and Minor League Baseball (MiLB) players. The MLB injury database for hip and groin injuries from 2011-2014 was analyzed. Occurrence of injuries was assessed based on level of play, field location, activity during which the injury occurred, mechanism of injury, and days missed. The treatment was recorded as nonoperative or surgical. The subsequent rehabilitation and return to play were recorded. Chi-square tests were used to test the hypothesis of equal proportions between the various categories of hip and groin characteristics. From 2011-2014, 1823 hip and groin injuries occurred among MLB and MiLB players, which accounted for approximately 5% of all injuries. Of these, 1514 (83%) occurred among MiLB players and 309 (17%) among MLB players; 96% of injuries were extra-articular. Among all players, a noncontact mechanism during defensive fielding was the most common activity causing injury (74%), and infielders experienced the most hip and groin injuries (34%). The majority of extra-articular injuries were treated nonoperatively (96.2%), resulting in an average of 12 days missed. Intra-articular pathology more commonly required surgery, and resulted in an average of 123 days missed. Hip and groin injuries can be debilitating and result in a significant number of days missed. Intra-articular pathology and athletic pubalgia were usually treated surgically, while the majority of extra-articular hip injuries were treated successfully with nonoperative modalities. Correct diagnosis and appropriate treatment can lead to a high rate of return to play for professional baseball players with injuries to the hip and groin.

Hip Labral Tear

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... that joint in the future. Prevention Hip labral tears are often associated with sports participation. If your sport puts a lot of strain on your hips, condition the surrounding muscles with strength and flexibility exercises. Try to avoid ...

Metal-on-Metal Total Hip Resurfacing Arthroplasty

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2006-01-01

conventional THR with a small (28 mm) ball. First, the large femoral head reduces the chance of dislocation, so that rates of dislocation are less than those with conventional THR. Second, the range of motion with hip resurfacing arthroplasty is higher than that achieved with conventional THR. A variety of MOM hip resurfacing implants are used in clinical practice. Six MOM hip resurfacing implants have been issued licences in Canada. Review Strategy A search of electronic bibliographies (OVID Medline, Medline In-Process and Other Non-Indexed Citations, Embase, Cochrane CENTRAL and DSR, INAHTA) was undertaken to identify evidence published from Jan 1, 1997 to October 27, 2005. The search was limited to English-language articles and human studies. The literature search yielded 245 citations. Of these, 11 met inclusion criteria (9 for effectiveness, 2 for safety). The result of the only reported randomized controlled trial on MOM hip resurfacing arthroplasty could not be included in this assessment, because it used a cemented acetabular component, whereas in the new generation of implants, a cementless acetabular component is used. After omitting this publication, only case series remained. Summary of Findings   Health Outcomes The Harris hip score and SF-12 are 2 measures commonly used to report health outcomes in MOM hip resurfacing arthroplasty studies. Other scales used are the Oxford hip score and the University of California Los Angeles hip score. The case series showed that the mean revision rate of MOM hip resurfacing arthroplasty is 1.5% and the incidence of femoral neck fracture is 0.67%. Across all studies, 2 cases of osteonecrosis were reported. Four studies reported improvement in Harris hip scores. However, only 1 study reported a statistically significant improvement. Three studies reported improvement in SF-12 scores, of which 2 reported a significant improvement. One study reported significant improvement in UCLA hip score. Two studies reported postoperative

Hip Replacement: MedlinePlus Health Topic

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... invasive hip replacement (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Hip Replacement updates ... replacement - precautions Minimally invasive hip replacement Related Health Topics Hip Injuries and Disorders National Institutes of Health ...

Hip Arthroscopy for Femoral-Acetabular Impingement: Do Active Claims Affect Outcomes?

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Gigi, Roy; Rath, Ehud; Sharfman, Zachary T; Shimonovich, Shachar; Ronen, Itai; Amar, Eyal

2016-04-01

To compare outcomes of 3 patient groups undergoing hip arthroscopy. This study included 138 consecutive hip arthroscopies (106 analyzed) for femoral-acetabular impingement (FAI) with or without labral tear in patients with a minimum 1-year follow-up. Inclusion criteria included patients older than 18 with clinical or radiologic manifestation of FAI with or without labral tear. Exclusion criteria included previous hip surgery and various hip pathologies. Patients were classified into 3 study groups. Group 1 included work-related injuries with active claims ACs (n = 33); mean age, 32 (range, 19 to 63); group 2 included sports injuries with no ACs (n = 35); mean age, 32 (range, 18 to 69); and group 3 included non-sports-related injuries without pending ACs (NAS; n = 38); mean age, 45 (range, 20 to 68). Outcomes were assessed using modified Harris hip scores (mHHS) and hip outcome scores (HOS) preoperatively and during the final evaluation. Baseline score for all groups did not significantly differ (P = .210 for mHHS, P = .176 for HOS). All groups significantly improved from preoperative to final evaluation (group 1: mHHS P = .42, HOS P = .001; group 2: mHHS P arthroscopy. Hip arthroscopy as an intervention in patients with ACs provided positive outcomes, corroborating that an AC is not a contraindication for this procedure. Level III, retrospective comparative study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Risk Factors for Hip Fracture in Older Home Care Clients

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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

Waist and hip circumferences and all-cause mortality: usefulness of the waist-to-hip ratio?

DEFF Research Database (Denmark)

Bigaard, J.; Frederiksen, K.; Tjønneland, A.

2004-01-01

inverse for both men and women, but only after adjustment for waist circumference, or BMI, or both. The mortality rate ratios of mutually adjusted waist and hip circumferences were 0.63 (95% CI: 0.56, 0.71), and 0.70 (95% CI: 0.63, 0.79) times higher per 10% larger hip circumference in men and women......, respectively, and 1.45 (95% CI: 1.34, 1.57) and 1.22 (95% CI: 1.14, 1.31) times higher per 10% larger waist circumference. The adequacy of the waist-to-hip ratio as a substitute for separate measurements of waist and hip circumferences depended on which other variables the analysis was adjusted for, indicating...... that the waist-to-hip ratio should be used with precaution. CONCLUSION: When mutually adjusted, waist and hip circumferences show opposite associations with all-cause mortality, probably due to different effects of adipose tissue in the abdominal and gluteofemoral regions. The waist-to-hip ratio cannot always...

Radiographic parameters of the hip joint from birth to adolescence

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

2004-03-01

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

On the effectiveness of incorporating shear thickening fluid with fumed silica particles in hip protectors

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Haris, A.; Goh, B. W. Y.; Tay, T. E.; Lee, H. P.; Rammohan, A. V.; Tan, V. B. C.

2018-01-01

The objective of this research is to develop a smart hip protector by incorporating shear thickening fluid (STF) into conventional foam hip protectors. The shear thickening properties of fumed silica particles dispersed in liquid polyethylene glycol (PEG) were determined from rheological tests. Dynamic drop tests, using a 4 kg drop platen at 0.5 m drop height, were conducted to study how STF improves energy absorption as compared to unfilled foam and PEG filled foam. The results show that PEG filled foam reduces the mean peak force transmitted by a further 55% and mean peak displacement by 32.5% as compared to the unfilled foam; the STF filled foam further reduces mean peak force and displacement by 15% and 41% respectively when compared to the PEG filled foam. At a displacement of 22 mm, the STF filled foam absorbs 7.4 times more energy than the PEG filled foam. The results of varying the drop mass and drop height show that the energy absorbed per unit displacement for STF filled foam is always higher than that of PEG filled foam. Finally, the effectiveness of a prototype of hip protector made from 15 mm thick STF filled foam in preventing hip fractures was studied under two different loading conditions: distributed load (plate drop test) and concentrated load (ball drop test). The results of the plate and ball drop tests show that among all hip protectors tested in this study, only the prototype can reduce the mean peak impact force to be lower than the force required to fracture a hip bone (3.1 kN) regardless of the type of loading. Moreover, the peak force of the prototype is about half of this value, suggesting thinner prototype could have been used instead. These findings show that STF is effective in improving the performance of hip protectors.

Use of DXA-Based Structural Engineering Models of the Proximal Femur to Discriminate Hip Fracture

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Yang, Lang; Peel, Nicola; Clowes, Jackie A; McCloskey, Eugene V; Eastell, Richard

2011-01-01

Several DXA-based structural engineering models (SEMs) of the proximal femur have been developed to estimate stress caused by sideway falls. Their usefulness in discriminating hip fracture has not yet been established and we therefore evaluated these models. The hip DXA scans of 51 postmenopausal women with hip fracture (30 femoral neck, 17 trochanteric, and 4 unspecified) and 153 age-, height-, and weight-matched controls were reanalyzed using a special version of Hologic’s software that produced a pixel-by-pixel BMD map. For each map, a curved-beam, a curved composite-beam, and a finite element model were generated to calculate stress within the bone when falling sideways. An index of fracture risk (IFR) was defined over the femoral neck, trochanter, and total hip as the stress divided by the yield stress at each pixel and averaged over the regions of interest. Hip structure analysis (HSA) was also performed using Hologic APEX analysis software. Hip BMD and almost all parameters derived from HSA and SEM were discriminators of hip fracture on their own because their ORs were significantly >1. Because of the high correlation of total hip BMD to HSA and SEM-derived parameters, only the bone width discriminated hip fracture independently from total hip BMD. Judged by the area under the receiver operating characteristics curve, the trochanteric IFR derived from the finite element model was significant better than total hip BMD alone and similar to the total hip BMD plus bone width in discriminating all hip fracture and femoral neck fracture. No index was better than total hip BMD for discriminating trochanteric fractures. In conclusion, the finite element model has the potential to replace hip BMD in discriminating hip fractures. PMID:18767924

Evolution of the hip and pelvis.

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Hogervorst, Tom; Bouma, Heinse W; de Vos, John

2009-08-01

Man's evolution features two unique developments: growing a huge brain and upright gait. Their combination makes the pelvis the most defining skeletal element to read human evolution. Recent revival in joint preserving hip surgery have brought to attention morphological variations of the human hip that appear similar to hips of extant mammals. In man, such variations can produce hip osteoarthrosis through motion. We reviewed the evolution of the hip and pelvis with special interest in morphology that can lead to motion induced osteoarthrosis in man. The combination of giving birth to big brained babies and walking upright has produced marked differences between the sexes in pelvis and hip morphology, each having their characteristic mode of hip impingement and osteoarthrosis.

An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study

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Ching-Lung Cheung

2018-03-01

Full Text Available Objectives: Hip fracture is a major public health problem. Earlier studies projected that the total number of hip fracture will increase dramatically by 2050, and most of the hip fracture will occur in Asia. To date, only a few studies provided the updated projection, and none of them focused on the hip fracture projection in Asia. Thus, it is essential to provide the most up to date prediction of hip fracture in Asia, and to evaluate the total direct medical cost of hip fracture in Asia. Methods: We provide the updated projection of hip fracture in 9 Asian Federation of Osteoporosis Societies members using the most updated incidence rate and projected population size. Results: We show that the number of hip fracture will increase from 1,124,060 in 2018 to 2,563,488 in 2050, a 2.28-fold increase. This increase is mainly due to the changes on the population demographics, especially in China and India, which have the largest population size. The direct cost of hip fracture will increase from 9.5 billion United State dollar (USD in 2018 to 15 billion USD in 2050, resulting a 1.59-fold increase. A 2%–3% decrease in incidence rate of hip fracture annually is required to keep the total number of hip fracture constant over time. Conclusions: The results show that hip fracture remains a key public health issue in Asia, despite the available of better diagnosis, treatment, and prevention of fracture over the recent years. Healthcare policy in Asia should be aimed to reduce the burden of hip fracture. Keywords: Hip fracture, Asia, Osteoporosis, Incidence

Occurrence of secondary fracture around intramedullary nails used for trochanteric hip fractures: a systematic review of 13,568 patients.

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Norris, Rory; Bhattacharjee, Dhritiman; Parker, Martyn J

2012-06-01

A sliding hip screw (SHS) is currently the treatment of choice for trochanteric hip fractures, largely due to the low incidence of complications. An alternative treatment is the use of intramedullary proximal femoral nails. Unfortunately these implants have been associated with a risk of later fracture around the implant. The aim of this study was to see if any improvements have been made to the current intramedullary nails, to reduce the incidence of secondary fracture around the distal tip of the nail. We analysed data related to 13,568 patients from 89 studies, focusing on the incidence of post operative secondary femoral shaft fracture following the use of intramedullary nails in the fixation of trochanteric hip fractures. The overall reported incidence of secondary fracture around the nail was 1.7%. The incidence of fracture has reduced in the 3rd generation Gamma nails when compared to the older Gamma nail (1.7% versus 2.6%, p value 0.03). However, the incidence of secondary fracture in the 3rd generation Gamma nails is still significantly higher than the other brands of short nail (1.7% versus 0.7%, p value 0.0005). Long nails had a slight tendency towards a lower risk of fracture although the difference was not statistically significant (1.1% versus 1.7%, p value 0.28). There was a significantly lower risk of fracture for those nails with a biaxial fixation as opposed to uniaxial fixation (0.6% versus 1.9%, p value fracture around a proximal femoral nail is one of the most significant of fracture healing complications, and this study suggests that continuing design changes to this method of fixation has reduced the risk of this complication occurring. Copyright © 2011 Elsevier Ltd. All rights reserved.

HIP FRACTURES IN THE ELDERLY PATIENT

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Franci Koglot

2001-11-01

Full Text Available Background. Hip fractures are typical of the ageingpopulation. They represent a severe trauma for the elderlypatient due to significant impact on life quality and morbidity.We analyzed the characteristics of patients with hip fractures,the methods and success of treatment. In conclusion, theimportance of continuous team approach and surgical treatmentwithin 24 hours are stressed. Methods. We retrospectively evaluated patients admitted forfemoral neck and intertrochanteric fractures between 1994–1999. The incidence of these fractures, patient age and sex, comorbidity,methods of treatment, hospital stay and success oftreatment with regard to ambulatory status were established.Results. 662 patients were treated in the above mentioned period,yielding a 1‰ annual incidence for the choosen population.The mean patient age was 76 years; there were 426 female(64% and 236 male patients (36%. 336 patients (51%had a history of accompanying disease, in 73 patients (11%additional fractures were diagnosed. 30 patients (4.5% weretreated conservatively, 632 (95.5% underwent surgery. Themean hospital stay length was 17 days. Success of treatmentwas evaluated as good in 441 patients (67%, satisfactory in112 patients (17% and poor in 78 patients (12%. 31 patients(5% died during hospital admission. Conclusions. Patients with hip fractures represent 10% of allin-hospital trauma patients; with hospital stays twice as longas average trauma patients and considering the financial demandsof surgical treatment they are a challenge in traumawards organization and management in the Slovenian environment.Here as well as abroad the number of these patientsis increasing, along with their mean age and co-morbidity. Itis evident that hip fractures, regardless the way of treatment,implicate a partial or complete loss of ambulancy and henceloss of life-quality in one-third of patients. We advise early aspossible surgery –within 24 h– where not absolutely

Taking care of your new hip joint

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Hip arthroplasty - precautions; Hip replacement - precautions; Osteoarthritis - hip; Osteoarthritis - knee ... After you have hip replacement surgery, you will need to be careful how you move your hip, especially for the first few months ...

Comparison of femoral neck fracture healing and affected limb pain after anterolateral-approach minimally invasive total hip replacement and hemiarthroplasty

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Xiao-Dong Cao

2017-04-01

Full Text Available Objective: To study the differences in femoral neck fracture healing and affected limb pain after anterolateral-approach minimally invasive total hip replacement and hemiarthroplasty. Methods: A total of 92 patients with femoral neck fracture who received hip replacement in our hospital between May 2013 and December 2015 were selected and randomly divided into total hip and half hip group, total hip group received anterolateral-approach minimally invasive total hip replacement, half hip group received anterolateral-approach minimally invasive hemiarthroplasty, and 1 month after operation, serum was collected to detect the levels of bone metabolism markers, osteocyte cytokines, SP and CGRP. Results: 1 month after operation, serum PINP, PICP, BMP, TGF-β, FGF, IGF-I and IGF-II levels of total hip group were significantly higher than those of half hip group while TRAP5b and CatK levels were significantly lower than those of half hip group; the day after operation, serum pain media SP and CGRP levels were not significantly different between the two groups of patients; 36 h after operation, serum SP and CGRP levels of total hip group were significantly lower than those of half hip group. Conclusion: The bone metabolism after anterolateral-approach minimally invasive total hip replacement is better than that after hemiarthroplasty, and the degree of pain is less than that after hemiarthroplasty.

Survival times of patients with a first hip fracture with and without subsequent major long-bone fractures.

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Angthong, Chayanin; Angthong, Wirana; Harnroongroj, Thos; Naito, Masatoshi; Harnroongroj, Thossart

2013-01-01

Survival rates are poorer after a second hip fracture than after a first hip fracture. Previous survival studies have included in-hospital mortality. Excluding in-hospital deaths from the analysis allows survival times to be evaluated in community-based patients. There is still a lack of data regarding the effects of subsequent fractures on survival times after hospital discharge following an initial hip fracture. This study compared the survival times of community-dwelling patients with hip fracture who had or did not have a subsequent major long-bone fracture. Hazard ratios and risk factors for subsequent fractures and mortality rates with and without subsequent fractures were calculated. Of 844 patients with hip fracture from 2000 through 2008, 71 had a subsequent major long-bone fracture and 773 did not. Patients who died of other causes, such as perioperative complications, during hospitalization were excluded. Such exclusion allowed us to determine the effect of subsequent fracture on the survival of community-dwelling individuals after hospital discharge or after the time of the fracture if they did not need hospitalization. Demographic data, causes of death, and mortality rates were recorded. Differences in mortality rates between the patient groups and hazard ratios were calculated. Mortality rates during the first year and from 1 to 5 years after the most recent fracture were 5.6% and 1.4%, respectively, in patients with subsequent fractures, and 4.7% and 1.4%, respectively, in patients without subsequent fractures. These rates did not differ significantly between the groups. Cox regression analysis and calculation of hazard ratios did not show significant differences between patients with subsequent fractures and those without. On univariate and multivariate analyses, age fracture. This study found that survival times did not differ significantly between patients with and without subsequent major long-bone fractures after hip fracture. Therefore, all

ACL Injury Prevention Training Results in Modification of Hip and Knee Mechanics During a Drop-Landing Task.

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Pollard, Christine D; Sigward, Susan M; Powers, Christopher M

2017-09-01

Injury prevention training has been shown to be effective in reducing the incidence of noncontact anterior cruciate ligament (ACL) injury; however, the underlying reason for the success of these training programs is unclear. To investigate whether an ACL injury prevention program that has been shown to reduce the incidence of ACL injury alters sagittal plane hip and knee biomechanics during a drop-landing task. Descriptive laboratory study. Thirty female club soccer players (age range, 11-17 years) with no history of knee injury participated in this study. Kinematics and ground-reaction forces were collected while each participant performed a drop-landing task prior to and immediately after participation in a 12-week ACL injury prevention training program. After ACL injury prevention training, participants demonstrated decreased knee extensor moments ( P = .03), increased energy absorption at the hip ( P = .04), decreased knee-to-hip extensor moment ratios ( P = .05), and decreased knee-to-hip energy absorption ratios ( P = .03). Participation in an ACL injury prevention training program decreased reliance on the knee extensor muscles and improved use of the hip extensor muscles, which may explain the protective effect of this type of training program on ACL injury. Based on these findings, clinicians can better understand how ACL injury prevention training, such as the Prevent Injury and Enhance Performance (PEP) Program, may change movement behavior at both the hip and knee. Furthermore, the study findings may support the implementation of the PEP Program, or a similar program, for clinicians aiming to improve use of the hip in an effort to reduce knee loading and consequent injuries.

Pelvic congestion syndrome masquerading as osteoarthritis of the hip

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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.

The association between eccentric hip abduction strength and hip and knee angular movements in recreational male runners

DEFF Research Database (Denmark)

Brund, René B. Korsgaard; Rasmussen, Sten; Nielsen, Rasmus O.

2018-01-01

Weak hip abductors may be related with increased hip adduction and knee abduction angular movement, which may be risk factors of lower extremity injuries. As the role of eccentric hip abduction strength (EHAS) on hip adduction angular movement and knee abduction angular movement (KABD) remains...... and Codamotion active marker system. Using multiple linear regression models (n=186 legs), no relationships between EHAS and hip and knee kinematics were found. A possible reason for the lack of relationship between EHAS and hip and knee kinematics may be owing to differences in the running kinematics. Some...

Encapsulation of Protein-Polysaccharide HIP Complex in Polymeric Nanoparticles

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Ripal Gaudana

2011-01-01

Full Text Available The objective of the present study is to formulate and characterize a nanoparticulate-based formulation of a macromolecule in a hydrophobic ion pairing (HIP complex form. So far, HIP complexation approach has been studied only for proteins with molecular weight of 10–20 kDa. Hence, we have selected bovine serum albumin (BSA having higher molecular weight (66.3 kDa as a model protein and dextran sulphate (DS as a complexing polymer to generate HIP complex. We have prepared and optimized the HIP complex formation process of BSA with DS. Ionic interactions between basic amino acids of BSA with sulphate groups of DS were confirmed by FTIR analysis. Further, nanoparticles were prepared and characterized with respect to size and surface morphology. We observed significant entrapment of BSA in nanoparticles prepared with minimal amounts of PLGA polymer. Finally, results of circular dichroism and intrinsic fluorescence assay have clearly indicated that HIP complexation and method of nanoparticle preparation did not alter the secondary and tertiary structures of BSA.

Erythrocyte antioxidant protection of rose hips (Rosa spp.).

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Widén, C; Ekholm, A; Coleman, M D; Renvert, S; Rumpunen, K

2012-01-01

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 C(18) 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.

Hip arthroscopy in patients with recurrent pain following Bernese periacetabular osteotomy for acetabular dysplasia: operative findings and clinical outcomes

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Cvetanovich, Gregory L.; Heyworth, Benton E.; Murray, Kerri; Yen, Yi-Meng; Kocher, Mininder S.; Millis, Michael B.

2015-01-01

To report the operative findings and outcomes of hip arthroscopy for recurrent pain following periacetabular osteotomy (PAO) for acetabular dysplasia. A departmental database was used to identify patients who underwent hip arthroscopy following PAO between 2000 and 2009. Demographic data, arthroscopic findings, functional outcome scores and patient satisfaction were analysed. Of 556 PAO patients, 17 hips in 16 patients (3.1%) underwent post-PAO hip arthroscopy. Mean age at PAO was 23.8 years, and mean age at arthroscopy was 27.0 years. Common hip arthroscopy findings included labral tears (13 hips, 81.3%), significant (≥grade 2) chondral changes (12 hips, 75%), cam impingement (7 hips, 43.8%) and pincer impingement (6 hips, 37.5%). At mean follow-up 2.8 years after arthroscopy, additional procedures had been performed in six hips (37.5%), including total hip arthroplasty in one hip. Post-PAO arthroscopy questionnaire revealed 85.7% of patients with improved hip pain, 57.1% improved hip stiffness and 57.1% improved hip function. There was no significant difference in functional outcome measures. Common post-PAO hip arthroscopy findings include labral tears, chondral changes and femoroacetabular impingement. Many patients reported subjective hip improvement from post-PAO arthroscopy, but hip outcome scores were unchanged and one-third of patients had further surgery. PMID:27011852

Tranexamic Acid Safely Reduced Blood Loss in Hemi- and Total Hip Arthroplasty for Acute Femoral Neck Fracture: A Randomized Clinical Trial.

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Watts, Chad D; Houdek, Matthew T; Sems, S Andrew; Cross, William W; Pagnano, Mark W

2017-07-01

We aimed to determine whether (1) tranexamic acid (TXA) reduces the incidence of transfusion (2) TXA reduces the calculated blood loss, and (3) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture (FNF). Prospective, double-blinded, randomized controlled trial. Level 1 Academic Trauma Center. One hundred thirty-eight patients who presented with a low-energy, isolated, FNF (AO 31B) treated with either hemi- or total hip arthroplasty within 72 hours of injury were randomized to either the TXA group (69 patients) or placebo group (69 patients). In the TXA group, patients received 2 doses of 15 mg/kg intravenous TXA dissolved in 100 mL of saline, each administered over 10 minutes; 1 dose just before incision, and the second at wound closure. In the placebo group, 100 mL of saline solution was administered in a similar fashion. Perioperative care was otherwise standardized including conservative transfusion criteria. Our primary outcome was to determine the proportion of patients who underwent blood transfusion during hospitalization. Secondary outcomes were calculated blood loss, number of units transfused during hospitalization, and incidence of adverse events at 30 and 90 days including thromboembolic event, wound complications, reoperation, hospital readmission, and all-cause mortality. TXA reduced mean incidence of transfusion by 305 mL (P = 0.0005). There was a trend toward decreased transfusion rate in the TXA group (17% vs. 26%, P = 0.22). TXA was safe with no differences in adverse events at 30 and 90 days. This randomized clinical trial found that TXA administration safely reduced blood loss with a tendency for decreased transfusion rate and total blood product consumption for patients undergoing hip arthroplasty for acute FNF. More studies are needed to further ascertain the role of TXA in the management of patients with FNF. Therapeutic Level I. See Instructions for Authors

A decreasing trend in fall-related hip fracture incidence in Victoria, Australia.

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Cassell, E; Clapperton, A

2013-01-01

In Victoria, Australia, the age-standardised incidence of fall-related hip fracture hospitalisations decreased significantly by 25% over the period 1998/1999-2008/2009. Significant decreases in fall-related hip fractures were observed in males and females, across all 5-year age groups, in Australian-born and overseas-born Victorians, in all socio-economic quintiles and in community-dwelling older people. The study aim was to investigate trends in the incidence of fall-related and hip fracture hospitalisations among Victorians aged 65 years and older overall and by age, gender, country of birth, socio-economic status (SES) and location of the event (home, residential care institution, etc.) over the 11-year period 1998/1999 to 2008/2009. Annual counts and age-standardised rates for fall-related hospitalisations among people aged 65 years and older were estimated using Victorian hospital admissions data. The statistical significance of changes in trends over time were analysed using a log-linear regression model of the rate data assuming a Poisson distribution of cases. Although the age-standardised incidence of fall-related hospitalisations increased significantly by 13% (95% confidence interval [CI], 9% to 18%) in Victoria, the age-standardised incidence of fall-related hip fracture hospitalisations decreased from 600/100,000 in 1998/1999 to 467/100,000 in 2008/2009 - an estimated overall reduction of 25% (95% CI, -29% to -22%). By contrast, the age-standardised incidence of fall-related hospitalisations for fractures at other body sites either increased significantly or showed no significant change. Significant decreases in fall-related hip fractures were observed in both males and females, across all 5-year age groups, in both Australian-born and overseas-born Victorians, in all socio-economic quintiles and in community-dwelling older people but not in people living in residential care facilities. Despite the downward trend in the age-standardised incidence of

Pathogenesis of osteoporotic hip fractures.

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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.

BILATERAL PATHOLOGICAL HIP DISLOCATION IN CHILDREN

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Yuriy E. Garkavenko

2017-03-01

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

Comprehensive care program for elderly patients over 65 years with hip fracture.

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Fernández-Moyano, A; Fernández-Ojeda, R; Ruiz-Romero, V; García-Benítez, B; Palmero-Palmero, C; Aparicio-Santos, R

2014-01-01

To report the health outcomes of a multidisciplinary care program for patients over 65 years with hip fracture. We have developed a care coordination model for the comprehensive care of hip fracture patients. It establishes what, who, when, how and where orthopedists, internists, family physicians, emergency, intensive care, physiotherapists, anesthetists, nurses and workers social intervene. All elderly patients over 65 years admitted with the diagnosis of hip fracture (years 2006 to 2010) were retrospectively evaluated. One thousand episodes of hip fracture, corresponding to 956 patients, were included. Mean age was 82 years and mean stay 6.7 days. This was reduced by 1.14 days during the 5 years of the program. A total of 85.1% were operated on before 72 yours, and 91.2% during the program. Incidence of surgical site infection was 1.5%. In-hospital mortality was 4.5%, (24.2% at 12 months). Readmissions at one years was 14.9%. Independence for basic activity of daily living was achieved by 40% of the patients. This multidisciplinary care program for hip fracture patients is associated with positive health outcomes, with a high percentage of patients treated early (more than 90%), reduced mean stay (less than 7 days), incidence of surgical site infections, readmissions and inpatient mortality and at one year, as well as adequate functional recovery. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Factors that influence soft tissue thickness over the greater trochanter: application to understanding hip fractures.

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Levine, Iris C; Minty, Lauren E; Laing, Andrew C

2015-03-01

Fall-related hip injuries are a concern for the growing population of older adults. Evidence suggests that soft tissue overlying the greater trochanter attenuates the forces transmitted to the proximal femur during an impact, reducing mechanical risk of hip fracture. However, there is limited information about the factors that influence trochanteric soft tissue thickness. The current study used ultrasonography and electromyography to determine whether trochanteric soft tissue thickness could be quantified reproducibly and whether it was influenced by: (1) gender; (2) hip postures associated with potential falling configurations in the sagittal plane (from 30° of extension to 60° of flexion, at 15° intervals), combined adduction-flexion, and combined adduction-extension; and (3) activation levels of the tensor fascia lata (TFL) and gluteus medius (GM) muscles. Our results demonstrated that soft tissue thickness can be measured reliably in nine hip postures and three muscle activation conditions (for all conditions, ICC >0.98). Mean (SD) thickness in quiet stance was 2.52 cm. Thickness was 27.0% lower for males than females during quiet stance. It was 16.4% greater at maximum flexion than quiet standing, 27.2% greater at maximum extension, and 12.5% greater during combined adduction-flexion. However, there was no significant difference between combined adduction-extension and quiet standing. Thickness was not affected by changes in muscle activity. Forces applied to the femoral neck during a lateral fall decrease as trochanteric soft tissue thickness increases; gender and postural configuration at impact could influence the loads applied to the proximal femur (and thus hip fracture risk) during falls on the hip. © 2014 Wiley Periodicals, Inc.

Effect of hip braces on brake response time: Repeated measures designed study.

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Dammerer, Dietmar; Waidmann, Cornelia; Huber, Dennis G; Krismer, Martin; Haid, Christian; Liebensteiner, Michael C

2017-08-01

The question whether or not a patient with a hip brace should drive a car is of obvious importance because the advice given to patients to resume driving is often anecdotal as few scientific data are available on this specific subject. To assess driving ability (brake response time) with commonly used hip braces. Repeated measures design. Brake response time was assessed under six conditions: (1) without a brace (control), (2) with a typical postoperative hip brace with adjustable range of motion and the settings: unrestricted, (3) flexion limited to 70°, (4) extension blocked at 20° hip flexion, (5) both flexion and extension limited (20°/70°) and (6) an elastic hip bandage. Brake response time was assessed using a custom-made driving simulator as used in previous studies. The participants were a convenience sample of able-bodied participants. A total of 70 participants (35 women and 35 men) participated in our study. Mean age was 31.1 (standard deviation: 10.6; range: 21.7-66.4) years. A significant within-subject effect for brake response time was found ( p = 0.009), but subsequent post hoc analyses revealed no significant differences between control and the other settings. Based on our findings, it does not seem mandatory to recommend driving abstinence for patients wearing a hip orthosis. We suggest that our results be interpreted with caution, because (1) an underlying pathological hip condition needs to be considered, (2) the ability to drive a car safely is multifactorial and brake response time is only one component thereof and (3) brake response time measurements were performed only with healthy participants. Clinical relevance Hip braces are used in the context of joint-preserving and prosthetic surgery of the hip. Therefore, clinicians are confronted with the question whether to allow driving a car with the respective hip brace or not. Our data suggest that hip braces do not impair brake response time.

[Malnutrition as a prognostic factor in elderly patients with hip fractures].

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Montero Pérez-Barquero, Manuel; García Lázaro, Milagros; Carpintero Benítez, Pedro

2007-05-19

Hip fracture occurs frequently in elderly patients, with devastating effects on the quality of life due to the high financial burden and the high mortality rate in patients with this condition. Malnutrition is prevalent in the elderly and it can negatively influence patients' recovery from hip fracture. Our proposal was to assess the relationship between malnutrition and the recovery of patients with hip fracture. A total of 110 patients with hip fractures who were admitted to the orthopedic unit at the Reina Sofía Hospital were reassessed one year after discharge. A prospective cohort design and logistic regression analysis was used. Mean age was 81.4, and 80% of patients were women. After one year 19.7% of patients had died. A multivariate analysis showed a significant relationship between a poor functional recovery and age (odds ratio [OR] = 1.19), caloric malnutrition (OR = 290), protein malnutrition (OR = 125); and there was a significant relationship between being confined to bed and a worse situation before fracture (OR = 10.02); caloric malnutrition (OR = 9.57) and protein malnutrition (OR = 15.23). Caloric and protein malnutrition were associated with a worse functional recovery in elderly patients with hip fracture.

Hip fracture prevention with a multifactorial educational program in elderly community-dwelling Finnish women.

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Pekkarinen, T; Löyttyniemi, E; Välimäki, M

2013-12-01

Guidelines suggest identification of women at fracture risk by bone density measurement and subsequently pharmacotherapy. However, most women who sustain a hip fracture do not have osteoporosis in terms of bone density. The present non-pharmacological intervention among elderly women unselected for osteoporosis reduced hip fracture risk by 55 % providing an alternative approach to fracture prevention. Hip fractures are expensive for society and cause disability for those who sustain them. We studied whether a multifactorial non-pharmacological prevention program reduces hip fracture risk in elderly women. A controlled trial concerning 60- to 70-year-old community-dwelling Finnish women was undertaken. A random sample was drawn from the Population Information System and assigned into the intervention group (IG) and control group (CG). Of the 2,547 women who were invited to the IG, 1,004 (39 %) and of the 2,120 invited to the CG, 1,174 (55 %) participated. The IG participated in a fracture prevention program for 1 week at a rehabilitation center followed by review days twice. The CG received no intervention. During the 10-year follow-up, both groups participated in survey questionnaire by mail. Outcome of interest was occurrence of hip fractures and changes in bone-health-related lifestyle. During the follow-up, 12 (1.2 %) women in the IG and 29 (2.5 %) in the CG sustained a hip fracture (P = 0.039). The determinants of hip fractures by stepwise logistic regression were baseline smoking (odds ratio (OR) 4.32 (95 % confidence interval [CI] 2.14-8.71), age OR 1.15/year (95 % CI 1.03-1.28), fall history OR 2.7 (95 % CI 1.24-5.9), stroke history OR 2.99 (95 % CI 1.19-7.54) and participating in this program OR 0.45 (95 % CI 0.22-0.93). Starting vitamin D and calcium supplement use was more common in the IG compared with the CG. The results suggest that this non-pharmacological fracture prevention program may reduce the risk of hip fractures in elderly

Total Hip Arthroplasty in Mucopolysaccharidosis Type IH

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S. O'hEireamhoin

2011-01-01

Full Text Available Children affected by mucopolysaccharidosis (MPS type IH (Hurler Syndrome, an autosomal recessive metabolic disorder, are known to experience a range of musculoskeletal manifestations including spinal abnormalities, hand abnormalities, generalised joint stiffness, genu valgum, and hip dysplasia and avascular necrosis. Enzyme therapy, in the form of bone marrow transplantation, significantly increases life expectancy but does not prevent the development of the associated musculoskeletal disorders. We present the case of a 23-year-old woman with a diagnosis of Hurler syndrome with a satisfactory result following uncemented total hip arthroplasty.

Imaging of hip arthroplasty

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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.

Assessment of the hip reduction angle for predicting osteoarthritis of the hip in the Labrador Retriever.

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Corfield, G S; Read, R A; Eastley, K A; Richardson, J L; Robertson, I D; Day, R

2007-06-01

Hip palpation has been used to provide semiquantitative information regarding passive joint laxity and susceptibility to hip dysplasia. The purpose of this study was to: (1) evaluate the intra- and inter-examiner repeatability of the hip reduction angle measured at 4 months of age by three examiners using manual goniometry and an electromagnetic tracking system; (2) compare the hip reduction angle measured with manual goniometry to the hip reduction angle measured with the electromagnetic tracking system; and (3) evaluate the hip reduction angle, distraction index and Ortolani manoeuvre at 4 months of age as predictors of the development of hip osteoarthritis at 12 months of age in 11 Labrador Retriever dogs. Intra- and inter-examiner repeatability was demonstrated for both the manual and electromagnetic goniometric measurement of the hip reduction angle (coefficient of variation goniometry was moderately correlated to the hip reduction angle measured by the electromagnetic tracking system (r = 0.603, P goniometry was a poor predictor of osteoarthritis at 12 months of age (r = 0.231, P < 0.062, and r = 0.321, P < 0.01). The distraction index was moderately correlated with the development of osteoarthritis by 12 months of age (r = 0.493, P < 0.0000). The Ortolani sign was sensitive (100%) but not specific (41%) for the development of osteoarthritis at 12 months of age. The hip reduction angle did not further quantify the Ortolani manoeuvre as a predictor of osteoarthritis in Labrador Retrievers.

Healing incisional surgical wounds using Rose Hip oil in rats

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Lainy Carollyne da Costa Cavalcante

2017-03-01

Full Text Available Purpose: To evaluate incisional surgical wound healing in rats by using Rose Hip (Rosa rubiginosa L. oil. Methods: Twenty-one days after the oophorectomy procedure, twenty-seven female, adult, Wistar rats were distributed into three groups: Control group (wound treatment with distilled water; Collagenase group (treatment with collagenase ointment; and Rose Hip group (wound treatment with Rose Hip oil. Each group was distributed according to the date of euthanasia: 7, 14 and 21 days. The wound was evaluated considering the macroscopic and microscopic parameters. Results: The results indicated differences in the healing of incisional wounds between treatments when compared to control group. Accelerated wound healing was observed in the group treated with Rose Hip oil in comparison to the control and collagenase, especially after the 14th day. Morphometric data confirmed the structural findings. Conclusion: There was significant effect in topical application of Rose Hip oil on incisional surgical wound healing.

Trends in hip fracture-related mortality in Texas, 1990-2007.

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Orces, Carlos H; Alamgir, Abul H

2011-07-01

There are limited data about trends in hip fracture-related mortality. In this study, we examined temporal trends in hip fracture mortality rates among persons aged 50 years or older in Texas between 1990 and 2007. Hip fracture-related mortality was defined as a death on the multiple cause of death record for which hip fracture was listed as a contributing cause. Population estimates for Texas were used as the denominator to calculate mortality rates per 100,000 persons. The joinpoint regression analysis was used to identify points where a statistically significant change occurred in the linear slope of the rates. A total of 14,350 death certificates listed hip fracture as a contributing cause of death. Hip fracture rates decreased predominantly among men by 0.8% (95% CI, -1.5 to -0.1) per year. Conversely, age-adjusted rates among women increased by 0.3% (95% CI, -0.4 to 1.0) per year. By race/ethnicity, hip fracture mortality rates increased annually 2.2% (95% CI, -0.1 to 4.4) among blacks, whereas the rates among whites and Hispanics remained steady. Moreover, the proportion of death records that listed nursing homes and residence as a place of death increased by 2.2% (95% CI, 1.6 to 2.9) and 8.7% (95% CI, 6.3 to 11.0) per year, respectively. Hip fracture mortality rates decreased predominantly among men in Texas during the study period. Increasing hip fracture mortality rates among blacks and nursing home residents merit further research.

EMG of the hip adductor muscles in six clinical examination tests.

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Lovell, Gregory A; Blanch, Peter D; Barnes, Christopher J

2012-08-01

To assess activation of muscles of hip adduction using EMG and force analysis during standard clinical tests, and compare athletes with and without a prior history of groin pain. Controlled laboratory study. 21 male athletes from an elite junior soccer program. Bilateral surface EMG recordings of the adductor magnus, adductor longus, gracilis and pectineus as well as a unilateral fine-wire EMG of the pectineus were made during isometric holds in six clinical examination tests. A load cell was used to measure force data. Test type was a significant factor in the EMG output for all four muscles (all muscles p stronger than Hips 45, Hips 90 and Side lay. BMI (body mass index) was a significant factor (p Muscle EMG varied significantly with clinical test position. Athletes with previous groin injury had a significant fall in some EMG outputs. Copyright © 2011 Elsevier Ltd. All rights reserved.

Emerging topics on the hip: Ligamentum teres and hip microinstability

International Nuclear Information System (INIS)

Cerezal, Luis; Arnaiz, Javier; Canga, Ana; Piedra, Tatiana; Altónaga, José R.; Munafo, Ricardo; Pérez-Carro, Luis

2012-01-01

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.

Ideologia hip-hopowa na przykładzie tekstów hip-hopowych

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Kozłowska, Monika

2012-01-01

The article is asort of analysis of hip hop lyrics in the context of their importance for identity formation process of young generation. Rap music, as one of the elements of hip hop culture, is a kind of special innovation for its audience. With rising interest for this musical genre and hip hop culture the discussion on formulating the issues through the prism of rap music’s message has been increasing. The article presents certain aspects of making sense to the reality, w...

Impact of hip prosthesis on dose distribution of pelvic radiotherapy

International Nuclear Information System (INIS)

Ren Jiangping; Zhang Songfang; Zhu Qibao; Guo Jianxin; Zha Yuanzi

2011-01-01

Objective: To study the scattering effect of Co-Cr-Mo hip prosthesis which was high Z material for patients undergoing pelvic irradiation. Methods: The hip prosthesis was set in water phantom (30 cm x 30 cm x 30 cm), determining points were chosen on the entrance side of both 6 MV and 10 MV beams at the distance of 0.5 cm, 1.0 cm, 2.0 cm to the hip prosthesis, and also on the exit side of both 6 MV and 10 MV beams at the distance of 3.0 cm, 5.0 cm, 7.0 cm to the hip prostheses. Dose behind the hip prosthesis at depths of 5.0 cm and 10.0 cm for 6 MV and 10 MV beams are also measured. Results: The dose deviation on the beams' entrance side is between 0 to 5.0%, the backscatter effect was more obviously with the higher energy beam. The dose deviation on the beams' exit side was between 21.6%-30.8%. With the same field size and depth, dose deviation becomes smaller when the beam energy was higher; while with the same energy and depth, dose deviation becomes smaller when the field size was bigger. Dose profiles behind the head of the hip prosthesis indicate obvious attenuation of the beam. Conclusions: Beam arrangements that avoid the prosthesis should be considered first or we should at least reduce the weight of the beam that pass through the prosthesis. (authors)

Recurrent Hip Fracture Prevention With Osteoporosis Management

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A. Shahla

2007-02-01

Full Text Available Background:Osteoporosis is a major public health threat,and hip fracture is a serious consequence of osteoporosis.Apatient with an osteoporosis-related hip fracture has an increased risk for a second hip fracture.The effect of osteoporosis management on the risk of recurrent hip fracture was evaluated in this study.Methods:58 hip fracture patients older than 50yr and BMD < 2.5 were discharged from hospital with Ca-Vitamin D- Alendronate prescriptions, and followed up for 4 years to determine the rate of recurrent hip fractures. Rate of second hip fractures was compared with 58 hip fractures in the control group (without osteoporosis treatment which were also followed for 4 years. Results:72% of patients continued treatment for 2 years. There were no second hip fractures in the critical first 12 months in the treated group.Overall second hip fractures in osteoporosis treated and control groups were 3.4% and 8.6%(p<0.03, respectively.Conclusion:Management of hip fractures in the elderly should include bone mineral density determination and osteoporosis treatment to prevent further fractures.

Validity of gait parameters for hip flexor contracture in patients with cerebral palsy

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Lee Sang Hyeong

2011-01-01

Full Text Available Abstract Background Psoas contracture is known to cause abnormal hip motion in patients with cerebral palsy. The authors investigated the clinical relevance of hip kinematic and kinetic parameters, and 3D modeled psoas length in terms of discriminant validty, convergent validity, and responsiveness. Methods Twenty-four patients with cerebral palsy (mean age 6.9 years and 28 normal children (mean age 7.6 years were included. Kinematic and kinetic data were obtained by three dimensional gait analysis, and psoas lengths were determined using a musculoskeletal modeling technique. Validity of the hip parameters were evaluated. Results In discriminant validity, maximum psoas length (effect size r = 0.740, maximum pelvic tilt (0.710, maximum hip flexion in late swing (0.728, maximum hip extension in stance (0.743, and hip flexor index (0.792 showed favorable discriminant ability between the normal controls and the patients. In convergent validity, maximum psoas length was not significantly correlated with maximum hip extension in stance in control group whereas it was correlated with maximum hip extension in stance (r = -0.933, p Conclusions Maximum pelvic tilt, maximum psoas length, hip flexor index, and maximum hip extension in stance were found to be clinically relevant parameters in evaluating hip flexor contracture.

Comparison between the Harris- and Oxford Hip Score to evaluate outcomes one-year after total hip arthroplasty

NARCIS (Netherlands)

Weel, Hanneke; Lindeboom, Robert; Kuipers, Sander E.; Vervest, Ton M. J. S.

2017-01-01

Harris Hip Score (HHS) is a surgeon administered measurement for assessing hip function before and after total hip arthroplasties (THA). Patient reported outcome measurements (PROMs) such as the Oxford Hip Score (OHS) are increasingly used. HHS was compaired to the OHS assessing whether the HHS can

Adventure sports and sexual freedom hip replacement: the tripolar hip.

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Pritchett, James W

2018-01-01

Certain athletic activities and lifestyles require a completely stable and very mobile hip. Total hip replacement with a natural femoral head size and two mobile-bearing surfaces (i.e., a "tripolar" prosthesis) is the most stable prosthesis. Elegant design and wear-resistant bearing surfaces are the keys to long-term implant survivorship. The hypothesis is that a ceramic-coated tripolar prosthesis using highly cross-linked polyethylene can provide full function and complete stability with low wear. This study sought to determine: (1) patient-reported outcomes, (2) functional outcomes, (3) implant survivorship and complications, and (4) postoperative sexual limitations. Between 1998 and 2011, the author performed 160 primary total hip replacements using tripolar prostheses in patients participating in adventure sports and other physically demanding activities. The institutional review board approved this study. The inclusion criteria were patients who needed unrestricted activity and who were not candidates for or did not choose hip resurfacing. Patients were followed every second year and assessed with radiographs, Harris Hip Score, WOMAC, SF-12, and UCLA functional outcome scores. Patients were asked about symptoms of instability and satisfaction with their hip replacement. Patients were asked both preoperatively and 2 years postoperatively four questions about their sexual activity. Mean follow-up was 11 years. At 2 years' postoperatively, 98% of patients reported their satisfaction as excellent or good and 99% were not limited for sexual activity following surgery. Seventy-four percent of patients reported they were recovered within 6 weeks of surgery. There were no dislocations. There were three revision procedures for implant loosening, infection, and periprosthetic fracture, but there were no failures of the tripolar articulation. The mean postoperative UCLA score was the highly athletic score of 8. There were no signs of osteolysis, wear, or metal

Rehabilitation following hip arthroscopy - A systematic review

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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

Hip strength and star excursion balance test deficits of patients with chronic ankle instability.

Science.gov (United States)

McCann, Ryan S; Crossett, Ian D; Terada, Masafumi; Kosik, Kyle B; Bolding, Brenn A; Gribble, Phillip A

2017-11-01

To examine isometric hip strength in those with and without CAI, and determine the degree of Star Excursion Balance Test (SEBT) variance explained by isometric hip strength. Single-blinded, cross-sectional, case-control study. Thirty individuals with CAI, 29 lateral ankle sprain (LAS) copers, and 26 healthy controls participated. We assessed dynamic postural control with the SEBT anterior (SEBT-ANT), posteromedial (SEBT-PM), and posterolateral (SEBT-PL) reaches, and isometric hip extension (EXT), abduction (ABD) and external rotation (ER) strength with hand-held dynamometry. The CAI and LAS coper groups' involved limbs and randomly selected limbs in controls were tested. Separate Kruskal-Wallis tests compared SEBT scores and isometric hip strength between groups. Backwards linear regression models determined the degree of SEBT variance explained by isometric hip strength. Statistical significance was set a priori at Phip strength compared to LAS copers and controls. Additionally, the CAI group's isometric hip strength significantly influenced dynamic postural control performance. Future CAI rehabilitation strategies should consider hip muscular strengthening to facilitate improvements in dynamic postural control. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Kirsti Uusi-Rasi

2017-01-01

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

Photovoltaic solar power in building engineering. Experience feedback in France of the European Hip Hip project. Advances and realizations; L'electricite solaire photovoltaique dans le batiment. Retour d'experience en France du Projet Europeen Hip Hip. Avancees et realisations

Energy Technology Data Exchange (ETDEWEB)

NONE

2003-07-01

The European demonstration project Hip Hip (house integrated photovoltaic high-tech in public) led the French photovoltaic market to reach a level comparable to those of the other European countries in terms of relevance of implemented solutions and costs. This document presents the best realizations and the experience gained through the Hip Hip project. Its aim is to convince the designers and managers of building projects of the advantages of photovoltaic installations integrated to the structure and connected to the power distribution grid: 1 - presentation of the technology; 2 - status of the Hip Hip demonstration project (goals, results: main innovations and impact on the French market); 3 - different possibilities of integration to the building structure; 4 - examples of projects realized in France in the framework of the Hip Hip project: integration in glass roof, frontage, added elements, fitting on roofs. (J.S.)

Impact properties of reduced activation ferritic/martensitic steel, F82H jointed by hot isostatic pressing

Energy Technology Data Exchange (ETDEWEB)

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

2007-07-01

Full text of publication follows: Reduced-activation ferritic/martensitic steels are the leading candidate structural material for the blanket system of fusion reactors. The important issue at the current stage is the finalization of a detailed manufacturing specification for ITER test blanket module. Hot isostatic pressing (HIP) process is one of the most important methods to fabricate the first wall with cooling channels. The objective of this paper is to optimize HIP condition to obtain the excellent joints mechanical properties. The materials used were F82H steels. The joint was produced by solid state HIP method. Before HIP treatments, specimens were heated in vacuum condition to out-gas. This treatment was conducted to decrease oxidation on the surfaces. HIP treatments were carried out for 2 h at 1100 deg. C - 140 MPa. The specimens were normalized at 960 deg. C for 0.5 h and tempered at 750 deg. C for 1.5 h. The bonding interface was characterized by scanning electron microscopy. Charpy impact tests and tensile tests were conducted to evaluate the mechanical properties of the HIP joint. Impact tests revealed that there were no significant differences in the ductile-brittle transition temperatures of HIP jointed specimens and base metal specimens, but the upper-shelf energy (USE) of the HIP joint specimens at room temperature was only about 10% of that of the base metal specimens. SEM observations of the fracture surface of HIP joint specimens revealed that a large number of oxides were formed on the HIP joint. This result indicates that oxides formed on the HIP joint are the dominant factor of the impact properties. Based on these results, the pre-HIP treatment conditions had been optimized to reduce the number of oxides, and USE of HIP joint specimens increased to about 50% of that of the base metal. The detailed analyses on the HIP joint microstructure will be reported. (authors)

Metal-on-metal hip resurfacings. A radiological perspective

International Nuclear Information System (INIS)

Chen, Zhongbo; Pandit, Hemant; Taylor, Adrian; Gill, Harinderjit; Murray, David; Ostlere, Simon

2011-01-01

It is important to be aware of the various complications related to resurfacing arthroplasty of the hip (RSA) and the spectrum of findings that may be encountered on imaging. The bone conserving metal-on-metal (MOM) hip resurfacing has become increasingly popular over the last ten years, especially in young and active patients. Initial reports have been encouraging, but long-term outcome is still unknown. Early post operative complications are rare and have been well documented in the literature. Medium and long term complications are less well understood. A rare but important problem seen at this stage is the appearance of a cystic or solid periarticular reactive mass, which occurs predominately in women and usually affects both hips when seen in patients with bilateral RSAs. The following imaging findings are illustrated and their significance discussed; Uncomplicated hip resurfacing arthroplasty, radiolucency around the femoral peg, femoral neck fracture, loosening and infection, suboptimal component position, femoral notching, dislocation, heterotopic ossification, femoral neck thinning and reactive masses. The radiologist should be aware of the normal radiographic appearances and the variety of complications that may occur following RSA and should recommend ultrasound or MRI in patients with an unexplained symptomatic hip and normal radiographs. (orig.)

Perioperative transfusion threshold and ambulation after hip revision surgery

DEFF Research Database (Denmark)

Nielsen, Kamilla; Johansson, Pär I; Dahl, Benny

2014-01-01

BACKGROUND: Transfusion with red blood cells (RBC) may be needed during hip revision surgery but the appropriate haemoglobin concentration (Hb) threshold for transfusion has not been well established. We hypothesized that a higher transfusion threshold would improve ambulation after hip revision...... surgery. METHODS: The trial was registered at Clinicaltrials.gov ( NCT00906295). Sixty-six patients aged 18 years or older undergoing hip revision surgery were randomized to receive RBC at a Hb threshold of either 7.3 g/dL (restrictive group) or 8.9 g/dL (liberal group). Postoperative ambulation...... received RBC. CONCLUSIONS: A Hb transfusion threshold of 8.9 g/dL was associated with a statistically significantly faster TUG after hip revision surgery compared to a threshold of 7.3 g/dL but the clinical importance is questionable and the groups did not differ in Hb at the time of testing....

Hip and ankle range of motion and hip muscle strength in young female ballet dancersand controls

Science.gov (United States)

Bennell, K.; Khan, K. M.; Matthews, B.; De Gruyter, M.; Cook, E.; Holzer, K.; Wark, J. D.

1999-01-01

OBJECTIVES: To compare the hip and ankle range of motion and hip muscle strength in 8-11 year old novice female ballet dancers and controls. METHODS: Subjects were 77 dancers and 49 controls (mean (SD) age 9.6 (0.8) and 9.6 (0.7) years respectively). Supine right active hip external rotation (ER) and internal rotation (IR) were measured using an inclinometer. A turnout protractor was used to assess standing active turnout range. The measure of ER achieved from below the hip during turnout (non-hip ER) was calculated by subtracting hip ER range from turnout range, and hip ER:IR was derived by dividing ER range by IR range. Range of right weight bearing ankle dorsiflexion was measured in a standing lunge using two methods: the distance from the foot to the wall (in centimetres) and the angle of the shank to the vertical via an inclinometer (in degrees). Right calf muscle range was measured in weight bearing using an inclinometer. A manual muscle tester was used to assess right isometric hip flexor, internal rotator, external rotator, abductor, and adductor strength. RESULTS: Dancers had less ER (pballetic training. 


 PMID:10522638

Confronting hip resurfacing and big femoral head replacement gait analysis

Directory of Open Access Journals (Sweden)

Panagiotis K. Karampinas

2014-03-01

Full Text Available Improved hip kinematics and bone preservation have been reported after resurfacing total hip replacement (THRS. On the other hand, hip kinematics with standard total hip replacement (THR is optimized with large diameter femoral heads (BFH-THR. The purpose of this study is to evaluate the functional outcomes of THRS and BFH-THR and correlate these results to bone preservation or the large femoral heads. Thirty-one patients were included in the study. Gait speed, postural balance, proprioception and overall performance. Our results demonstrated a non-statistically significant improvement in gait, postural balance and proprioception in the THRS confronting to BFH-THR group. THRS provide identical outcomes to traditional BFH-THR. The THRS choice as bone preserving procedure in younger patients is still to be evaluated.

Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercise in the management of hip osteoarthritis.

Science.gov (United States)

Brosseau, Lucie; Wells, George A; Pugh, Arlanna G; Smith, Christine Am; Rahman, Prinon; Àlvarez Gallardo, Inmaculada C; Toupin-April, Karine; Loew, Laurianne; De Angelis, Gino; Cavallo, Sabrina; Taki, Jade; Marcotte, Rachel; Fransen, Marlene; Hernandez-Molina, Gabriela; Kenny, Glen P; Regnaux, Jean-Philippe; Lefevre-Colau, Marie-Martine; Brooks, Sydney; Laferriere, Lucie; McLean, Linda; Longchamp, Guy

2016-10-01

The primary objective is to identify effective land-based therapeutic exercise interventions and provide evidence-based recommendations for managing hip osteoarthritis. A secondary objective is to develop an Ottawa Panel evidence-based clinical practice guideline for hip osteoarthritis. The search strategy and modified selection criteria from a Cochrane review were used. Studies included hip osteoarthritis patients in comparative controlled trials with therapeutic exercise interventions. An Expert Panel arrived at a Delphi survey consensus to endorse the recommendations. The Ottawa Panel hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) considered the study design (level I: randomized controlled trial and level II: controlled clinical trial), statistical significance (p osteoarthritis. Strength training exercises displayed the greatest improvements for pain (Grade A), disability (Grades A and C+), physical function (Grade A), stiffness (Grade A), and range of motion (Grade A) within a short time period (8-24 weeks). Stretching also greatly improved physical function (Grade A), and flexibility exercises improved pain (Grade A), range of motion (Grade A), physical function (Grade A), and stiffness (Grade C+). The Ottawa Panel recommends land-based therapeutic exercise, notably strength training, for management of hip osteoarthritis in reducing pain, stiffness and self-reported disability, and improving physical function and range of motion. © The Author(s) 2015.

A preliminary biomechanical study of a novel carbon-fibre hip implant versus standard metallic hip implants.

Science.gov (United States)

Bougherara, Habiba; Zdero, Rad; Dubov, Anton; Shah, Suraj; Khurshid, Shaheen; Schemitsch, Emil H

2011-01-01

Total hip arthroplasty is a widespread surgical approach for treating severe osteoarthritis of the human hip. Aseptic loosening of standard metallic hip implants due to stress shielding and bone loss has motivated the development of new materials for hip prostheses. Numerically, a three-dimensional finite element (FE) model that mimicked hip implants was used to compare a new hip stem to two commercially available implants. The hip implants simulated were a novel CF/PA12 carbon-fibre polyamide-based composite hip stem, the Exeter hip stem (Stryker, Mahwah, NJ, USA), and the Omnifit Eon (Stryker, Mahwah, NJ, USA). A virtual axial load of 3 kN was applied to the FE model. Strain and stress distributions were computed. Experimentally, the three hip stems had their distal portions rigidly mounted and had strain gauges placed along the surface at 3 medial and 3 lateral locations. Axial loads of 3 kN were applied. Measurements of axial stiffness and strain were taken and compared to FE analysis. The overall linear correlation between FE model versus experimental strains showed reasonable results for the lines-of-best-fit for the Composite (Pearson R(2)=0.69, slope=0.82), Exeter (Pearson R(2)=0.78, slope=0.59), and Omnifit (Pearson R(2)=0.66, slope=0.45), with some divergence for the most distal strain locations. From FE analysis, the von Mises stress range for the Composite stem was much lower than that in the Omnifit and Exeter implants by 200% and 45%, respectively. The preliminary experiments showed that the Composite stem stiffness (1982 N/mm) was lower than the metallic hip stem stiffnesses (Exeter, 2460 N/mm; Omnifit, 2543 N/mm). This is the first assessment of stress, strain, and stiffness of the CF/PA12 carbon-fibre hip stem compared to standard commercially-available devices. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

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

2016-01-25

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.

A model-based approach to stabilizing crutch supported paraplegic standing by artificial hip joint stiffness.

Science.gov (United States)

van der Spek, Jaap H; Veltink, Peter H; Hermens, Hermie J; Koopman, Bart F J M; Boom, Herman B K

2003-12-01

The prerequisites for stable crutch supported standing were analyzed in this paper. For this purpose, a biomechanical model of crutch supported paraplegic stance was developed assuming the patient was standing with extended knees. When using crutches during stance, the crutches will put a position constraint on the shoulder, thus reducing the number of degrees of freedom. Additional hip-joint stiffness was applied to stabilize the hip joint and, therefore, to stabilize stance. The required hip-joint stiffness for changing crutch placement and hip-joint offset angle was studied under static and dynamic conditions. Modeling results indicate that, by using additional hip-joint stiffness, stable crutch supported paraplegic standing can be achieved, both under static as well as dynamic situations. The static equilibrium postures and the stability under perturbations were calculated to be dependent on crutch placement and stiffness applied. However, postures in which the hip joint was in extension (C postures) appeared to the most stable postures. Applying at least 60 N x m/rad hip-joint stiffness gave stable equilibrium postures in all cases. Choosing appropriate hip-joint offset angles, the static equilibrium postures changed to more erect postures, without causing instability or excessive arm forces to occur.

Dura arhtroplasty of the hip a case report with follow up to 10 years

International Nuclear Information System (INIS)

Prasartritha, T.

1999-01-01

Freeze-dried human dura allograft was used to cover the dislocated femoral head of a 9 years old with left hip dislocation. The left hip was dislocated as a consequence of pyogenic arthritis of the hipjoint afterbirth. After medical treatment the child regained his health and began to walk at the age of one year. At the age of 9 years old, limping was clearly obvious with 2.5 cms of limb length discrepancy. The dislocated hip was surgically reduced and the joint was stabilized by Chiari medial displacement osteotomy. The child was kept in a 1 1/2 hip spica for 4 weeks, after which the Yirschner wires were removed. Two years after surgery, the hip joint was mobiled, stable and pain free, leg length discrepancy was 1 cm. Ten years follow up, the child (1 9 years old) becomes a normal developed adult with nearly full range hip motion. The thigh circumference of the affected limb is smaller than the other, leg length discrepancy is 2 cms but he can walk, run and participate in sports. Follow up X-rays show a well located hip with deformed femoral head

Ultrasound screening for decentered hips in children with severe cerebral palsy: a preliminary evaluation

Energy Technology Data Exchange (ETDEWEB)

Smigovec, Igor; Dapic, Tomislav [University Hospital Center Zagreb, Zagreb University School of Medicine, Department of Orthopedic Surgery, Zagreb (Croatia); Trkulja, Vladimir [Zagreb University School of Medicine, Zagreb (Croatia)

2014-09-15

0.995 mm). In children with cerebral palsy, US can be reliably used in screening for decentered hips and can greatly reduce the need for repeated radiographic assessments, thus reducing radiation burden in these children. (orig.)

Ultrasound screening for decentered hips in children with severe cerebral palsy: a preliminary evaluation

International Nuclear Information System (INIS)

Smigovec, Igor; Dapic, Tomislav; Trkulja, Vladimir

2014-01-01

0.995 mm). In children with cerebral palsy, US can be reliably used in screening for decentered hips and can greatly reduce the need for repeated radiographic assessments, thus reducing radiation burden in these children. (orig.)

Adherence With Bisphosphonates and Long-Term Risk of Hip Fractures: A Nested Case-Control Study Using Real-World Data.

Science.gov (United States)

Shalev, Varda; Sharman Moser, Sarah; Goldshtein, Inbal; Yu, Jingbo; Weil, Clara; Ish-Shalom, Sophia; Rouach, Vanessa; Chodick, Gabriel

2017-09-01

Hip fracture is a major complication of osteoporosis. Bisphosphonate medication is the mainstay of treatment for osteoporosis. However, concerns have been raised regarding the effectiveness of bisphosphonates in reducing hip fracture risk after long-term use, particularly among patients with suboptimal adherence. To examine the association between adherence with bisphosphonate therapy and long-term risk of hip fracture. Included in the present nested case-control study were osteoporotic women (n = 14 357) who initiated bisphosphonate therapy in 2000-2010 and were retrospectively followed for incident hip fracture through November 2014. Within this cohort, each case of primary hip fractures was individually matched to 3 controls without a primary hip fracture. Proportion of follow-up days covered (PDC) with bisphosphonates was calculated from bisphosphonate purchases. Adherence was categorized into the following groups: purchase of 1 or 2 months' supply (reference group), at least 3 months' supply to PDC ≤20%, PDC >20% to ≤80%, PDC >80% to ≤100%. Included in the analysis were 426 case-control groups with a mean age (SD) of 73.7 years (7.9). Compared with the reference group, PDC of 80% to 100% with bisphosphonates was associated with a significant reduction in hip fracture risk for patients with 8 to 15 years of follow-up (OR = 0.39; 95% CI = 0.18-0.87). Among patients with a follow-up of up to 3 years, OR was 0.58 (95% CI = 0.31-1.06). Adherence with bisphosphonates among osteoporotic patients is associated with lower risk of hip fracture, with no indication of diminished effectiveness with long-term use.

Walking pattern in 9 women with hip dysplasia 18 months after periacetabular osteotomy

DEFF Research Database (Denmark)

Pedersen, Eva N G; Alkjaer, Tine; Søballe, Kjeld

2006-01-01

. METHODS: The gait pattern of 9 women (median age 39 years) with hip dysplasia who were treated with unilateral periacetabular osteotomy was analyzed before periacetabular osteotomy and an average of 1.5 years afterwards. Data were collected using 5 video cameras and 2 force plates. An inverse dynamics...... upright walking pattern but continued to relieve the hip joint by maintaining a reduced flexor moment....

Pre-operative ambulatory measurement of asymmetric leg loading during sit to stand in hip arthroplasty patients

NARCIS (Netherlands)

Martínez-Ramírez, Alicia; Weenk, D.; Lecumberri, Pablo; Verdonschot, Nicolaas Jacobus Joseph; Pakvis, Dean; Veltink, Petrus H.

Total hip arthroplasty is a successful surgical procedure to treat patients with hip osteoarthritis. Clinicians use different questionnaires to evaluate these patients. Gait velocity and these questionnaires; usually show significant improvement after total hip arthroplasty. This clinical evaluation

Life Estimation of Hip Joint Prosthesis

Science.gov (United States)

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

2015-07-01

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.

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

Throw Yo' Voice Out: Disability as a Desirable Practice in Hip-Hop Vocal Performance

Directory of Open Access Journals (Sweden)

Alex S. Porco

2014-12-01

Full Text Available Disabled bodies and disabling spaces— especially the recording studio— shape the sound iconicity of hip-hop vocal performances. The disabled voice is the audible sign by which hip-hop artists trouble cultural definitions of the self and other; exceptionalism and failure; the natural and techno-mediated; comedy and tragedy; and aesthetic play and seriousness. Hip-hop vocal performances also function as self-conscious acts of transvaluation that challenge the discursive dominance of ableism. A materialist approach to vocal performance resists reducing voice to a silent metaphor for race, oppositionality, or liberation; and it emphasizes, instead, the physiological and social processes that render hip-hop voices unique, particular, and audible. It emphasizes the agency hip-hop artists possess in seeking out disabled bodies and assuming disabled identities for aesthetic and political ends. Thus, the body is returned to the analysis of style.

Ultrasound-Guided Femoral Nerve Block to Facilitate the Closed Reduction of a Dislocated Hip Prosthesis

Directory of Open Access Journals (Sweden)

Edward Carlin

2017-10-01

Full Text Available Prosthetic hip dislocation is a common but unfortunate complication in patients who have undergone total hip arthroplasty. Successful closed reduction in the emergency department leads to a reduced length of stay and rate of hospitalization. 1, 2 The use of regional anesthesia by femoral nerve block represents a novel approach for controlling pain in patients with hip pathologies. 3 Ultrasound-guided approaches have been used with great success for controlling pain in patients with hip fractures. 4, 5 Here we report the case of a 90-year-old male who presented with a dislocated hip prosthesis, which was subsequently corrected with closed reduction following delivery of regional anesthesia to the femoral nerve under ultrasound guidance. To our knowledge, this represents the first reported use of an ultrasound-guided femoral nerve block to facilitate closed reduction of a dislocated prosthetic hip, and highlights a novel approach that avoids the use of procedural sedation in an elderly patient.

Scintimetry in transient synovitis of the hip in the child

International Nuclear Information System (INIS)

Hasegawa, Yukiharu; Wingstrand, H.; Gustafson, T.

1988-01-01

Fifty-five consecutive children presenting with transient synovitis of the hip were examined with 99m Tc-MDP scintigraphy and pin-hole collimator technique. Quantitative assessment was performed along a profile of interest across the hip joint. The criteria for the normal scintimetric pattern in the child's hip were established and the pathologic pattern of uptake in the acute phase, as well as in the follow-up after synovitis, was described. A decrease in isotope uptake in the proximal femoral epiphysis was observed in 13 children. This was correlated with a reduced uptake in the growth-plate, indicating a disturbance of blood supply to these regions. A characteristic pattern of isotope uptake with duration of symptoms was observed: a decrease in uptake during the first week followed by rebound hyperemia within 1 month. One child developed osteonecrosis (Legg-Calve-Perthes disease). (author)

Metallic Modular Taper Junctions in Total Hip Arthroplasty

Directory of Open Access Journals (Sweden)

Timothy McTighe

2015-08-01

Full Text Available The emergence of modularity in total hip arthroplasty (THA in the 1980s and 1990s was based on the fact that the benefit of these design features outweighed the risk. The use of metallic modular junctions presents a unique set of advantages and problems for use in THA. The advantages include improvement in fit and fill of the implant to bone, restoration of joint mechanics, reduced complications in revision surgery and reduction of costly inventory. However, the risks or concerns are a little harder to identify and deal with. Certainly corrosion, and fatigue failure are the two most prevalent concerns but now the specifics of fretting wear and corrosive wear increasing particulate debris and the potential biological response is having an impact on the design and potential longevity of the reconstructed hip. Material and designs are facing a shorter life expectancy than what was previously thought, mostly due to an increasing level of physical activity by the patient. Because there are no accurate laboratory test whereby the service life and performance of these implants can be predicted, early controlled clinical evaluations are necessary. Early publication of testing and clinical impressions should be encouraged in an attempt to reduce exposure to potential at risk patients, implants and material. The reduction and possible elimination of risks will require a balancing of all the variables requiring a multidisciplinary endeavor. This paper is designed to review the risk factors, and benefits of modular junctions in total hip arthroplasty (THA. Also some basic engineering principals that can reduce risk factors and improve functionality of modular junctions.

Risk factors for the need of hip arthroscopy following periacetabular osteotomy

DEFF Research Database (Denmark)

Hartig-Andreasen, Charlotte; Troelsen, Anders; Thillemann, Theis M

2015-01-01

was to identify risk factors predicting the need for a hip arthroscopy (HA) after periacetabular osteotomy (PAO). Ninety-nine patients (104 hips) scheduled for PAO were evaluated preoperatively and at 2-year follow-up. MRA was performed in all patients prior to PAO. At follow-up, patients were divided into a non-arthroscopy...... and arthroscopy group. The two groups were compared clinical and radiological, and risk factors for HA after PAO were calculated. Patient reported outcome measures (WOMAC, Oxford Hip and SF36) were filled out before PAO and at follow-up. Ninety-five hips (91.3%) were evaluated. Twenty-six hips (27%) required...... an arthroscopy within 2 years of the PAO. Risk factors were preoperative borderline dysplasia, acetabular retroversion and complete labral detachment. Labral tearing, degeneration or hypertrophy did not negatively affect the outcome of PAO. Patients not requiring an arthroscopy had a statistically significant...

[Vestibular function, falls and hip fracture in elderly--a relationship study].

Science.gov (United States)

Zur, Oz; Carmeli, Eli; Himellfarb, Mordechi; Berner, Yitshal N

2004-03-01

Falling is the main reason for which people over 70 arrive at emergency rooms. Over 90% of hip fractures occur as a direct result of falling. To examine the relationship between the function of the vestibular system and hip fractures following falls in elderly. The research group (n = 84) undergone hip surgery as a result of a fall and were then hospitalized in a rehabilitative geriatric care unit at the Meir Hospital in Kfar Sava. The control group (n = 85)--without any history of a hip fracture and living in a retirement home. Four clinical tests were given to each examinee in order to locate any impairment of the vestibular system. Three of the clinical examinations concentrated on testing the VOR while the fourth test was especially used to locate BPPV (Benign Paroxysmal Positional Vertigo). Sociodemographic status and medical history were taken. A significant difference was found between the two groups (those with a hip fracture and those without any hip fracture) with regard to the functioning of the VOR, age, endocrine disease and medications for treating diabetic. However, there was no significant difference found in the appearance of the BPPV. It is important to locate the elderly who are at risk of falling in nursing homes and the community at large by performing the four simple clinical tests. Correct diagnosis and early treatment of the vestibular impairment in elderly patient can prevent the next fall.

Isometric and isokinetic hip strength and agonist/antagonist ratios in symptomatic femoroacetabular impingement.

Science.gov (United States)

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