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Query: UNIPROT:P50502 (Hip)
 7,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Our study aimed at analysis and presentation of intraoperative complications during total hip replacements with the use of limited posterior approach according to T.V. Swanson. Consecutive 210 hip arthroplasies (79 males, 131 females, aged 20-87 years, mean age 61 +/- 12,) were analyzed according to intraoperative complications. Left hip was operated in 117 cases, right in 93, bilateral procedure was performed in 27 cases (9 men, 18 women). Idiopathic disease occurred in 196 hips, 8 were result of rheumatoid arthritis, in 5 was of dysplastic origin and one occurred due to idiopathic necrosis of femoral head. In 120 cases concomitant arthrosis of the lumbosacral spine and the other joints of the lower limbs was recorded. Preoperative Harris Hip Score (HSS) was 30 +/- 5 points and Body Mass Index (BMI) ranged from 23 to 36. Our clinical material was divided into three equeal series of consecutive hip replacements (n = 70). Each of the series represented different intraoperative complications. In the first series five intraoperative notorious bleedings, four transient sciatic nerve palsies, two injuries to piriforimis muscle and one spiral fracture of the proximal femur were noted. In the second series no important adverse intraoperative findings occurred. In the third series two perforations of the acetabulum and one fracture of the femur were observed. Differences of frequencies of vascular and neural complications between these three series appeared statistically significant. The authors suggested that these observations represent the "learning curve" of the new surgical procedure--the first phase reflects difficulties and technical errors, the second without complications--maturity of the procedure and the third one carelessness due to having false sense of "perfection" by the operators.
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PMID:[Modified Swanson's hip replacement--intraoperative complications and learning curve of the procedure]. 1951 71

Myalgias most commonly occur in polymyalgia rheumatica (PMR). About 45% of patients with giant cell arteritis present with symptoms of PMR. Other vasculitides may also lead to arthralgia and myalgia. While shoulder and pelvic pain is characteristic for PMR pain often also occurs in the back of the neck and in the region of the thoracic spine. In addition, patients often present with malaise, morning stiffness and weight loss. CRP and ESR are elevated. Ultrasound and MRI delineate minor synovitis, tenosynovitis and bursitis in the shoulder. Hip joint synovitis and trochanteric bursitis are also commonly seen. PMR should be distinguished from rheumatoid arthritis. The initial treatment comprises a prednisolone dose of 15-25 mg/day, followed by a weekly decrease of 1-2.5 mg. Once 10 mg/day has been reached the dose should be reduced more slowly.
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PMID:[Myalgia in polymyalgia rheumatica, temporal arteritis and other vasculitides]. 1958 33

We reviewed a series of 17 hip arthroplasties in 16 patients performed when the patients were 30 years old or younger who presented to us for consideration of revision. The mean age was 23.1 years (14 to 30) at the initial arthroplasty. At the time of the original procedure there were 4 sequelae of septic arthritis, 7 old traumatic hip injures, 3 cases of developmental dysplasia (DDH), 1 case of rheumatoid arthritis (RA), 1 steroid-induced avascular necrosis, and 1 old slipped upper femoral epiphysis (SUFE) The implants inculded 11 total hip arthroplasties (THA), 3 double cup arthroplasties,1 bipolar arthroplasty,1 monopolar arthroplasty and 1 cup arthroplasty. The cause for revision lay on the acetabular side in 16 cases and on the femoral side in 6 cases (some had failure on both sides of the joint). There was one revision for recurrent dislocation. The patients had undergone a mean of 1.1 procedures (range 0-3) before the primary arthroplasty. There was a mean interval of 10.6 years (2-33)between the arthroplasty and the revision and the patients had a mean of 1.9 further revision procedures(0 to 4). Complications of revision surgery inculded 1 case of sepsis, 2 recurrent dislocations and 8 re-revisions. Postel and Merle d'Aubigne (PMA) score increased from 10.1 to 14.6 at an mean follow-up of 5.4 years (1 to 20). The typical patient was male (11/17) having had the first arthroplasty at age 23 for trauma sequelae (7/17), a revision at 34 (acetabular failure (16/17). At age 46.4, and after 1.9 secondary procedures hip scores were not exceptional. Such generally disappointing results arose from errors in implant selection or technical mistakes. Careful surgery is critical, and the way of life of the patient may need to be modified.
Hip Int
PMID:Hip arthroplasty up to the age of 30 and considerations in relation to subsequent revision. 1989 Oct 48

The authors evaluated 124 patients operated on by means of cemented Poldi THR in the period 1980-1986 on average 14,2 years after the primary implantation (12,2-18,0). Average age of patients was 55 years (in the range of 33 to 75). Pre-operative diagnosis was osteoarthritis in 78 cases and rheumatoid arthritis in 46 patients. All patients had normal anatomical relations. The implants applied included a 49 mm polyethylene cup and a bananashaped CoCr polished stem with 32 mm head with the use of 1st generation method of cementing. Harris Hip Score averaged prior to the surgery 49 (19-52) and after the surgery 68 (49-98). In 59 patients Harris Hip Score was above 70 points. In total, 10 revision surgeries were performed of which 9 due to aseptic loosening (the cup - 6times, the cup and the stem - twice, the stem - once) and 1 due to septic loosening. There were 23 cases of evident loosening of the cup (of which 8 symptomatic and 15 asymptomatic one) and 8 probable. The number of potential operations of the cup is 46 and that of the stem 11. Combined prevalence of revision surgeries accomplished and potential is 54 (43,5 %) in case of the cup and 14 (11,2 %) in case of the stem. The survival rate after 14 years is 81,5 % in the acetabular cup and 95,2 % in case of the stem. Authors found out an increased number of THR failure after 12 years due to aseptic loosening of the acetabular cup. After the Kaplan-Maier curve the survival rate of THR after 4 years is 99 %, after 8 years 97 %, after 10 years 94 %, after 12 years 91 % and after 15 years 76 %. Linear polyethylene wear of the cup is on average 0,14 mm annually, and the volumetric one amounts to 189 cubic mm annually. Key words: THR, longterm results.
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PMID:[Longterm results of poldi hip replacement.]. 2047 42

The purpose of this study was to evaluate the effectiveness of routine pathological examination of operative specimens obtained during primary total hip arthroplasty (THA) performed for osteoarthritis (OA) and rheumatoid arthritis (RA). 100 consecutive patients (50 OA, 50 RA) were prospectively evaluated. A radiological score (Kellgren-Lawrence/Larsen) and a clinical score (Harris Hip Score) were calculated in each case. Specimens of bone and cartilage from the femoral head as well as capsule were obtained intraoperatively. A histological grading (Mankin score) was obtained, and additional histological findings were also reported. In patients with RA the clinical and pathological diagnoses were concordant in 37 (74%) and discrepant in 13 patients (26%). In patients with OA there was concordance in 30 (60%) and discrepancy in 20 patients (40%). Discrepancies were additional findings such as focal osteonecrosis amyloidosis or crystal deposits. Discordance (management alteration) did not occur in any case. Histological evaluation of the capsule and the synovium was more informative than evaluation of bone. Calcium pyrophosphate (CPPD) and amyloid was frequently found in OA suggesting that these substances may contribute to joint damage, and control of their production by therapeutic means may prevent degeneration.
Hip Int
PMID:The value of routine histopathology during hip arthroplasty in patients with degenerative and inflammatory arthritis. 2129 25

Rheumatoid disease can be extremely debilitating due to progressive joint destruction and multiple joint involvement. While there are varying results for THR in patients with RA, there is only one report of metal-on-metal resurfacing for rheumatoid patients with hip arthritis. We present preoperative and latest follow-up UCLA scores, SF-12 scores, HHS and range of motion in a series of 13 hips (10 patients). The patients experienced no complications associated with their resurfacing procedure and there have been no failures 3 to 13 years after surgery. Our results show that rheumatoid arthritis patients with hip involvement treated with metal-on-metal resurfacing can have extremely good outcomes.
Hip Int
PMID:Metal-on-metal hip resurfacing in rheumatoid patients. A report on thirteen hips with minimum 3 year follow-up. 2129 27

Pseudallescheria boydii infection of the hip joint was diagnosed 2.5 years after implantation of a prosthetic joint in a woman with rheumatoid arthritis. Cure was achieved with a 10-month course of voriconazole coupled with removal of the prosthesis and repeat surgical debridement. Pseudallescheria boydii is an environmental mold that can cause osteoarticular infection, most often not only after local trauma but also after local injections and surgical procedures. Hip involvement was rarely reported, and this is the first description of a prosthetic joint infection with Scedosporium sp.
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PMID:Pseudallescheria boydii infection of a prosthetic hip joint--an uncommon infection in a rare location. 2168 Oct 69

The aim of this study was to examine the frequency of amyloid deposition in patients with end-stage rheumatoid arthritis (RA) of the hip. The impact on the clinical situation and the RA severity regarding the inflammation was analyzed. Fifty patients with RA who consecutively underwent total hip replacement were prospectively evaluated. X-rays of the patients were analyzed radiologically (Larsen score) to quantify the radiological changes. A clinical score (Harris Hip Score) was preoperatively calculated from every patient. A laboratory set of inflammation markers (erythrocyte sedimentation rate, CRP, serum amyloid A-SAA, electrophoresis) was measured in every patient the day before the operation. Specimens of bone and cartilage from the femoral head and of the capsule were obtained from every patient intraoperatively for histological evaluation. A histological grading was performed. In patients with amyloid deposits, the subtypes were characterized immunohistologically. Ninety-two percent of the patients had raised SAA in the blood samples, but the only amyloid subtype was ATTR. No correlation was found for any other measured item, such as inflammation signs in the blood samples, the histological grading, the radiological or the clinical score. Amyloid plays a role in inflammatory joint destruction processes in RA with raised SAA values, but the amyloid deposits in the joint are of a different subtype. Thus, these amyloid deposits can be considered as minor pathologic significance. A correlation to the radiological and histological changes was ruled out by our study. As in degenerative arthritis, ATTR amyloid deposits may be an incidental finding in aged joints.
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PMID:Amyloid deposition in rheumatoid arthritis of the hip. 2178 21

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.
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PMID:Rheumatoid arthritis is associated with less optimal hip structural geometry. 2185 70

Girdlestone is one of the options for treating an infected hip arthroplasty (along with isolated antibiotics, debridement, and one or two-stage exchange). The choice must be based on a list of previous considerations. RESULTS OF GIRDLESTONE: Major differences among different series are reported in literature: from 13% to 83% of patients are satisfied with the result. Healing of infection is attained in 80% to 100% of patients, but figures are worse in special subsets (rheumatoid arthritis, enterococcal and methicillin-resistant infections, or when cement is retained). Pain is reported as severe in 16% to 33% of patients, moderate in 24% to 53% and mild in 76%, while only some authors refer to "satisfactory pain relief". Up to 45% of geriatric patients are unable to walk and only 29% walk independently. The literature reports Harris Hip scores from 25 to 64. INDICATIONS FOR GIRDLESTONE: Absolute indications: non-ambulatory patients because of other problems or diseases, and impossible reimplantation (2nd-stage surgery) (unacceptable anaesthetic or surgical risk, technical difficulties, patient rejection). RELATIVE INDICATIONS: Dementia (risk of dislocation vs. severely reduced walking ability), immunocompromise (up to what degree of immune impairment do we accept to take the risk?), intravenous drug abuse (how can you prove it?).
Hip Int
PMID:Girdlestone procedure: when and why. 2295 80


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