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

Four hundred consecutive hip fractures were studied prospectively. Two hundred forty-seven patients were classified as unhealthy (poor cardiac status, pneumonia, cancer history, bowel obstruction history, malnutrition, dehydration, stroke history, renal failure history, cirrhosis). Twenty-two percent of this unhealthy group died, while only 6% of the remaining healthy group died. Death rates varied with admission activity level and mental status but not when patient health status was factored out. After factoring out health status, age was associated with higher death rates only in patients older than age 85. Confusion, a change of mental status in the hospital, occurred in 25% of patients. Confusion was associated with a medical complication in 94% of cases, was the presenting symptom of a medical complication in 79% of cases, and was associated with a 39% death rate. Major medical complications occurred in 9% of the healthy group (29% of them died) and 21% of the unhealthy group (64% of them died). Major medical complications in unhealthy, shut-in patients were associated with an 80% death rate. Vigorous urinary tract monitoring and early treatment of bacteriuria decreased death rate. Postfracture malnutrition was associated with higher complication rates. Hip surgery performed within 72 hours on patients with acute medical illnesses in addition to their fracture was associated with a higher death rate. Whether a patient walked postfracture seemed not to be correlated with the death rate. Patients who were not walking prefracture but treated by internal fixation had a 34% failure rate.
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PMID:Hip fracture mortality. A prospective, multifactorial study to predict and minimize death risk. 161 47

At the orthopedic departments in Sweden, the hip fracture patients continuously occupy up to one third of the bed resources. Hip fractures in Sweden consume more hospital days than all the cancer patients together. In the middle of the 1980s, the annual number of hip fractures amounted to 6,500 in Denmark, 4,500 in Finland, 260 in Iceland, 6,000 in Norway and 14,000 in Sweden. The calculated number of hip fractures in the year 2000 is dependent on if the prognosis is based solely on the increasing number of elderly in the population or if also the increasing incidence during the last decades is included. An increase up to the year 2000 of 50-100 percent is prognosticated for Scandinavia. The proportions cervical/trochanteric fractures varies. In Norway and Sweden it is close to 1/1, whereas Iceland and Finland have more cervical than trochanteric fractures. In Iceland, however, trochanteric fractures are increasing. Finally, in all of Scandinavia, 3 out of 4 hip fracture patients are women.
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PMID:Optimal treatment of hip fractures. 201 39

Hip and pelvic injuries are relatively rare in the young athlete. Contusions and musculotendinous sprains are the most common injuries about the hip and pelvis. Apophyseal avulsion fractures and stress fractures are the most frequently encountered skeletal injuries. Each of these entities can be successfully treated with guided physical therapy following conservative management with rest, anti-inflammatory medications, and ice massage until the patient is pain free. Epiphyseal, diaphyseal, or pathologic fractures are rare entities that are secondary to violent trauma. These injuries are severe and often require operative intervention. Femoral neck fractures have a high rate of complications from avascular necrosis, nonunion, or malunion. Pelvic fractures have frequent associated genitourinary, abdominal, neurologic, and musculoskeletal injuries. Pathologic fractures are most commonly secondary to benign lesions, such as unicameral bone cysts, and less likely owing to malignancy. Finally, in children with hip pain during athletic activities, even with antecedent trauma, the sports clinician must screen for slipped capital femoral epiphysis, Perthes' disease, congenital subluxation of the hip, toxic synovitis, systemic neoplasia, or infectious process.
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PMID:Hip and pelvic injuries in the young athlete. 304 59

In 12 patients with acetabular metastases, we reconstructed the hip with a support ring, cement, and Charnley prosthesis with a 22 mm head. There were no immediate postoperative deaths or cardiovascular complications. Dislocations occurred in 5 patients, 1 of whom required open reduction. At follow-up, 3 patients were alive 11, 15, and 18 months after surgery. 9 patients died after 8 (2-13) months. All patients obtained relief from pain, became ambulatory and were discharged to their homes. 1 patient had rapid disease progression with pathologic fracture and cranial dislocation of the support ring. Among the remaining 11 patients, the hip has not again caused pain or limited function. There were no signs of loosening, except in the patient with fracture of the hemipelvis. Remineralization was observed in 2 breast cancer patients after chemotherapy. Hip reconstruction can restore painless function until death in cancer patients with severe destruction of the acetabulum.
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PMID:Reconstruction in metastatic destruction of the acetabulum. Support rings and arthroplasty in 12 patients. 894 45

A majority of hip disarticulations are performed in young people, with malignancy being the most common cause. The exoskeletal Canadian Hip Disarticulation prosthesis had been widely used as a standard total hip disarticulation prosthesis until recently when an endoskeletal modular version became the prosthesis of choice. However, the "basket-shaped" socket provided by the standard total hip disarticulation prostheses has been a source of discomfort and a reason for prosthetic rejection by many patients. This report concerns two patients with true lower limb disarticulation at the hip joint. Both of the patients failed to adapt to the standard total hip disarticulation prosthesis but successfully used a new total contact suction socket design. This new prosthesis provided improved suspension, better patient compliance, and enhanced prosthetic acceptance and mobility.
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PMID:Total hip disarticulation prosthesis with suction socket: report of two cases. 1008 92

Although gender differences in fall rates may partly explain the higher prevalence of fractures in elderly women than men, male bones may also be intrinsically stronger or suffer less structural degradation with age than those of women. We used hip structural analysis (HSA) to study gender differences in hip geometry and bone mineral density (BMD) as they evolved over time in elderly white men and women with the aim of identifying candidate biological pathways leading to heightened risk of hip fracture. We recruited 443 women and 439 men aged 67-79 years from a diet and cancer prospective population-based cohort study to a study of hip bone loss. Hip BMD was measured on two occasions 2-5 years apart by dual-energy X-ray absorptiometry and HSA software used to derive BMD and structural parameters at the narrow neck (NN), the intertrochanter (IT), and the shaft (S) regions. Structural indices calculated in each region were cross-sectional area (CSA)-amount of bone surface area in the cross section after excluding soft tissue space; section modulus (Z)-an index of bending resistance, subperiosteal width, endocortical width, cortical thickness; and cortical buckling ratio (CBR)-a measure of cortical instability. Compared to men, women had lower values of BMD, CSA, Z, subperiosteal width, endocortical width, and cortical thickness in all regions, except S endocortical width, after adjusting for weight, height, and age (P < 0.0001). CBR was higher in women than in men (P < 0.0001) in all regions. Longitudinal analysis of rates of change revealed faster rates of BMD decline in women than in men at the Hologic total hip, Hologic femoral neck, and IT regions (P < 0.029). Women had faster rates of subperiosteal and endosteal expansion than men at the NN (P < 0.011) and IT (P < 0.049) and faster increase in Z at the NN (P = 0.029). At the IT region, cortical thinning was faster in women than in men (P = 0.037) and CBR increased at a faster rate in women (P = 0.011). In conclusion, Z is lower in women than in men and expansion of the proximal femur occurs in both sexes, being faster in women than in men. Z does not decline at the same rate as BMD, implying that part of the effect of aging on BMD is due to expansion of the bony envelope without loss of bone mineral content. Faster expansion in the female femoral neck may in turn lead to greater fragility if wider diameter and thinner cortices become locally unstable.
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PMID:Effects of gender, anthropometric variables, and aging on the evolution of hip strength in men and women aged over 65. 1275 73

The purpose of this study was to evaluate the results and complications of hip arthroplasty done for salvage of failed treatment of pathologic proximal femoral fractures secondary to malignancy. Between 1980 and 2000, 42 patients with a mean age of 63 years were treated with hip arthroplasty to salvage failed treatment of a pathologic proximal femoral fracture. Total hip arthroplasty was done in 16 patients (3 uncemented, 2 hybrid, 11 cemented), and bipolar hemiarthroplasty in 26 (2 uncemented, 24 cemented). A modular, proximal femoral replacement construct was used in 15 patients. Patients were followed a mean of 5.8 years (range, 15 days-20 years). Four hips required reoperation, all for deep infection. Harris Hip score improved from an average of 42 points (range, 17-76 points) preoperatively to an average of 83 points (range, 52-100 points) postoperatively. Most recent radiographs showed femoral component loosening in only one patient. Implant survivorship free of revision for any reason at 5 years was 90% (range, 65-96%) and free of revision for aseptic failure or radiographic failure was 97% (range, 64-99%). Hip arthroplasty is an effective treatment for salvage of failed treatment of pathologic proximal femoral fractures. Modular proximal femoral replacements were often required. The most concerning complication was deep prosthetic infection, which occurred in nearly 10% of this patient population, and in 21% of patients with prior irradiation.
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PMID:Complications and results of arthroplasty for salvage of failed treatment of malignant pathologic fractures of the hip. 1555 36

The metal-on-metal articulations in total hip arthroplasty (THA) were widely used between 1960 and 1975. The McKee-Farrar and other first-generation prostheses failed at a high rate because impingement caused early component loosening. The problem of early component loosening was corrected by improved component design and better manufacturing quality. Second-generation metal-on-metal total hip replacements have experienced short and medium-term success as assessed by Harris Hip Scores and patient self-assessment. The combined annual linear wear of the metal-on-metal femoral head and acetabular insert is less than 10 mm and osteolysis has only rarely been observed in association with well-fixed metal-on-metal total hip replacements. Hypersensitivity is not a common cause of loosening with second-generation hip replacements and remains to be proven as a definitive diagnosis in unusual cases of unexplained pain. More than 40 years of use has demonstrated no increase in the incidence of renal failure or cancer in patients with metal-on-metal total hip replacements. The scientific evidence of the results using the metal-on-metal articulations would recommend its continued use in any patient who does not have compromised renal function.
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PMID:The clinical performance of metal-on-metal as an articulation surface in total hip replacement. 1608 65

Heat-shock protein 90 (HSP90) has diverse functions in mammalian cells. It acts as molecular chaperone, together with several co-chaperone molecules (such as Hop, Hip, p23, cdc37, Aha, and immunophilins). HSP90 binds to its client proteins (such as steroid receptors, AKT, Bcr-Abl, Apaf-1, survivin, cyclin dependent kinases which are involved in signal transduction that regulate cell cycle, survival, and death, and promote their proper protein folding, assembly, and transportation across different cellular compartments. Failure of Hsp90 chaperone activity leads to misfolding of client proteins, which leads to ubiquitination and proteasome degradation, and this deregulating cellular homeostasis. Since tumor cells frequently overexpress the active form of HSP90, which is more susceptible to inhibition by small molecules such as geldanamycin and its analogs, HSP90 became an attractive target for cancer therapy. This paper will review the recent advances in HSP90-biology and will discuss the emerging role of the HSP90 inhibitors such as 17-allylamino-17 demethoxy-geldanamycin and other HSP-90-directed small molecules in cancer therapy.
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PMID:Heat-shock protein 90 inhibitors in cancer therapy: 17AAG and beyond. 1655 99

Background. Proximal femur defects resulting from tumor resections can be repaired with various types of hip endoprostheses. Major surgical procedures involving muscle detachments and extensive endoprosthesis implantation are prone to deep infections and the hip instability. The purpose of our study was to assess the outcome of hip prosthesoplasty after resection of large tumors from the proximal femur. Material and methods. Over the last 5 years, 49 patients have undergone hip prosthesoplasty after tumor resection in the proximal femur for 37 bone metastases and 12 primary neoplasms during the last 5 years. Three total megaprostheses were used, as well as 34 conventional long stem endoprostheses, including 26 bipolar and 12 Austin Moore prostheses. Results. Two patients died shortly after surgery, and another 4 were nonambulatory due to diffusion of the cancer. There were 3 cases of endoprosthesis luxation, 1 deep implant infection and 1 metastasis recurrence. We had 28% excellent functional outcomes and 60% good; the latter were complicated by Trendelenburg gait. Conclusions. Hip instability is the most common complication in prosthesoplasty after tumor resection in the proximal femur.
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PMID:Results of the megaprosthesis replacement reconstruction proximal femoral resection bone tumors. 1761 20


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