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

Between 1978 and 1994, 130 deaths after hip fractures were investigated at the Institute of Forensic Medicine of the Free University of Berlin. In this period more than 3500 such cases occurred in Berlin. Eight persons were found dead at home, 17 had conservative treatment or died before the planned operation, and 105 had an operation. Hip replacement was carried out in 49, nailing in 17, and other kinds of osteosynthesis (especially using screws) were used in 39 cases. In the surgically treated group, death occurred during the operation in 6 cases (all hip replacements), on the day of operation or the first postoperative day in 7 cases, and within the first week in 21 cases. In the conservative group 10 cases died during the first week after trauma. The main, clearly detectable causes of death were pneumonia (30) and thromboembolism of the lungs (22). Fat embolism was responsible for death in at least 6 cases (3 intra- and 3 postoperative); in 2 additional intraoperative and 7 early postoperative deaths, a potentially lethal fat or bone marrow embolism occurred together with other deadly factors. A fat embolism was present in 9 cases within the first week, diminishing with survival time. Hip replacement was clearly dominant for the genesis of pulmonary fat embolism: in none of the early post-endoprosthetic deaths was there little or no fat embolism in contrast to the other types of operation. Bone marrow embolization can induce the formation of multiple small, red intravenous thrombi-possibly a factor explaining the lethal outcome in only a few cases with intraoperative fat embolism. This form of "thromboembolism" must be differentiated from typical lung thromboembolism, originating from a preceding venous thrombosis.
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PMID:[Significance of pulmonary fat embolism in intra- and early postoperative fatal cases following femoral fractures of the hip region]. 775 44

We report a rare complication during primary total hip arthroplasty. A fatal fat pulmonary embolism immediately followed removal of the femoral head, prior to further preparation of the acetabulum or femoral shaft. Fat embolism syndrome is a well-known complication during total joint arthroplasty, usually attributed to preparation of the femoral shaft, particularly intramedullary reaming and insertion of the prosthesis. These risk factors have previously been identified in the literature. We believe that this case highlights the need for further research to establish the intramedullary pressures during the processes of dislocation and resection of the femoral neck and the attendant risk.
Hip Int
PMID:Fatal fat embolism following femoral head resection in total hip arthroplasty. 1909 14

Fat embolism during total joint arthroplasty or intramedullary procedures is well documented and is infrequently fatal. Considerable morbidity is associated with fat embolism syndrome, and post operative cognitive dysfunction is frequently seen, yet the exact pathophysiology remains unclear. Intraoperative cerebral microemboli can be detected using transcranial Doppler ultrasound and moreover the presence of a patent foramen ovale (PFO) may be examined for using a validated technique employing this modality. Persistent patent foramen ovale may act as a conduit for embolic material to traverse from the venous to the systemic circulation and consequently affect cerebral function. We wished to 1) investigate the incidence of cerebral microembolisation during primary hybrid total hip arthroplasty and compare this with hip resurfacing, 2) examine the influence of patent foramen ovale on cerebral microembolisation and 3)assess the influence of cerebral microemboli on the outcome of patients undergoing these procedures. We prospectively compared 12 patients undergoing hip resurfacing with 12 patients undergoing hybrid total hip replacement (THR) for the incidence and load of intraoperative cerebral microemboli, using transcranial Doppler. All patients were tested for the presence of a patent foramen ovale using a validated technique. Outcome was assessed using the WOMAC, Harris Hip Score, Oxford Hip Score and EuroQoL quality of life measure. No patient in the hip resurfacing group demonstrated intra-operative cerebral microembolisation. Five patients in the THR group showed transcranial Doppler evidence of microemobli during the procedure. With the small numbers of patients available, there was not a significant difference in microemboli load between the groups (p = 0.09). There was no significant difference between the groups regarding the incidence of PFO (p = 0.78). There was no significant relationship between the incidence and total microemboli load and the incidence of PFO (p = 0.56). There was no significant difference in outcome at six months between patients who demonstrated microemboli and those who did not. The incidence of cerebral microembolisation during hip resurfacing appears to be very low. Although our study demonstrated cerebral microemboli in a significant proportion of patients undergoing primary hybrid THR, the numbers of microemboli were low and the presence of a patent foramen ovale did not influence microemboli incidence or load. Finally, patients who demonstrated cerebral microemboli did not have a worse outcome than patients who did not.
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PMID:Intra-operative cerebral microembolisation during primary hybrid total hip arthroplasty compared with primary hip resurfacing. 1999 81

We describe the first case of clinically significant neurological manifestations of the fat embolism syndrome in the absence of both patent foramen ovale and cardiopulmonary resuscitation during hip hemiarthroplasty. This is an important differential diagnosis in postoperative neurological dysfunction requiring high index of suspicion. Management is supportive.
Hip Int
PMID:Cerebral fat embolism following hip hemiarthroplasty in the absence of a patent foramen ovale with almost complete resolution. 2461 69