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

Hip disarticulation, especially in patients with peripheral vascular disease, has been associated with high morbidity and mortality rates. This report describes patient characteristics that influence the clinical outcome of hip disarticulation. The medical records of all patients undergoing hip disarticulation from 1966 to 1989 were reviewed for surgical indication, perioperative wound complications, and postoperative deaths. Fifty-three patients underwent hip disarticulation for limb ischemia (10), infection (12), infection and ischemia (14), or tumor (17). The overall incidence of wound complications was 60%, and no significant differences were found among the groups. Prior above-knee amputation and urgent/emergent operations were significantly associated with increased wound complications (p less than 0.05). The overall mortality rate was 21%, ranging from 0% (tumor) to 50% (ischemia) and differed significantly among the groups (p less than 0.02). Mortality was significantly associated with urgent/emergent operations (p less than 0.01). Age, diabetes mellitus, and previous inflow procedures did not influence mortality rates. The presence of limb ischemia influenced mortality rates to a greater extent than did infection, and a history of cardiac disease was statistically predictive of death. Wound complications frequently accompanied hip disarticulation, regardless of operative indication, and were significantly increased by urgent/emergent operations and prior above-knee amputation. Hip disarticulation can be performed with low mortality rates in selected patients. Both limb ischemia and infection substantially increase operative mortality rates.
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PMID:Hip disarticulation: factors affecting outcome. 188 Aug 49

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

Salvage of severely compromised, deficient, and insufficient acetabula associated with failed total hip arthroplasty, nonunited or malunited acetabular fractures, and metastatic tumor can be accomplished with the bipolar prosthesis. The procedure must be regarded as a salvage procedure, providing the patient with limited functional capabilities. All patients are prescribed permanent external support, even though some have refused to use it. This procedure is usually done by means of a transtrochanteric approach and frequently requires bone grafting. The acetabular component is fitted as tightly as possible, consistent with complete seating, stability, and rim or equatorial fit, and, in my opinion, holds and molds the bone grafts. The procedure is far more acceptable and gives a much more functional result than a Girdlestone resection. If necessary, a standard total hip arthroplasty acetabular component could be inserted after graft incorporation, fracture healing, or both.
Hip 1984
PMID:Salvage of acetabular insufficiency with bipolar prostheses. 652 73

The administration of radiation to prevent heterotopic bone formation after total hip arthroplasty has been highly successful in this prospective study. It was extremely effective in high-risk patients, including those with preexisting heterotopic ossification. No early deleterious effects were noted. Long-term follow-up is planned to observe for late tumor induction. No wound complications were encountered. Trochanteric nonunions did occur and may be in part related to the radiation. This study demonstrated the importance of the early initiation of treatment. Ninety-eight percent of high-risk patients who began treatment on the second to fourth day postoperatively were free of heterotopic bone after surgery. Meticulous technique is always employed to eliminate debris in the surgical wound, and soft tissues are handled carefully. The search continues for a more complete explanation of the pathogenesis of heterotopic bone formation. A current study has been constructed to demonstrate the minimum dose of radiation that will continue to be effective. Further evaluation of methods to more accurately identify the high-risk patient continues. The effectiveness of radiation therapy in the prevention of heterotopic bone following total hip replacement has been shown.
Hip 1982
PMID:Radiation therapy in the prevention of heterotopic ossification after total hip arthroplasty. 682 16

Forty-six patients who had undergone excision of one or more well defined hip and/or thigh muscles because of a soft-tissue tumor or a tumoriform lesion were investigated with respect to the function of the operated limb and the isometric and isokinetic strength of the affected motion or motions, relative to the non-operated side (percentage). Hip flexion: Loss of the iliopsoas caused slight impairment of function. The flexion strength decreased with increasing flexion of the hip joint. Loss of the rectus femoris reduced the isometric strength by 37 and the isokinetic strength by 17 per cent. Hip abduction: The strength reduction was only about 50 per cent and the impairment of function only slight or moderate even in patients with extensive loss of abductor muscles. Hip adduction: Removal of all three prime adductors (longus, brevis, magnus) caused a strength reduction of about 70 per cent but the impairment of function was only slight or moderate. Hip extension: Loss of the gluteus maximus caused only a small strength reduction and no impairment or only slight impairment of function. Significant strength reduction was only seen when all hamstrings had been removed. Knee extension: Loss of one, two, and three of the quadriceps muscles reduced the isometric strength by 22, 33, and 55 per cent, respectively. The isokinetic strength was reduced somewhat more. The strength reduction usually had to exceed 50 per cent to cause more than slight impairment of function. Knee flexion: Loss of the semitendinosus, the biceps femoris, and all the hamstrings reduced the isometric strength by 24, 28, and 67 per cent, respectively. The isokinetic strength was reduced somewhat less. Loss of one of the hamstrings usually caused no impairment of function whereas loss of all three resulted in moderate impairment of function.
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PMID:Function after removal of various hip and thigh muscles for extirpation of tumors. 731 31

Thirty-one cases of endoprosthetic proximal femoral reconstruction after resection for bone tumors are reported. The minimum follow-up period was 2 years (average, 63 months). There were two local recurrences, two deaths from pulmonary metastases, two postoperative infections (1 superficial and 1 deep), both responding to therapy, one postoperative dislocation of a bipolar endoprosthesis, and two cases of loosening of acetabular cups on the same patient. Clinical results (Enneking grade) showed 27% E, 56% G, 14% F, and 3% P. Diaphyseal remodeling results (Rizzoli grade) were 29% A, 6% B, 49% C, 10% D, and 6% E. Anchorage (International Society of Limb Salvage grade) was assessed as 97% E and 3% F, whereas interface (International Society of Limb Salvage grade) was 100% E. Hip (bipolar) articulation was graded as 30% E, 56% G, 11% F, and 3% P. Initial rigid stabilization of the stem with cross-fixation screws allows for excellent bone ingrowth, but presents the problem of proximal cortical atrophy. Bipolar hip components are easy to insert and offer greater inherent stability and so are to be recommended for use in tumor surgery. The results suggest good medium- to long-term results with respect to wear. A new radiographic grading system is presented for bipolar arthroplasty. Survivorship of the femoral component in this series is 100% at a maximum follow-up period of 8 years.
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PMID:Prosthetic reconstruction of the proximal femur after resection for bone tumors. 767 7

A male patient aged 69 years suffering from Paget-coxarthrosis with a large distension of the proximal femur was implanted a cementless tumor reconstruction system. The surgical procedure consisted of opening of the femoral shaft with a special drill, insertion of the prosthesis and its anchorage within the healthy distal bone. By this method we were able to save the femoral muscle insertion planes. Twenty-eight months postoperatively the patient is pain-free and very satisfied with the outcome. The X-rays show a good fit of the prosthesis. The Harris Hip Score is now 90.1 points as compared to 46.4 points preoperatively.
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PMID:[Paget's coxarthrosis. Implantation of a modular tumor reconstruction system. Case report]. 794 88

Hip-Arg-Phe-, Hip-Phe-Arg- and Hip-His-Leu-cleaving dipeptidyl carboxypeptidase activities were measured in the supernatant (S2) and pellet (P2) fractions obtained by ultracentrifugation of human adrenal tumor preparations. Negligible enzyme activity was found in cortical tumor whereas highly significant activities were present in the P2 fractions of the two pheochromocytoma specimens. The hydrolysis rates, expressed in terms of the percent of added substrate were 58-66%/60 min for Hip-Phe-Arg, 55-58%/60 min for Hip-Arg-Phe and 19-30%/60 min for Hip-His-Leu. The angiotensin-converting enzyme inhibitor, captopril, differentially inhibited the enzyme splitting Hip-His-Leu versus the one cleaving Hip-Arg-Phe; Hip-Phe-Arg is probably the substrate of both. It is concluded that the Hip-Arg-Phe-cleaving enzyme in adrenomedullary tumor is probably identical to the purportedly novel dipeptidyl carboxypeptidase that we detected earlier in rabbit ear artery wall, which converts (Met5)-enkephalin-Arg6,Phe7 to (Met5)-enkephalin.
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PMID:Hip-Arg-Phe-, Hip-Phe-Arg- and Hip-His-Leu-cleaving dipeptidyl carboxypeptidases in human adrenal tumors. 957 25

Between 1980 and 1997, we treated 39 patients (mean age 39 (16-66) years, 24 men) with megaprosthetic replacement of a large bone defect (> 10 cm) of the pelvis. The bone resection was necessary in 38 cases due to malignant bone and soft tissue tumors and in 1 case due to hydatid disease. Polyacetal hemipelvic replacement was performed in 29 cases, CAD hemipelvic replacement in 8 cases, and a saddle prosthesis was inserted in 2 cases. All patients were followed clinically and radiographically. The mean follow-up was 58 (15-110) months. 20 patients have died of their tumor. 10 local infections occurred, in 2 cases necessitating hemipelvectomy. Hip dislocation occurred in 6 cases. 13 of the remaining 17 survivors had good or excellent clinical results according to the Enneking evaluation (MSTS). In 6 of the 17 survivors, radiographs revealed implant loosening.
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PMID:Megaprosthetic replacement of the pelvis: function in 17 cases. 1056 64

The authors describe a free-functioning latissimus dorsi muscle transplantation for reconstruction of hip abduction. A radical "buttockectomy" was performed on a 62-year-old patient with recurrent soft-tissue sarcoma. The patient received a muscle transplantation immediately after resection of the tumor. Until recovery of the muscle, a complete absence of hip abductors resulted in a marked lurch in the patient's gait, requiring him to use walking aids. Reinnervation of the muscle was confirmed via electromyography 6 months after surgery. Hip abduction was restored along with muscle recovery, and walking support was no longer required. Although the strength of the muscle was not sufficiently powerful to overcome gravity fully, the latissimus dorsi muscle improved markedly the performance of an otherwise unstable hip. This patient demonstrates that microsurgical reconstruction is of great value in enhancing the functional outcome of a salvaged limb after tumor surgery.
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PMID:Reconstruction of hip abduction using free muscle transplantation: a case report and description of the technique. 1094 47


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