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

Hip dysplasia is a major cause of osteoarthrosis in adults. Early aggressive osteotomy has the potential of preventing the development of arthritis, but carries with it significant risks. The problem is further complicated because the surgeon has no means of quantifying the dysplastic deformity or of predicting what a particular combination of osteotomies would do to correct the deformity. This study describes methods of quantifying hip-joint geometry in three dimensions based on computed tomography and magnetic resonance studies, and of simulating pelvic osteotomy to correct the deformities. The study analyzes 49 normal hip joints and 20 dysplastic hip joints. The results show that the normal acetabulum is nearly a full hemisphere, which is anteverted 20 degrees and abducted 53 degrees. The normal lateral center-edge angle is 37 degrees. The dysplastic acetabulum is not anterolaterally maldirected, as has been assumed, but is globally dysplastic. Analysis of the individual dysplastic hip joints showed a wide variability. Some patients were deficient globally, some anterolaterally, and some posterolaterally. Methods of analyzing a patient's hip joint, quantifying abnormalities, simulating surgery, and predicting results are demonstrated in a case example.
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PMID:Acetabular dysplasia in the adolescent and young adult. 842 62

The authors compared seven radiologic indices of hip osteoarthritis to establish which provided the best definition of the disease for epidemiologic purposes. Hip joints were assessed from intravenous urograms taken in a British hospital between 1982 and 1987 in 1,315 men aged 60-75 years. The indices examined were an overall qualitative grading of osteoarthritis, four measures of joint space, the maximum thickness of subchondral sclerosis, and the size of the largest osteophyte. Minimal joint space (i.e., the shortest distance between the femoral head margin and the acetabulum) was the index most strongly associated with other radiologic features of osteoarthritis. Among a subset of 759 men who answered a questionnaire about symptoms, the overall qualitative grading, minimal joint space, and thickness of subchondral sclerosis were the radiologic indices most predictive of hip pain. Within- and between-observer repeatability were tested in a subset of 50 subjects. Measures of joint space were more reproducible than other indices. These data suggest that, at least in men, minimal joint space is the best radiologic criterion of hip osteoarthritis for use in epidemiologic studies.
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PMID:Defining osteoarthritis of the hip for epidemiologic studies. 238 55

Four-hundred and forty patients who presented for Total Hip Replacement to the Orthopaedic Hospital, Cappagh were included in this study. Each case was classified into radiographic and aetiologic groups on the basis of the patients history, the results of special investigations, and the radiographic appearance of the hips. This classification allowed a further differentiation into primary and secondary osteoarthritis. Primary or idiopathic osteoarthritis was the single most common aetiologic group. A surprisingly high percentage of patients with secondary osteoarthritis had congenital dysplasia. It is suggested that this faulty biomechanical situation is the initiator of subsequent joint degeneration due to stress loading on the supero-lateral border of the hip. The reasons why such changes may be delayed until the 6th and 7th decades are unclear but degeneration once started progresses quickly. The possible place of surgical correction of the underlying biomechanical fault in delaying or preventing the onset of osteoarthritis is demonstrated and discussed.
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PMID:The aetiology of degenerative disease of the hip. A review of 400 cases. 266 69

Fourteen hip arthroscopies between January 1985 and May 1988 were reviewed. Included were ten women and four men with an age ranging from 12 to 76 years. Indications were avascular necrosis; loose bodies; osteoarthrosis, arthritis, or pain; and snapping hip. The diagnosis was verified in five cases, including arthroscopic removal of a loose body in one and resection of a plica bridging the space between the femoral head and acetabular roof in two patients. The diagnosis was rejected in three cases. In five cases, no pathologic changes were found. One arthroscopy was inconclusive because of a narrow field of vision in a dysplastic hip. No serious complications occurred. Hip arthroscopy is useful in diagnostics and surgical treatment of selected hip disorders. The rehabilitation time is short. Hip arthroscopy is, however, a technically demanding procedure.
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PMID:Arthroscopy in diagnosis and treatment of hip disorders. 271 Jul

Hip subluxation occurs in 4% to 5% of Down's patients; adulthood coxarthrosis may result. Eight total hip replacements were performed in five Down's patients (ages 37 to 64 years) for painful coxarthrosis. The patients were followed for a mean of 4.3 years. The hip scores improved from an average of fair preoperatively to excellent postoperatively, with a Harris hip score of 92. All of the patients demonstrated clinical improvement and were cared for more easily by virtue of the procedure. There were no major complications. Total hip replacement should be considered a useful surgical option for the treatment of hip osteoarthritis in patients with Down's syndrome.
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PMID:Total hip replacement in Down's syndrome. 295 47

Heterotopic bone formation after total hip arthroplasty is a common occurrence in patients with osteoarthritis, and severe amounts of ectopic bone may limit motion or cause pain. Diphosphonates have been suggested as a method of preventing ectopic bone formation, but no long-term clinical evaluation of their effectiveness has been published. Because patients with osteoarthritis appeared to respond well to diphosphonate therapy in an earlier study, we thought that they would be an appropriate group of patients to study. We evaluated the results of 177 patients with 200 total hip arthroplasties performed for primary osteoarthritis. Considerable postoperative heterotopic bone formation (classes III and IV according to the classification system of Brooker and associates) was found in 36 hips (18%). The incidence of heterotopic bone formation was found to be as high as in the patients who had received either a placebo or no drug therapy. The postoperative range of motion of the hips, as well as ratings for pain, walking, and function, did not differ significantly between the treated and untreated groups. Diphosphonates (EHDP) have been demonstrated to inhibit the growth of hydroxyapatite crystals in vitro by chemisorption onto the crystal surface and thus have been thought to have the potential of preventing pathological calcification in vivo. However, diphosphonates have no inhibitory effect on the formation of osteoid matrix, and the delay in mineralization of matrix is reversed when therapy is discontinued. Although this delay in mineralization was known at the onset of these clinical trials, we hoped that the ultimate amount of heterotopic bone would be less in the treated patients and that the range of motion would be improved as a result of delaying the process of mineralization. Unfortunately, the final range of motion in the diphosphonate-treated patients did not differ significantly from that in the untreated group, and the final amount of heterotopic ossification was not reduced. Therefore diphosphonate therapy must be considered ineffective.
Hip 1987
PMID:Prevention of heterotopic bone formation: clinical experience with diphosphonates. 310 7

Diagnostic and operative arthroscopies of the hip joint have been performed from an anterior approach after extension of the joint. The force needed to achieve a sufficient visualization of the hip joint was studied. In an anesthetized patient 300 Newtons (N) to 500 N was required, whereas up to 900 N was needed in an unanesthetized subject to achieve sufficient joint extension. Hip arthroscopy has been performed with a standard 5 mm Storz arthroscope. Alternatively, fluid and gas was used. It was possible to achieve good visualization of the anterior parts of the hip. Gas gave better information about the degree of degenerative arthritis while fluid was preferable for operative arthroscopy, eg, arthroscopic synovectomy. Synovial biopsies, removal of loose bodies, and partial arthroscopic synovectomy have been performed. The advantage was a very short time of rehabilitation. No serious complications occurred.
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PMID:Diagnostic and operative arthroscopy of the hip. 396 Jul 59

Bursae or abscess cavities communicating with the hip joint were demonstrated by hip arthrography or by computed tomography (CT) in 40 cases. The bursae or abscess cavities were associated with underlying abnormalities in the hip, including painful hip prostheses, infection, and inflammatory or degenerative arthritis. Structures communicating with the joint capsule included iliopsoas bursae (13 cases), bursae associated with the greater trochanter (21 cases), ischiotrochanteric bursae created by abnormal articulation between the ischium and lesser trochanter (two cases), and abscess cavities not associated with a bursa (four cases). Symptoms may be produced directly as a result of infection or indirectly as a result of inflammation or pressure on adjacent structures. In cases of suspected infection, direct puncture and aspiration of the bursa or abscess cavity, in addition to joint aspiration, may be necessary to obtain organisms for culture as joint aspiration may not yield fluid. Hip arthrography can confirm a diagnosis of bursae and abscess cavities communicating with the hip joint in patients with hip pain or soft-tissue masses around the groin. Differentiation of enlarged bursae from other abnormalities is important to avoid unnecessary or incorrect surgery.
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PMID:Bursae and abscess cavities communicating with the hip. Diagnosis using arthrography and CT. 401 91

Hip arthroplasty using a bipolar prosthesis was performed in 73 patients (75 hips) with femoral neck fracture, osteoarthritis, rheumatoid arthritis, or degenerative arthritis. Bipolar hip arthroplasty is more conservative than conventional total hip arthroplasty, because methyl methacrylate usually is not needed to fix the bipolar prosthesis to bone. Overall results were 67.1% good to excellent, 20.5% fair, and 12.3% poor; among the arthritic patients, the results were 72.9% good to excellent, 19.1% fair, and 8.5% poor. Complications included one deep wound infection and one arterial embolus; no dislocations occurred.
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PMID:Experience with the bipolar prosthesis in hip arthroplasty. A clinical study. 409 86

Between Jan. 1, 1976 and Dec. 31, 1981, 257 patients (age range from 21 to 65 years) with osteoarthritis of one or both hips were treated with ceramic hip replacement (Mittelmeier type). The cause of the osteoarthritis was variable. Hip replacement was carried out for the following conditions: rheumatoid arthritis including ankylosing spondylitis, aseptic necrosis of femoral head including post-traumatic and idiopathic forms, osteoarthritis of unknown origin, osteoarthritis following dysplasia or subluxation of the hips and loosened cemented hip prosthesis. The operative technique is described. Full weight bearing is not permitted for 16 weeks postoperatively, but mobilization and isometric exercises begin 2 days after operation and isotonic exercises are introduced later. Complications included fracture of the femoral shaft during operation, fracture of the acetabulum, protrusion, dislocation and infection early after operation (within 16 weeks) and aseptic loosening and pulmonary embolism (after 16 weeks). The results with this new type of hip replacement are encouraging. Good results based on patient satisfaction were obtained in 79% and poor results in 13%.
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PMID:Uncemented total hip replacement. 662 46


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