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

Osteolysis, which is considered to be a major source of morbidity following total hip joint replacement, has been notoriously difficult to measure accurately, particularly in the acetabular area. In order to study periacetabular osteolysis, specialized software for computerized tomography (CT) scan image analysis has been developed. This software (3D-CT) eliminates metal artifacts, allows three-dimensional segmentation of the CT image, and reconstructs the segmented image to provide an accurate representation and measurement of volume for osteolytic lesions. In the present study, 20 patients underwent periacetabular osteolytic volume determination using 3D-CT, functional assessment (using the Harris Hip Scale, the Western Ontario and McMaster University Osteoarthritis Index, and the short form 36 questionnaire), and two-dimensional analysis of volumetic polyethylene wear using digitalized plain films. Periacetabular osteolysis correlated directly with the polyethylene wear rate (relative risk [RR] = 0.494, P = 0.027). If one patient with an acetabular revision, one patient with recurrent dislocation, and one patient with a Biomet prosthesis are excluded, then the correlation between wear and osteolysis is improved (RR = 0.685, P = 0.002). In summary, the current study demonstrates both the feasibility of CT imaging of periacetabular osteolysis and the correlation between polyethylene wear and osteolytic volume, providing a potential outcome measure for clinical trials that are designed to examine interventions in this complex disease process.
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PMID:Volumetric computerized tomography as a measurement of periprosthetic acetabular osteolysis and its correlation with wear. 1187 38

Hip dysplasia is one of the most common disorders of the hip, presenting in the first three years of life. Literature has shown that an association exists between developmental dysplasia of the hip and the development of secondary hip osteoarthritis in early adulthood. Treatment options are directed toward relieving symptoms and delaying or preventing the onset of arthritis in the affected hip. Total hip arthroplasty is a surgical option, but has been associated with a high rate of failure in younger, physically active patients. This article discusses the Bernese periacetabular osteotomy procedure as a treatment modality, which restores coverage of the femoral head with the acetabulum. Changing the anatomy allows the surgeon to increase the surface area of the femoral head that bears the patient's weight. Increasing the weight-bearing surface may prevent further damage to the hip's cartilage and delay the onset of osteoarthritis.
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PMID:Bernese periacetabular osteotomy for hip dysplasia in young adults. 1196 71

The rationale of uncemented taper stems is based on fixation in the proximal portion of the femoral diaphysis, a self-locking principle, and a low modulus of elasticity. The aim of this study was to evaluate a collarless femoral component designed to be a three-dimensional taper for press-fit insertion with regard to clinical outcome, efficacy of fixation, incidence of osteolysis, and periprosthetic bone-remodeling. The first 48 consecutive patients (50 hips) with osteoarthritis who had had primary total hip arthroplasty using the Cerafit Multicone stem and the Cerafit Triradius-M press-fit cup with alumina-alumina pairing (Ceraver Osteal, Paris, France) were followed-up for a mean of 2.3 years (2 to 2.5 years). The mean age of patients at index operations was 52.5 years. Current criteria were used for clinical and radiological assessment. Quantitative evaluation of periprosthetic bone-remodeling was prospectively assessed using computed tomography. Clinical and radiological follow-up was obtained in all hips. Forty-nine hips (98%) were clinically rated good or excellent, one hip (2%) was rated fair, owing to a persisting limp. The mean preoperative Harris Hip Score was rated 62, and it has improved to 93.5 at the time of follow-up. One hip (2%) had marked postoperative thigh pain. This pain had disappeared at 3-month follow-up. All stems showed radiological signs of stable fixation by bone ingrowth. No stem required revision. Thirty-four hips (68%) had either no change in femoral bone density or only patchy loss of bone density isolated to Gruen zones 1 and 7. Sixteen hips (32%) had some reduction of bone density isolated to zone 1. Radiolucencies without progression were found in zones 1 and 7 in 3 hips (6%), and in zone 1 alone in 3 other hips (6%). A slight cortical hypertrophy was seen in 3 hips (6%). Twenty-three hips (46%) developed radiographic appearance of bone apposition at the stem tip as partial pedestal (19 hips) and as complete pedestal (4 hips). No signs of cup loosening were detected at follow-up. Twenty-four patients (25 hips) were eligible for computed tomography. The mean decrease of the overall bone mineral density in the metaphyseal portion of the femur one year after insertion of the stem was rated 15.4%, and the mean decrease of the cortical bone mineral density was rated 17.2%. On the other hand, a mean decrease of the cortical bone mineral density of less than 5% was observed in the diaphyseal portion of the femur around the implant. The clinical and radiological results of the Cerafit Multicone stem at a mean follow-up of 2.3 years are very promising and do not contrast with those achieved using other uncemented stems with tapered design. Furthermore, results of quantitative evaluation of periprosthetic bone-remodeling were considered satisfactory favourably with others reported in the literature using stems inserted without cemented.
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PMID:Clinical outcome and quantitative evaluation of periprosthetic bone-remodeling of an uncemented femoral component with taper design. A prospective study. 1202 51

Knee effusion is a common occurrence in elderly patients following hip surgery. We prospectively studied 106 patients undergoing proximal femoral surgery. These patients were examined pre-operatively, on days 4 and 8, and six weeks post operatively for the presence of an ipsilateral knee effusion. 71 patients had undergone Total Hip Arthroplasty (THA), 26 Dynamic Hip Screw (DHS) insertion and 9 had hemiarthroplasty. The incidence of pre-operative ipsilateral knee effusion was 13% (14 patients). 42% (44 patients) had an effusion at one week post operatively and 12% (13 patients) at 6 weeks. 57% (60 patients) of the study group had radiological evidence of osteoarthritis in their knees. However, the incidence of effusion in patients with and without arthritis was the same. The majority of these effusions resolved after six weeks with no residual effects.
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PMID:A prospective study for evaluation of knee effusion after hip surgery. 1209 94

Normal hip joint function is fundamental in running-, jumping-, and kicking-based sporting activities. Hip disorders do not account for a large portion of exercise-related injuries, but they can pose a clinical dilemma since symptoms tend to be non-specific. Conventional radiographs may demonstrate some causes of hip pain, such as stress fractures and degenerative joint disease. Magnetic resonance (MR) imaging of the hip has proven valuable in the diagnosis of radiographically occult osseous abnormalities and periarticular soft tissue disorders such as stress fractures, avulsion injuries, musculotendinous abnormalities, and bursitis. Conventional MR imaging has been less useful in the evaluation of intra-articular lesions including acetabular labral tears, intra-articular loose bodies, and cartilage lesions. The visualization of intra-articular structures and their abnormalities can be improved by the injection of diluted Gadolinium, which distends the capsule and leaks into labral tears. This article will focus on the use of conventional radiography and MR imaging in recreational and professional athletes with painful hip joints, and where possible it will compare MR imaging with other diagnostic modalities such as bone scan and CT.
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PMID:Imaging of hip disorders in athletes. 1211 25

Hip arthroplasty has become a common and still increasing procedure for the treatment of osteoarthritis, advanced head necrosis, post-inflammatory arthritis or rheumatoid arthritis. Radiography is the most important imaging modality for monitoring the normal, asymptomatic hip arthroplasty. Radiographs are obtained at the end of a surgical treatment, to exclude complications like fracture or component misplacement. In the follow-up radiographs are used for the diagnosis of loosening and infection of the hip arthroplasty as well as soft tissue ossification. Together with the history and clinical information, the analysis of morphological findings allows to find the grade of loosening. MRI has been advocated in the diagnosis of infection, in particular in the localisation of soft tissue involvement. Imaging, especially by radiographs, is used for the evaluation of the normal and complicated follow-up of hip arthroplasty.
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PMID:[Diagnostic imaging in hip prostheses]. 1214 8

A retrospective study was carried out to evaluate prophylaxis for heterotopic ossification (HO) about the hip joint post total hip arthroplasty (THA). Between 1990 and 1996, 20 patients with known risk for developing HO were treated prophylactically to prevent this complication. Patients at risk were divided into 3 groups based on risk factors for HO formation (previous ipsilateral hip HO formation, previous contralateral hip HO formation and bilateral hypertrophic osteoarthritis) Single fraction radiotherapy of 600, 700 or 800 cGy was administered postoperatively to all patients. The aim was to irradiate all patients within 72 hours of THA. 12 (60%) patients received in addition a short course of postoperative indomethacin for less than 13 days. Patients in this study were investigated for the following treatment variables: relative risk for forming HO, radiotherapy doses administered, time delays between surgery and irradiation, combined radiotherapy and indomethacin treatment versus radiotherapy alone, and surgical approach used for THA. Heterotopic ossification in patients was measured radiographically by use of the Brooker grading sytem, and was assessed clinically by use of the Harris Hip Score (HHS). A significant difference was found between relative risk groups (p = 0.02). Patients with previous HO formation in the ipsilateral hip joint were at greater risk of developing HO than those with previous contralateral HO formation. Moreover both of these groups were at greater risk than those with advanced bilateral hypertrophic osteoarthritis. Other variables studied showed differences that were not significant due to small sample numbers. This study, though limited by sample number, addresses questions regarding effective radiotherapy dosage, time delays acceptable before irradiation postoperatively, usefulness of short course postoperative indomethacin, and preferred operative approaches to minimise HO.
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PMID:Prevention of heterotopic bone formation in high risk patients post-total hip arthroplasty. 1246 61

To further develop the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC LK 3.0) for people with hip disability with or without hip osteoarthritis (OA), 52 subjects (median age 64 yrs, 35 women) answered a version of the Index with additional dimensions, twice, with a one-week interval. Reproducibility, percentage of zero scores (best possible scores), mean score of symptoms, and importance, were analyzed. This resulted in the Hip disability and osteoarthritis outcome score (HOOS LK 1.1), a 39-item questionnaire with five separate sub-scales. There were higher median scores (more symptoms) for three of HOOS sub-scales Pain, Activity limitations--sport and recreation, and Hip-related Quality of life compared to those in the WOMAC, improving the ability to assess change in patients over time. The HOOS appears to be an evaluative instrument for assessing important self-rated hip problems for people with hip disability with/without hip OA, but additional studies are needed.
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PMID:Hip disability and osteoarthritis outcome score. An extension of the Western Ontario and McMaster Universities Osteoarthritis Index. 1263 46

'Hip' pain is usually located in the groin, upper thigh or buttock and is a common complaint. Slipped capital femoral epiphysis, avascular femoral head necrosis and apophyseal avulsion are the most common diagnoses in childhood and adolescents. Strains and fractures are common in sport-active adults. Osteoarthritis occurs in middle-aged and older adults. Trauma may result in femoral head fracture or typical muscle and tendon sprains and bursitis. Septic or inflammatory arthritis can occur at every age. Septic arthritis, fractures and acute epiphyseal slipping are real emergency cases. Congenital dysplasia of the hip joint may lead to labral tears and early osteoarthritis. The most important hip problems in children, adolescents, adult and older people are discussed; these problems originate from intra-articular disorders and the surrounding extra-articular soft tissues. Medical history, clinical examination and additional tests, including imaging, will be demonstrated. Principles of treatment are given for specific disorders.
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PMID:'Hip' pain. 1265 22

Many elders suffer from chronic pain resulting from osteoarthritis (OA) of the knee or hip. This review identifies useful pain measures for assessing OA. Several disease-specific pain measures are discussed: Arthritis Impact Measurement Scales pain subscale, Western Ontario and McMaster University OA Index pain subscale, pain subscales of the Index of Severity for OA of the Hip or of the Knee, and Knee Pain Scale. Generic pain measures, the verbal descriptor scale, and the 21-point box scale, also are discussed. Because knee/hip OA is characterized by pain that is activated during or aggravated by certain activities, disease-specific pain scales that measure pain associated with these various activities are more effective than a generic pain scale.
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PMID:Disease-specific pain measures for osteoarthritis of the knee or hip. 1271 63


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