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

Quality of life outcome and patient satisfaction after total hip arthroplasty are complex phenomena and many confounding determinants have been identified. Degenerative disease of the hip joint may present with variable patterns of pain referral in the lower limb. However the effect of varied preoperative pain referral patterns on patient outcome and satisfaction after total hip arthroplasty has not previously been examined. From 2000 to 2003, 236 eligible patients scheduled to undergo primary total hip arthroplasty were prospectively enrolled. The principal pain referral pattern (as hip, thigh or knee) was identified in all patients. Health related quality of life (HRQOL) was examined using the Harris Hip score (HHS), the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and the 36-Item Short-Form Health Survey (SF-36) pre-operatively, 1 year and 2 years postoperatively and with the HHS at 3 months postoperatively. All patients were followed up for a minimum of 2 years. The frequency of the pain referral distributions were; hip pain 41%, knee pain 32% and thigh pain 27%. Patients in all groups were comparable preoperatively with respect to age, HHS, and both mean and domain specific WOMAC and SF-36 scores. The mean duration of symptoms was significantly greater in patients with knee pain when compared to the remaining two pain patterns. All patients demonstrated improvements in HHS, SF-36 and WOMAC scores after surgery. At all times postoperatively there were significant differences in mean HHS and mean and domain specific WOMAC and SF-36 scores between patients with hip or thigh pain and those with knee pain (p < 0.001). While notable, differences between hip and thigh pain were not as consistent however. Based on these findings, it appears that pre-operative pain referral patterns of hip arthritis are among the determinant factors for patient outcome and satisfaction after total hip arthroplasty, as measured using validated HRQOL scoring systems.
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PMID:Do pain referral patterns determine patient outcome after total hip arthroplasty? 1630 78

Femoroacetabular impingement (FAI) is likely one of the main causes for osteoarthritis in young adults. Surgical treatment has until now been performed via open dislocation of the hip joint. With respect to its invasive nature and long rehabilitation, arthroscopic techniques have become established in recent years. The following article presents the latest developments in hip arthroscopy for FAI with a detailed description of technical aspects, pitfalls, and limitations. Hip arthroscopy is performed in the standard fashion with and without traction for arthroscopy of the central and peripheral compartments. Under traction, the anterosuperior cartilage and adjacent base of the acetabular labrum have to be inspected for frequent lesions such as cartilage flap tears and delaminations of the cartilage from the subchondral bone. An ossified labrum can be trimmed back with a burr. Currently, techniques are being developed for temporary detachment of the labrum, trimming of the acetabular rim, and refixation of the labrum with suture anchors. Without traction, femoroacetabular impingement has to be confirmed arthroscopically under flexion, internal rotation, and adduction of the hip. With respect to the frequent loss of internal rotation, the zona orbicularis and the iliofemoral ligament are released and removed if needed. The anterolateral bump of the head-neck junction is trimmed back for restoration of a more physiological head-neck offset. Postoperatively, continuous passive motion is important to prevent adhesions between the bleeding bone of the head-neck junction and the articular capsule. Weight bearing as tolerated is allowed if no treatment of cartilage defects or refixation of the acetabular labrum was performed. The early results after hip arthroscopy for FAI are very promising. Arthroscopic techniques will upstage open exposures of the hip joint for the treatment of FAI.
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PMID:[Hip arthroscopy for femoroacetabular impingement]. 1632 68

It is difficult to identify objective parameters for assessing the joint function when evaluating the outcome of orthopaedic procedures, especially endoprosthetic replacement. Spatial and temporal parameters of gait have clinical relevance in the assessment of motor pathologies, particularly in orthopaedics. However, the influence of gait speed on these biomechanical parameters has been difficult to be taken into consideration so far. The objective of the present study was to analyse the impact of gait speed on gait parameters and to set a standard walking speed for patients with osteoarthritis by means of a special treadmill control mechanism. The second objective is to compare the gait patterns in patients with unilateral osteoarthritis of the hip joint or of the knee joint to the gait pattern of healthy control subjects. A total of 20 patients with severe unilateral osteoarthritis of the hip, 20 patients with severe unilateral osteoarthritis of the knee and 20 healthy elderly subjects without any history of lower extremity joint pathology were investigated at four different gait speeds. The gait analysis equipment used consisted of an infinitely adjustable force-instrumented treadmill and an ultrasound-based motion analyser system with electromyography. Our data suggest that most of the biomechanical parameters depend on gait speed. The highest gait speed that all our patients with severe osteoarthritis were suitable with, without pain and loss of coordination, was 2.00 km/h. Our findings indicate that the changes in gait parameters may occur in patients with unilateral osteoarthritis of the hip joint or the knee joint compared to the gait pattern of healthy control subjects. Hip joint or knee joint degeneration was compensated for in part by the pelvis and other joints in the lower limb. Reduced motion of the hip joint or knee joint leads to an increased pelvic motion, which should affect the natural mobility of the lumbar spine and cause pain in the lumbar region of the spine because of their kinematic interaction.
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PMID:The influence of walking speed on gait parameters in healthy people and in patients with osteoarthritis. 1633 21

Canine hip dysplasia (CHD) is characterized by a malformation of the hip joint that leads to joint laxity and consequential degenerative joint disease. The most widely used method for diagnosis of CHD is the ventrodorsal hip-extended radiologic view, commonly referred to as the Orthopedic Foundation for Animals (OFA) method. The method of the University of Pennsylvania Hip Improvement Program (PennHIP), an alternative technique that is based on hip joint laxity, provides a quantitative assessment, the distraction index (DI), of the likelihood of the development of CHD because of increased laxity in the hip joint. Linear regression analysis showed that, across many breeds of dog, the incidence of CHD, as defined by the OFA, is positively correlated with the mean DI, the determination coefficient (r2) being 26%. We used families of Boykin spaniels (BSs) to determine the level of joint laxity in the breed and to conduct an initial whole-genome screening to identify markers that co-segregate with increased joint laxity. Although there was a positive correlation between the incidence of hip dysplasia and increased joint laxity, we did not find significant linkage in the 28 BSs that underwent genotyping, likely owing to the small size of the pedigree.
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PMID:Clinical and genetic assessments of hip joint laxity in the Boykin spaniel. 1663 48

Diffuse idiopathic skeletal hyperostosis (D.I.S.H.) is a common disorder of unknown aetiology characterized by exuberant hyperostosis of the antero-lateral aspect of the spinal column, that sometimes leads to bone ankilosis, and by ossification of extra-spinal entheses. This condition is often associated with the metabolic derangement of type 2 diabetes. Primary hypertension, its cardiovascular aftereffects and lithiasis are also often present in these patients. D.I.S.H. has to be distinguished from osteoarthritis, although they often coexist in the same patient. The mean difference lies in the anatomical target of the pathological process, that is represented by articular cartilage in osteoarthritis and by entheses in diffuse idiopathic skeletal hyperostosis. The enthesopathy leads to the ossification of the anterior longitudinal ligament of the spine and causes the formation of flowing osteophytes, while intervertebral disc space is quite preserved in early phases of the disease. Symptoms of spine involvement are not typical of the disease and consist of pain and stiffness, usually worsened by inaction and damp. It has also been described the ossification of posterior longitudinal ligament which can lead to medullary canal stenosis. Appendicular skeleton is symmetrically involved in early phases of the disease, the most distinctive affected sites being feet, olecranus and patella. Hip involvement is also frequent and may lead to severe disability and represents an important cause of invalidity. The purpose of the present review is to remark on aetiopathogenetic and clinical aspects of diffuse idiopathic skeletal hyperostosis.
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PMID:[Diffuse idiopathic skeletal hyperostosis (D.I.S.H.)]. 1682 87

Osteoarthritis is the leading cause of hip and knee pathology in the geriatric population. Hip and knee arthroplasty are the definitive interventions to alleviate pain and restore physical functioning. Complications related to these procedures do occur: the most com-mon of these are infection, thromboembolism, dislocations, and periprosthetic fractures. New improvements related to minimally invasive and computer-assisted navigation surgery techniques are promising and already have shown excellent outcomes in patients exposed to joint arthroplasty.
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PMID:Hip and knee arthroplasty in the geriatric population. 1686 Feb 43

Ultrasonography (US) is a reliable and useful diagnostic tool for the assessment of hip pathology. It depicts changes within the coxo-femoral joint (synovitis, erosions, osteophytes) and in the adjacent peri-articular tissues (calcifications, tendonitis, enthesitis, bursitis) in many rheumatic diseases (rheumatoid arthritis, spondyloarthritis, osteoarthritis, polymyalgia rheumatica ) and in some orthopaedic disorders (septic arthritis, trauma, abscess, painful hip after arthroplasty). It is commonly used both in adults and in children. In the assessment of hip joint pathology, US exerts considerable diagnostic supremacy over physical examination. In fact, by virtue of its size and position, reliable physical examination of the hip is often difficult thus making US particularly useful as a bedside tool for the evaluation of a painful hip. Hip US has also proven to be of great practical benefit when performing aspiration and injection within the joint and in the periarticular soft tissues. The relatively limited acoustic windows available to the US beam is the principal limitation to hip US thereby making detailed examination of some important structures impossible together with the interpretation of power Doppler signal sometimes unreliable. In addition, the deep location of the hip can confer further problems to US scanning in obese or particularly muscular subjects.
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PMID:Ultrasound imaging for the rheumatologist III. Ultrasonography of the hip. 1687 87

Concurrent osteoarthritis of the hip and lumbar spine occurs frequently. Our study tests the hypothesis that hip anesthetic arthrograms can be used as predictive diagnostic tool before total hip arthroplasty when standard evaluation techniques fail to provide convincing evidence of the source of pain. Thirty-four consecutive hip anesthetic arthrograms were reviewed retrospectively. Quantified outcome measures included Visual Analog Pain Score, Harris Hip Score, and patient satisfaction. The pain relief after hip anesthetic arthrogram accurately predicted pain relief after hip arthroplasty (positive predictive value = 95.23%, negative predictive value = 87.5%). Our study supports the selected use of hip anesthetic arthrograms in the preoperative assessment of patients with concurrent hip and lumbar spine osteoarthritis associated with nondiagnostic history and physical examinations.
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PMID:The diagnostic and predictive value of hip anesthetic arthrograms in selected patients before total hip arthroplasty. 1687 60

A computer-aided classification system was developed for the assessment of the severity of hip osteoarthritis (OA). Sixty-four radiographic images of normal and osteoarthritic hips were digitized and enhanced. Employing the Kellgren and Lawrence scale, the hips were grouped by three experienced orthopaedists into three OA-severity categories: Normal, Mild/Moderate and Severe. Utilizing custom-developed software, 64 ROIs corresponding to the radiographic Hip Joint Spaces were manually segmented and novel textural features were generated. These features were used in the design of a two-level classification scheme for characterizing hips as normal or osteoarthritic (1st level) and as of Mild/Moderate or Severe OA (2nd level). At each classification level, an ensemble of three classifiers was implemented. The proposed classification scheme discriminated correctly all normal hips from osteoarthritic hips (100% accuracy), while the discrimination accuracy between Mild/Moderate and Severe osteoarthritic hips was 95.7%. The proposed system could be used as a diagnosis decision-supporting tool.
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PMID:Osteoarthritis severity of the hip by computer-aided grading of radiographic images. 1696 Jul 46

In the 20-50-year age group, hip pain usually indicates dysplasia. Chronic mechanical pain is the usual pattern, although acute pain caused by avulsion or degeneration of the labrum may occur. The morphological characteristics of the dysplastic hip should be evaluated, and the link between the dysplasia and the osteoarthritis should be confirmed. Three factors indicate a favorable prognosis: joint space preservation, age younger than 40 years, and correctable femoral and acetabular abnormalities. Reconstruction is highly desirable, as it delays the need for joint replacement by 20 years. After 15 years, good outcomes are seen in 87% of patients after shelf arthroplasty and 85% after femoral varus osteotomy with or without shelf arthroplasty. Chiari acetabular osteotomy can be performed in patients with osteoarthritis but is followed by prolonged limping. Periacetabular osteotomy should be reserved for patients with moderate dysplasia and no evidence of osteoarthritis. Shelf arthroplasty and femoral osteotomy require 5-8 months off work (compared to 5 months after hip replacement surgery) but subsequently permits a far more active lifestyle. Hip replacement, which is required 20 years or more after biologic reconstruction, carries the same prognosis as first-line hip replacement (good results in 80% of patients after 15 years). Acute sharp pain related to anterior hip derangement also occurs in primary femoroacetabular impingement (FAI). The most common pattern is cam impingement, which is due to a decrease in head-neck offset and manifests as pain during flexion and adduction of the hip. Cam impingement can be corrected by anterolateral osteoplasty, which is often performed arthroscopically. Pincer-type impingement is contact between the anterior acetabular rim and the femoral neck due to retroversion of the proximal acetabulum. The imaging study strategy is discussed. Coxometry, computed tomography, and arthrography can be used. Primary FAI, which occurs as a result of geometric abnormalities, should be distinguished from secondary impingement. Causes of secondary impingement include exaggerated lumbar lordosis with pelvic tilt and to hip osteophytosis (sports or posterior hip osteoarthritis). Osteoplasty is rarely appropriate in patients with secondary impingement. The features of acute anterior hip derangement are now better defined. They can be used to guide palliative treatment, which is effective, in the medium term at least. Experience acquired over the last two decades has established the efficacy of surgery for hip dysplasia.
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PMID:Hip pain from impingement and dysplasia in patients aged 20-50 years. Workup and role for reconstruction. 1713 20


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