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

The role of hip sonography in neonatal hip screening is still a controversial matter. This paper reports the results of the Austrian ultrasound hip screening program, in which all Austrian babies undergo hip sonography twice: at the birth clinic during the 1st week of life and at an age of 12-16 weeks. Data from all public health insurance companies since 1985 and all ICD data about children hospitalized because of CDH in Austria were collected and analyzed. The rate of sonographically pathological hips was 6.57% (1994). The treatment rate before introduction of hip sonography was 13.16% (1985). The rate of open reduction went down to 0.24 per 1000 newborns, including a high number of unscreened children born abroad and also children with teratological dislocation of the hip. Hip sonography screening proved to be effective in detecting true instability of the hip joint as well as dysplasia. The optimal time for sonographic screening does not seem to be immediately after birth when only "high risk" hips (clinical instability, positive family history, breech delivery) should undergo hip sonography, but at an age between 4 and 6 weeks when the hip has already shown its true nature. Since one sonographic scan appears to be sufficient for screening, a further reduction of costs could be accomplished. Disability owing to DDH can be avoided in a number of cases, and costs for conservative and surgical treatment as well as for later endoprostheses and early retirement can be economized.
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PMID:[Results of hip ultrasonographic screening in Austria]. 908

DDH, septic coxarthritis and slipped capital epiphysis should be diagnosed as soon as possible. Hip sonography is the goal of DDH examination technique, anatomical identification and 3 landmarks check up are there most important points of the method. With the progress of ossification and loss of the 3 landmarks consecutively, x-rays become increasingly important. Septic coxarthritis is an orthopaedic emergency case, sonography is the most important tool in primary diagnosis. Slipped capital epiphysis requires an x-ray in 2 planes, MRI oder CT scans respectively makes sense in special cases to localize the area of necrosis and to plan further reconstructive procedures.
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PMID:[Profile of radiologic-orthopedic requirements in pediatric hip dysplasia, coxitis and epiphyseolysis capitis femoris]. 1214 7

Authors presented the results of the treatment of osteoarthritis of the hip with MAYO endoprosthesis. The paper is focused on young adults. 34 operations in the 2000-2006 were performed. Cementless MAYO stems were used. 32 patients (24 females and 8 males) were evaluated. The age of patients was 20-54 years (average 32,7 years). The main cause of the hip osteoarthritis was DDH (50%). Among others we identified posttraumatic deformities (14.7%), avascular necrosis of the head, multiepiphyseal dysplasia and the other (35.3%). Cementless press-fit Trilogy cup (Zimmer) was applied in 94.1% and cementless threaded acetabular cup in 5.9% patients. Results were analyzed according to clinical Hip Harris score and radiological assessment. After 7 years follow up good and very good outcomes were found in the majority of patients. Mayo stem causes minor damage of intertrochanteric region during procedure and has minimal effect on medullary cavity. It is an advantage in a case of the migration of endoprosthesis. It preserves the bone stock and allows Total Hip Replacement with cementless stem. Obtained results confirm the value of implantation of this kind of endoprosthesis in the case of young adults. Longer follow up period and bigger group of patients are required to confirm our observations.
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PMID:[Total hip replacement in young patients with use of MAYO prosthesis--early result of treatment]. 1809 93

A variety of conditions may lead to arthritis of the hip during adolescence. Although uncommon, total hip arthroplasty may occasionally be necessary for treatment of end-stage disabling arthritis of the hip in the young. There is paucity of information documenting the outcome of uncemented total hip arthroplasty in adolescents. We report our experience with total hip arthroplasty in patients under the age of twenty years. The results of 35 consecutive total hip arthroplasties performed at our institution in 25 patients between 1993 and 2003 were reviewed. There were 17 females and 8 males with a mean age of 17.6 years (range: 13.5 to 20). All patients received a Hydroxyapatite (HA) plasma sprayed Titanium acetabular component and a tapered femoral stem proximally coated with HA. Follow-up averaged 6.6 years (range: 4.2 to 10). The underlying diagnosis was avascular necrosis (16 hips), juvenile rheumatoid arthritis (9 hips), sequelae of DDH (2 hips), spondyloepiphyseal dysplasia (2 hips), sequelae of Perthes (2 hips), osteoarthritis (2 hips), post-traumatic arthritis (1 hip), and pseudo rheumatoid chondrodysplasia (1 hip). There was a significant improvement in function and relief of pain as measured by the Harris Hip score and SF-36. All uncemented components were found to be stable and osseo-integrated at the latest followup. There were no complications, or reoperations. There was one revision secondary to severe polyethylene wear. This patient was revised 10 years after the index surgery. Uncemented total hip arthroplasty was found to confer a significant improvement in function and to have an acceptable short-term outcome in very young patients with end-stage arthritis of the hip. Longer-term follow-up is needed to assess the durability of this procedure in adolescents.
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PMID:Uncemented total hip arthroplasty in patients less than twenty-years. 1905 94

Hip sonography in the "Graf technique" is an important tool to detect early DDH cases and dysplastic hips in the German speaking countries, although hip sonography is still controversially discussed in the English speaking countries. The reason may be different techniques with different classification and outcome. Exact anatomical identification, measurement technique, typing, difference between instability and elasticity with a reproducible "standard plane" is absolutely necessary to make hip ultrasound (US) comparable and reliable. US screening had reduced open reductions in Germany to 1:4000, in Austria to 0.23 per thousand. Because of the early screening and earlier less aggressive treatment, the overall costs could be reduced by 1/3 in comparison to the pre-ultrasound area. US screening seems to prevent many, but not all operations and can be recommended as an important tool for prevention.
Hip Int 2007
PMID:Hip sonography: 20 years experience and results. 1919 79

This study reviews the data regarding clinical and ultrasound (US) examinations, collected during an 11-year period, in a DDH dedicated outpatient clinic. The material was analysed in order to verify the importance of US hip examination and Ortolani's test for early DDH diagnosis, to select dysplastic, unstable hips, to identify the role of the labrum in DDH, and to analyse the treatment strategy. Of the 21709 newborns (43418 hips) examined with US and Ortolani's manoeuvre for DDH diagnosis, 431 patients (356 F; 75 M; average age 42+/-33 days) had 574 unstable, dysplastic hips (1.32%). The hips identified according to Graf's classification were: 298 type D, 252 type IIIa, 4 type IIIb, 20 type IV. In 73.09% of the patients, no risk factors were identified; 18.56% had positive family history for DDH, 5.57% had breech presentation, 2.78% had both risk factors. Only 10.63% had a positive Ortolani's test. The diagnosis was made in 21.5% of cases by the 2nd week of life, in 52.9% between the 2nd-8th week, and in 25.5% after the 8th week. Unstable dislocated hips were treated, after reduction with or without sedation, by applying a cast; dysplastic hips were treated using a Gekeler splint. No open reductions or reconstruction surgery were needed. The labrum was always positioned on top of the femoral head, never inverted, and it was not an obstacle to closed reduction. Neither the Ortolani's sign, nor the risk factors are sure signs for the early diagnosis of DDH and its instability. Only US examination permits an early diagnosis of dysplasia and instability of the hip.
Hip Int 2007
PMID:Early diagnosis and treatment of DDH: a sonographic approach. 1919 80

The spontaneous correction of hip dysplasia occurs at every level of growth of the lower limb and it may be inadequate at any of these levels. Every abnormality of correction may induce different troubles at any level of the lower limb. A complete clinical evaluation, X-ray with different special views and CT examination is mandatory. Every deformation in any of the three spatial planes must be detected for a good understanding of the defect. The authors describe the X-ray techniques necessary for a complete evaluation of the patient and propose a CT protocol to precisely calculate the different angles of torsion of the lower limb. The possibilities of surgical treatment at different levels of the lower limb (acetabular, femoral, tibial and ankle or foot level) in DDH are pointed out to address directly the proper procedure at the correct level of the pathology.
Hip Int 2007
PMID:Anomalies of the natural correction of dysplasia of the hip and treatment proposals. 1919 82

The necessity to operate on hip dislocation has decreased because the natural history of this congenital disease has been completely changed by using clinical and ultrasonographic screening. At present in our country surgical reduction is indicated in the rare cases of true congenital severe hip dislocation or in the few cases missed during screening. Our long experience in the treatment of such pathology since the start of the 1960s is summarized in this paper in which we describe our indications in surgical treatment of dislocated and subluxated hips affected by DDH. We point out our approach to open the dislocated hip laterally explaining the advantage of this particular and not common approach. We also describe the radiological assessment necessary to evaluate residual dysplasia in order to plan the necessary pelvic or femoral osteotomy to correct these residual joint alterations.
Hip Int 2007
PMID:Surgical treatment of hip dislocation in early infancy. 1919 83

Triple pelvic osteotomy was performed for sequel of DDH including AVN between 1981 and 2002 for 329 patients (351 hips, 280 females, 49 males, average age at surgery 16.5 years, range 9-41 years, follow-up 4-25 years). A small modification of Steel's technique consisting of strictly subperiostal resection of segment from both pubic and ischial bone was used. Average gain of lengthening extremity was 1.8 cm. The average CE angle was improved from 7.8 to 35.5 degrees. Clinical results were evaluated according to Merle d'Aubigne and reflected to the preoperative clinical and radiological findings. There were 146 hip joints in 128 patients (76%) with excellent results in the group of congruent hips without arthrosis. In 182 hips in 178 patients with hip joints with some deformity, limited ROM and decentration, 40% were excellent, 32% good, 23% fair and 5% unsatisfactory results were achieved. The group of decentrated hip joints in young adults in incongruency, limited ROM and sometimes severe arthrosis consisted of 23 monolateral surgeries with 39% unsatisfactory, 39% fair and 22% good results, respectively. No major neurovascular complications were seen. Non-unions were recorded in 19 patients (5.4%), including 2 triple and 2 double non-unions. Based on our long-term experience, we can conclude that triple pelvic osteotomy according to Steel in our modification is a safe method and gives regularly excellent or good results for correction of clinical and radiographic appearance of acetabular dysplasia when there is a proper indication.
Hip Int 2007
PMID:The role of triple pelvic osteotomy in therapy of residual hip dysplasia and sequel of AVN: long-term experience. 1919 85

Total hip arthroplasty is the procedure of choice for most adult patients with symptomatic arthrosis secondary to developmental dysplasia (DDH), but it requires complex reconstructive techniques, is usually performed in young patients, and has an increased risk of complications. THA is indicated in presence of severe pain and when osteotomy is contraindicated. The complexity of surgery is related to the degree of dysplasia. Anatomic abnormalities in the acetabulum and femur are the cause of the complexity and complications of this procedure. Acetabular bone deficiency requires reconstructive techniques before implanting the cup at the anatomic acetabular location, such as bone autograft augmentation, implanting the cup at higher level of the hip center and cup medialization. Femoral shortening and special cemented or uncemented stems are currently used to avoid intraoperative complications. While a cemented stem needs metaphyseal femoral shortening, subtrochanteric shortening requires a cementless stem. Because of these patients' age, alternative bearing surfaces, such as alumina-on-alumina couples are recommended when possible. Although the long-term results of total hip arthroplasty in DDH are inferior to those in a general population, the results show a high level of pain relief and functional improvement.
Hip Int 2007
PMID:Cemented femoral stems in patients with DDH. 1919 94


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