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

Aseptic necrosis developed in 11 (6%) of 171 recipients of renal allografts who underwent transplant operations at Childrens Hospital of Los Angeles between February 1967 and August 1977. Pain was the predominant presenting symptom and preceded roentgenographic evidence of aseptic necrosis by as long as seven months. Initial symptoms occurred two months to four years posttransplant. Limited weight bearing and reduction in the dosage of prednisone failed to prevent the progressive destruction of five femoral heads in three patients. Hip replacement led to an amelioration of the symptoms and a resumption of normal activity in each patient. Two patients with involvement of multiple osseous structures have persistent knee and elbow joint pain and effusions, and one of them has required prosthetic replacement of the proximal humerus. No therapy was required for patients with aseptic necrosis of single bones of the hand and foot. There was no statistically significant difference in the total steroid dose received during the first posttransplant year between patients in whom aseptic necrosis developed, and those in whom it did not develop.
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PMID:Aseptic necrosis after renal transplantation in children. 35 87

Hip arthroplasty using the Thompson femoral prosthesis with methyl methacrylate fixation was performed on 109 hips in 106 patients. During an average follow-up period of 36 months, 26 patients died. Fifty-one procedures were performed for fresh fractures of the femoral neck and results were satisfactory in this group provided the patient was minimally active. Results were unsatisfactory in patients who had idiopathic avascular necrosis (18), painful, failed noncemented prostheses (6), and osteoarthritis (3). In these last three groups, one-half required conversion to total hip arthroplasty and an additional one-third had pain. Reoperation was required in 22 cases. Intraoperative death occurred in one elderly patient after insertion of cement. Results suggest that the primary indication for this procedure is in the minimally ambulatory or nonambulatory elderly osteoporotic patient who has a fresh fracture of the femoral neck.
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PMID:Results after hemiarthroplasty of the hip using a cemented femoral prosthesis. A review of 109 cases with an average follow-up of 36 months. 86 30

Hip involvement in ankylosing spondylitis (AS) is a common and disabling problem. The clinical and x-ray records of 87 patients with definite AS (Rome criteria) were examined to define and characterize their hip disease. Clinical hip disease was present in 33 cases (38%), was usually bilateral (91%), and tended to begin early in the disease course; it was the cause of 50% of the Class III and IV disability in the entire study group. Typical findings included regional pain, limitation of motion, muscle atrophy, and flexion contractures. Radiologic hip abnormalities occurred in 42 cases (48%). The radiographic pattern was distinctive when compared to that in two control groups and included axial migration of the femoral head (63%), concentric joint space narrowing (50%), rufflike femoral osteophytosis (36%), and protrusio acetabuli (30%). Eight patients required bilateral hip surgery. Para-articular ossification occurred in 8 of 16 replaced hips; in 5 of 8 hips it caused clinical immobility. This potentially serious complication may limit the usefulness of hip arthroplasty in some AS patients.
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PMID:Hip involvement in ankylosing spondylitis. 94 99

The design of and early clinical results with the uncemented porous-coated LSF Anatomic and Midstem Total Hip Systems are described. In a Food and Drug Administration-approved program, a random selection method was used to determine which patients receive implants with a hydroxyapatite (HA) coating applied to the porous surface and which patients receive non-HA-coated implants. The early clinical results with the HA-coated systems appear superior to the non-HA-coated systems. A greater percentage of patients with HA systems have clinical scores in the excellent/good range, which is primarily a reflection of less prosthesis-related pain. Radiographically, all components appear well fixed with evidence of bone ingrowth. The HA-coated systems have a decreased incidence of radiolucencies, particularly in proximal zones.
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PMID:Early clinical results with the hydroxyapatite-coated porous LSF Total Hip System. 131 Jun 57

Classification of cerebral palsy according to the topographical distribution of clinical phenomena permits determination of a prognosis of the natural history of CP and the probability of hip problems to some extent. In 55 patients with CP, 101 muscle release operations were performed between 1971 and 1988. Preoperatively, the diagnosis was established by the neuropediatrician, function was evaluated according to the Rancho-los-amigos system, and the X-rays of the hip were assessed according to Reimers. For the postoperative evaluation patients were grouped according to neurologic diagnosis: hemiplegia (4), diplegia (19), total body involvement (31). Patients with hemiplegia had no functional or radiological changes as a result of the operation. In diplegia functional deterioration was seen in 4 cases (21%); in 3 cases (16%) this meant loss of the ability to walk. The migration percentage was improved from 48% to 39% on average. In 19 cerebral palsy patients with total body involvement surgery was considered to be indicated on the basis of a suspected dislocation of the hip. No functional changes occurred as a result of surgery. Hip dislocation was successfully prevented in 90% of the cases. The migration percentage was improved from 73% to 33%. In another 12 patients with total body involvement, adductor and iliopsoas release was performed to allow better hygiene and care and for pain relief. These goals were achieved; neither the Rancho-Los-Amigos function classification system nor X-rays were used to evaluate the results.
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PMID:[The hip in infantile cerebral palsy, natural developmental course and treatment concepts]. 140 25

Fifty-one skeletally immature cerebral palsied (C.P.) children with 70 subluxated or dislocated hips were treated by conservative methods: femoral osteotomy (65 hips), pelvic osteotomy (52 hips) and arthrotomy when necessary (19 cases). 31 children were less than 10 years of age when operated on (mean 6 years, 6 months), 20 children were more than 10 years of age (mean 13 years, 13 months); mean follow-up was 4 years. Reduction and coverage were achieved and maintained in all patients, except for 6 redislocations: a pelvic obliquity was neglected in 3 cases; femoral shortening was not performed in 2 cases. Post-operative course was difficult in eldest patients with pain and stiffness but functional result was acceptable at follow-up in all cases except redislocations. Open reduction was related to a higher rate of postoperative rehabilitation problems. Modeling of previously deformed femoral heads and improvement of hip mobility were consistently seen at last follow-up, except for 3 redislocations. It is concluded that conservative methods are quite advisable in CP children and adolescents. Hip reduction should be preferred to femoral resection even in adolescent.
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PMID:[Surgical treatment of dislocations and subdislocations of the hip in patients with cerebral palsy by femoral and pelvic osteotomy]. 141 Jul 25

Total hip arthroplasty (THA) is commonly performed in an older population, for whom gold is often the only form of exercise. Members of the Hip Society do not feel that golfers have increased rates of complications after THA when compared to nongolfers and permit their patients to play gold with a THA. Most golfers will see their handicaps increase after total joint arthroplasty, although this does not appear to be a function of drive length. Most golfers with a successful primary total joint arthroplasty will not have pain while playing golf but will likely experience a mild ache in the hip region after playing. Hybrid and uncemented primary THAs appear to have lower rates of radiographic loosening in active golfers when compared to cemented THAs. However, symptoms of pain while playing or after playing do not differ among these groups, despite this radiographic difference.
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PMID:Total hip arthroplasty in active golfers. 143 14

Forty-nine consecutive uncemented porous-coated LSF total hip prostheses were implanted in 41 patients and studied prospectively. Clinical rating as described by Harris was performed preoperatively, at 6 months and 1 year postoperatively, and annually thereafter. Anteroposterior and lateral radiographs were obtained preoperatively, immediately postoperatively, at 6 and 12 months, and annually thereafter. At the most recent follow-up visit, patients were evaluated clinically and radiographically utilizing the format recently recommended by the Hip Society. A patient satisfaction questionnaire was also completed. The follow-up period averaged 37 months (range, 24-48 months). Preoperative hip scores averaged 38 (range, 18-68) and improved to 93 at the most recent follow-up visit (range, 76-100). The incidence of mild pain was 14% at 1 year and 4% at 2 years or more. The incidence of limp was 16% slight and 8% moderate at 1 year, and 12% slight and 2% moderate at 2 years or more. Surgical fit was objectively graded as excellent in 61%, good in 33%, and poor in 6%. The authors were unable to correlate surgical fit with clinical scores or radiographic findings. According to radiographic criteria, all components were judged to be stable and 86% were judged to demonstrate objective signs of osseointegration. Patient satisfaction with the procedure was 100%. All patients stated that the procedure increased their function and decreased their pain and need for medication. Compared to a normal hip, in terms of symptoms and function, the patients rated their postoperative hip at 85% (range, 50-100%). Compared to their level of activity before their hip was symptomatic, they rated their current activity level as 83% (range, 50-100%).
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PMID:Clinical and radiographic analysis of the uncemented LSF total hip arthroplasty. 143 16

Hip flexor spasticity, which is often associated with central nervous system (CNS) diseases, is a major impediment in rehabilitation. In order to cope with this problem, lumbar nerve blocking techniques developed by Meelhuysen and major and minor psoas muscle blocking techniques developed by Awad have been used in combination with physical therapies. Based on these techniques, we conducted major and minor psoas muscle phenol block (motor point block or intramuscular nerve block) under ultrasonic monitoring. Phenol block was conducted in nine patients with cerebral infarction (13 blocking procedures) and three with spinal cord injuries (six blocking procedures) while keeping them in a lateral position with the operation side upside. The beginning of the femoral nerves and part of the lumbar artery were visualized by ultrasound in some patients. As a result of the improvement of hip flexor spasticity, the range of hip joint motion (determined by the Mundale technique, prone hip extension and Thomas test) improved shortly after blocking. When physical therapy was conducted after blocking, improvement of skin care management was observed in eight cases, ability to keep in a stable sitting position in nine, improvement of a standing posture in three, increases in the ability to walk in two and alleviation of pain in three. Although nerve block is reported to result in hematoma, decreases in muscle force, pain, cystic/rectal disorders and hypogonadism, we have observed no such complication in our patients.
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PMID:Phenol block for hip flexor muscle spasticity under ultrasonic monitoring. 144 69

The application of a thin coating of hydroxylapatite to total hip implants has provided the opportunity to realize stable fixation of a press-fit prosthesis without a porous coating or an intervening fibrous tissue layer. This series consists of 436 total hip arthroplasties, of which 320 cases have a minimum two-year follow-up period and 142 cases have a minimum three-year follow-up period. The femoral prosthesis used was a roughened titanium alloy with a 50-microns surface treatment of hydroxylapatite applied to the proximal one third. The acetabular components implanted included porous-coated implants (132), hydroxylapatite-coated acetabular shells of varying geometries (285), and bipolar implants (16). Analysis of the clinical results demonstrates a mean Harris Hip Score of 93 at six-months postarthroplasty, 95 at one and two years, and 96 at three years. At the three-year follow-up evaluation, 4.2% of patients complained of mild to moderate pain in the operative limb, whereas only 2.2% at two years and 1.4% at three years complained of activity-related thigh pain. The femoral mechanical loosening rate representing stems revised for aseptic loosening (two) plus roentgenographically unstable stems (zero) is 0.46%. Three hydroxylapatite-coated acetabular cups (1%) have shown measurable migration at two years, but none have been revised for aseptic loosening. The roentgenographic evaluation provides evidence for excellent proximal femoral fixation with distal stress transfer. Radiolucencies typically occur around the uncoated distal tip of the femoral stem (74%), but rarely in the proximal hydroxylapatite-coated anterior (3%) and lateral (2%) zones. Femoral cancellous condensation characteristically is seen at the transition zone of hydroxylapatite coated-to-uncoated stems (86%), whereas up to 32% of cases show cortical hypertrophy at the medial distal stem. These roentgenographic changes are progressive from one through three years postoperatively.
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PMID:Hydroxylapatite-coated hip implants. Multicenter three-year clinical and roentgenographic results. 144 26


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