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

The effects of heterotopic bone formation on hip function after arthroplasty was studied in 145 cases of total hip arthroplasty. Hip muscle strength was determined 1.8-2.9 years after the operation, using a Cybex II dynamometer. Heterotopic bone formation was seen after 75% of the operations, and in 21% significant amounts developed (Brooker's classes III and IV). The gain in range of motion after surgery was significantly less in the groups with class III or IV heterotopic bone than in those without heterotopic bone formation. Heterotopic bone did not cause pain or Trendelenburg's limp after surgery; in fact, patients with trochanteric pain had less heterotopic bone than those without this pain. Hip flexion strength was greater in men with heterotopic bone than in those without heterotopic bone. Also, men with heterotopic bone formation had a higher mean maximum strength in extension but lower mean strength in abduction than did men without heterotopic bone (NS). When only patients with unilateral hip disease were considered, the same differences were found around the healthy hip; men with heterotopic bone formation had greater strength in flexion and extension than men without heterotopic bone formation and the same tendencies were seen in women. Accordingly, heterotopic bone had no serious impact on hip muscle strength in this study.
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PMID:Functional significance of heterotopic bone formation after total hip arthroplasty. 250 53

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 and pelvic injuries are relatively rare in the young athlete. Contusions and musculotendinous sprains are the most common injuries about the hip and pelvis. Apophyseal avulsion fractures and stress fractures are the most frequently encountered skeletal injuries. Each of these entities can be successfully treated with guided physical therapy following conservative management with rest, anti-inflammatory medications, and ice massage until the patient is pain free. Epiphyseal, diaphyseal, or pathologic fractures are rare entities that are secondary to violent trauma. These injuries are severe and often require operative intervention. Femoral neck fractures have a high rate of complications from avascular necrosis, nonunion, or malunion. Pelvic fractures have frequent associated genitourinary, abdominal, neurologic, and musculoskeletal injuries. Pathologic fractures are most commonly secondary to benign lesions, such as unicameral bone cysts, and less likely owing to malignancy. Finally, in children with hip pain during athletic activities, even with antecedent trauma, the sports clinician must screen for slipped capital femoral epiphysis, Perthes' disease, congenital subluxation of the hip, toxic synovitis, systemic neoplasia, or infectious process.
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PMID:Hip and pelvic injuries in the young athlete. 304 59

Hip problems form about 10% (7.0 to 14.2%) of most published series of ballet injuries. The abnormally large range of external rotation needed for a perfect turnout is primarily due to soft tissue adaptation, more readily achieved in the young dancer. Insufficient range of motion at the hip throws considerable stress on the other lower limb segments. The snapping hip syndrome is common (43.8% of hip problems), with about one-third associated with pain. A tight iliotibial band may contribute to this, and balanced flexibility requires special attention to abductor stretching. The external clicking hip must be distinguished from the internal clicking hip, which is associated with the joint and psoas tendon. Stress fractures of the hip are easily overlooked and, if undetected, they may progress to a complete fracture. Knee problems account for 14.0 to 20% of complaints, and over 50% of these are peri- or retropatellar problems. This includes synovial plica, medial chondromalacia, lateral patella facet syndrome, subluxing patella and the fat pad syndrome. Specific diagnosis leads to specific treatment and the best chance of cure. Mild hyperextension of the knee may be aesthetically desirable, but excessive range leads to symptoms in the posterior capsule and poor control. Young dancers with a tendency to very lax joint structures should be identified early and protected from overstretching. In the author's series, meniscal lesions did not appear to be as big a problem as reported elsewhere in the literature. Ballerinas appear to have less leg strength than other groups of athletes, having only 77% of the weight-predicted norms. The introduction of strength training for male and female dancers may reduce injuries and improve balance, but it requires an intensive educational programme to dispense with the many myths. There are several references to the development of early arthritis but, while relatively common in the foot, symptomatic arthrosis in ballet dancers' hips and knees is not more prevalent than in the general population. The young age at which serious dance training begins, the long and rigorous hours of practice, the thin ballet slipper, dancing en pointe and unusual dietary regimens may all contribute to injury patterns in varying degrees.
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PMID:Prevention of hip and knee injuries in ballet dancers. 306 38

The early results with the PCA total hip replacement have been most gratifying, especially the absence of complications related to the acetabular component. The radiographic evaluation was done critically, and the finding of no progressive acetabular radiolucencies was unexpected. Longer-term evaluation of these interfaces is necessary, but the short-term results have been encouraging. No components have migrated despite the absence of adjunct fixation mechanisms such as screws and flanges. The pressfit achieved with the roughened hemispherical surface has been adequate, and the fixation with the two outrigger pegs appears to have been sufficiently stable to preserve the prosthetic stability and has resulted in successful anchorage of all the components. The results with femoral components are obviously related to technique. In a few early cases when undersized prostheses were used, loosening occurred, and four of these components advanced to detectable loosening. One of these components was revised since this analysis. Attention to detail with maximal filling of the proximal femur apparently led to improved results, with successful anchorage in all subsequent implantations. The application of the dimensional analysis before surgery may indicate those cases in which a tight fitting metaphysis cannot be achieved. In elderly patients who have osteoporotic bone, a substantial mismatch exists between the size of the metaphysis and the diaphysis, and it may be advisable to continue with cement in these cases. By applying the dimensional analysis to preoperative templating, the surgeon may be sufficiently informed to know that a tight fit can be achieved at surgery. No catastrophic failures have occurred. If loosening does occur because of undersizing of the prosthesis, the process appears to be gradual and, although associated with pain, does not result in sudden failure. Despite the prosthesis not being anchored by cement or collar, no sudden subsidence of the components has resulted. Patients' clinical performance has been somewhat slower when compared to cemented series. Performance seems to accelerate once weight bearing occurs, however, and after 2 years no difference exists between this series and a corresponding cemented series. Noncemented total hip arthroplasty appears to offer as good if not better results than cemented total hip arthroplasty, if performed correctly and in the appropriate patient. Successful outcome depends greatly on technique, but when technically adequate implantation has been performed, the results have been gratifying.(ABSTRACT TRUNCATED AT 400 WORDS)
Hip 1987
PMID:Two-year follow-up of the PCA noncemented total hip replacement. 310 5

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

In 34 femoral neck fractures, CT was performed within 1-32 days after internal fixation. All the cases except one showed an increased distance between the femoral neck and the anterior aspect of the joint capsule as compared with the intact side, indicating varying degrees of hip joint effusion and/or synovitis. Hip joint aspiration in 11 patients revealed increased intracapsular pressure varying between 10 and 112 mmHg and volumes of aspirated joint effusion up to 23 ml. Pain relief and increased joint motion after drainage of the intracapsular effusion was observed in 3 patients whose postoperative mobilization was facilitated.
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PMID:Hemarthrosis after femoral neck fracture fixation. 318 56

In 1979, using the name "small patella syndrome", Scott and Taor described a family in which hypoplasia or aplasia of the patella was inherited by autosomal dominant transmission. Hip dysplasias and pelvic changes accompanying the patellar changes have also been observed in some cases. On the basis of three personal observations this dysplasia syndrome is described in more detail and compared with the other syndromes involving the kneecap and pelvis. One case was discovered as a result of a femoropatellar pain syndrome, a second because of slight functional disturbances. The third case was a chance finding. Although, in two of the cases, several affections of the locomotor apparatus were found in the patients' families, it could not be confirmed that the syndrome was hereditary.
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PMID:[The small patella syndrome. A combination of knee and pelvic dysplasia]. 338 66

Bone ingrowth in the porous canine implants does occur; the early clinical results are indeed encouraging and justify further investigation. The quality of ingrowth as measured by depth and extent in the dog was stress-related. Remodelling was superior in the more compliant or elastic acetabular components without an interposed metal shell. No human specimens have been retrieved thus far, but we are encouraged because the results in the canine model with acrylic-fixed implants were comparable to the results we subsequently observed in human THARIES implantation. Those were initially excellent, but with time radiolucencies increased and loosening occurred. The quality of the canine biologic ingrowth suggests optimism for secure and durable fixation. Our patients have continued to improve through the follow-up period. There has not been a single case in which a qualitative increase in pain occurred over the cemented versions after operation. The technical problems of the surgical procedure have been overcome, but it must be performed precisely to achieve the initial inherent stability to assist in biologic ingrowth. The operative procedures in this series have been performed by or under the direct supervision of the senior author. As our competence has grown, we have applied the procedure to younger patients and those who have bone stock deficiency. One of the major advantages of the biologic ingrowth systems is the facility to graft cysts and defects. For humans, the current chamfered cylinder is an extremely bonestock-conservative procedure when combined with reaming of the femoral head to the neck size. Although space is limited in resurfacing, we have been able to achieve a minimum 4-mm bearing thickness of polyethylene. We believe that the compliant mesh chamfered cylinder system provides excellent stability. However, the hemispheric component, although technically more difficult to seat and fix, has definite applications in bonestock deficiency and with further refinement will be useful in primary replacements as well. Nevertheless, because of the uncertain future of any type of implant, especially new, we have encouraged the patients to follow a careful postoperative management program and refrain from heavy activity during the first year. Many are active and some are now participating in athletics, although this is certain to shorten the life of these implants just as was observed in acrylic-fixed devices. The biologic problems of interface corrosion, migration, and metal ion transfer indicate that these implants must be followed for longer periods. Therefore it seems unwise to extend this technology to a wide clinical use at this time.
Hip 1985
PMID:Comparative experience with canine and human cementless acetabular components. 383 Sep 85

The report is based on a follow-up of over 54 osteosyntheses employing the Dynamic Hip Screw (DHS) of the AO on the proximal femur. The patients, of an average age of 72 years, exhibited the following lesions: fractures of 7 femoral necks, 43 fractures in the pertrochanteric region, 3 reverse fractures and 1 subtrochanteric metastasis. An unstable fracture was present on 26 occasions. The follow-up, carried out personally, was done from 3 to 26 months postoperatively on 38 out of 40 patients still alive. The average age was 68 years. In not a single case was an implant failure or a protrusion of the screw into the joint observed. Technical faults were present in 4 cases (7.4%) that led in 1 case to an infection (1.85%). 37 patients (97%), of which 23 were between 70 and 90 years of age, were able to walk during the follow-up. 34 (89%) of the patients showed symmetrical, or less than 20 degrees of limited hip movement while 12 (32%) sporadically complained of slight pain or weather dependency. 2 of the 7 patients with femoral neck fractures and 4 of the remaining 47 patients with trochanteric fractures (including 1 subtrochanteric metastasis) had to be reoperated. The DHS proved to be a simple and efficient fixation device for proximal femoral fractures in the hands of ten different surgeons. The telescopic sliding of the screw enables a compulsory sintering of the fracture, without leading to penetration of the femoral head or breakage of the implant.
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PMID:[Initial results with the AO Dynamic Hip Screw (DHS)]. 401 77


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