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

In a prospective, consecutive series, 41 total hip arthroplasties were performed in 27 small-proportioned patients with small femoral dimensions. The 17 female and 10 male patients averaged 23.6 years (range, 14-47 years), and the mean height and weight were 157 cm (range, 132-183 cm) and 53.5 kg (range, 36-84 kg). The most common preoperative diagnosis was juvenile rheumatoid arthritis in 18 patients (28 hips). Most patients were severely disabled in their daily activity, and 68% of the patients were classified as Charnley functional class C. The femoral implants consisted primarily of the proximally porous-coated miniature Anatomic Medullary Locking femoral component (AML/CDH, Depuy, Warsaw, IN) in 33 hips in 22 patients (average stem diameter, 9.5 mm; range, 8-12.0 mm). A porous ingrowth acetabular cup fixed with screws was used in all procedures. At an average follow-up of 51 months, Harris Hip Scores improved significantly from 34 points (range, 0-65 points) preoperatively to 85 points (range, 33-100 points) after arthroplasty. There were no intraoperative complications. There was 1 revision because of femoral implant loosening. Three cementless femoral components showed evidence of nonprogressive subsidence. One patient had significant bilateral acetabular component polyethylene wear and underwent revision. All other femoral and acetabular components were radiographically stable. The relief of pain and improvement of function were dramatic. The miniature AML/CDH femoral component, combined with an uncemented acetabular cup, provides a promising, off-the-shelf alternative in small-proportioned patients.
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PMID:Outcome of total hip arthroplasty in small-proportioned patients. 1065 59

The results of 15 conversions of a hip arthrodesis into a total hip arthroplasty performed in the years 1980-1995 are reported. Fifteen patients (8 men, 7 women) underwent total hip arthroplasty 30.9 (range 2-61) years after spontaneous or operative fusion of a hip joint. The primary indications of the conversion were low-back pain (n = 10), knee pain (n = 2) and hip problems (n = 3). At follow-up examination 5.4 (range 2-13.3) years postoperatively, the Harris Hip Score averaged 86.0 (range 70.1-99.0). Six patients were pain-free, 7 had less pain, 2 felt no improvement of pain. All patients confirmed that they would undergo the operation again. The Trendelenburg sign was negative or mild in 8 patients and moderate to severe in 7. Aseptic loosening of 2 stems (1 cemented, 1 cementless) and 2 deep infections required revision surgery. We conclude that this operation can lead to satisfactory results even after a long duration of the arthrodesis. However, full function with no pain and a negative Trendelenburg sign could be obtained in only 20% (3/15) of the cases.
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PMID:Total hip arthroplasty after arthrodesis of the hip joint. 1073 78

Thirty-five patients with unilateral or bilateral neglected congenital dislocation of the hip (CDH) were treated with subtrochanteric valgus-extension osteotomy between 1975 and 1992. There were 29 females and 6 males in the group. A total of 50 osteotomies was performed. The mean age of the patients was 22 years; the mean follow-up was 7 years. Before operation, the main complaints were pain and gait abnormalities. Leg-length discrepancy was another problem, especially for unilateral cases. The main indication for the operation was pain. This pelvic support osteotomy was performed to correct the instability of the hip and as a result of this to relieve pain. Patients were retrospectively evaluated based upon Harris Hip Score and self-evaluation. The mean Harris Hip Score was 49 before operation and improved to 72 after the operation. Alleviation of the pain was the most significant functional outcome of the treatment. It was also noted that limping could be improved if an adequate rehabilitation program was followed. We conclude that in neglected CDH cases with pain, limping and lumbar hyperlordosis in the young adult, a subtrochanteric valgus-extension osteotomy can give satisfactory results.
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PMID:Subtrochanteric valgus-extension osteotomy for neglected congenital dislocation of the hip in young adults. 1084 80

Valgus extension osteotomy (VGEO) is a salvage procedure for 'hinge abduction' in Perthes' disease. The indications for its use are pain and fixed deformity. Our study shows the clinical results at maturity of VGEO carried out in 48 children (51 hips) and the factors which influence subsequent remodelling of the hip. After a mean follow-up of ten years, total hip replacement has been carried out in four patients and arthrodesis in one. The average Iowa Hip Score in the remainder was 86 (54 to 100). Favourable remodelling of the femoral head was seen in 12 hips. This was associated with three factors at surgery; younger age (p = 0.009), the phase of reossification (p = 0.05) and an open triradiate cartilage (p = 0.0007). Our study has shown that, in the short term, VGEO relieves pain and corrects deformity; as growth proceeds it may produce useful remodelling in this worst affected subgroup of children with Perthes' disease.
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PMID:Valgus extension osteotomy for 'hinge abduction' in Perthes' disease. Results at maturity and factors influencing the radiological outcome. 1085 80

Hip disease occurs in between 8% and 28% of patients with Down's syndrome, many of whom develop disabling pain. We have carried out total hip replacement in six adult patients (9 hips) with severe arthritis of the hip. The mean follow-up was 7.75 years (2 to 14). At the latest review, all had relief of pain and full hip function. Increasing longevity and a high incidence of hip disease in these patients suggest a greater role for total hip arthroplasty in the future.
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PMID:Total hip arthroplasty in patients with Down's syndrome. 1087 61

This study investigated the effect of intramedullary corticocancellous bone plug on the fixation and stability of hydroxyapatite-coated femoral stems in total hip arthroplasty (THA). Intramedullary corticocancellous bone plug was used in 30 patients with hydroxyapatite-coated femoral stems (group A) and a consecutive series of 30 patients with hypdroxyapatite-coated stems without bone plug served as the control group (group B). Patients underwent clinical and radiographic follow-up for at least 2 years. The addition of corticocancellous bone plug to the hydroxyapatite-coated stem significantly improved clinical and radiographic results. The mean Harris Hip Score at 3 and 6 months postoperatively was 92 and 94 in group A, and 84 and 87 points in group B (P<.004 and P<.001, respectively). There was no significant difference between groups at 1 year postoperatively and thereafter. The predominant cause for the difference was the thigh pain score, which was reduced at both 3 and 6 months in group A compared to group B (P<.01 and P<.05, respectively). There also were statistical differences between the two groups regarding radiographic signs. The evidence of endosteal bone formation in group A patients was superior at 3 and 6 months (P<.001 and P<.01, respectively). The appearance of a radiolucent line was significant in group B patients at 3 and 6 months (P<.001). Femoral stem migration of 3 mm was noted in three group B patients versus no group A patients (P<.05). These short-term clinical and radiographic results suggest corticocancellous bone plug can provide early pain relief and durable implant fixation, but long-term follow-up should be considered.
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PMID:The effect of intramedullary bone plug on femoral stem migration of hydroxyapatite-coated hip arthroplasty. 1091 42

Current treatment for femoral head avascular necrosis has shown good results in early stages of disease, but are not as impressive after progression to collapse. We treated 19 patients (20 hips) with Stage III avascular necrosis (AVN) by open reduction augmented by methylmethacrylate cementation. Follow up ranges from 6 months to 2 years (average = 8.7 months). We followed patient progress with pre- and post-operative Harris Hip Scores, Womac Osteoarthritis Index and a Health Status Questionnaire (SF36). All patients realized immediate post-operative pain relief and improvement in function. Harris Hip, Womac Osteoarthritis Index and SF36 physical health scores improved significantly from 54.0 to 79.5 (p < 0.05), 54.3 to 29.8 (p < 0.05) and 28.4 to 42.4 (p < 0.05), respectively. Three patients had a conversion to total hip arthroplasty. Cementation is technically simple, burns no bridges and enables patients a rapid recovery. The long term results, in regards to progression of disease and secondary arthritis, are unknown.
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PMID:Open reduction and cementation for femoral head fracture secondary to avascular necrosis: preliminary report. 1093 20

Total hip arthroplasty for severe chronic proximal femoral migration, most commonly seen in congenital dislocation of the hip, has been associated with high rates of complications. A new technique of femoral subtrochanteric shortening osteotomy with the prosthesis in situ is described. This technique minimizes the potential complications, allows for correction of severe femoral neck anteversion, and gives excellent rotational stability, while preserving the proximal femur for better press-fit cementless fixation. In this series, there were 9 cases: 6 women and 2 men with a mean age of 53 years (range, 26-77 years). The average follow-up period was 56 months (range, 6-86 months). The mean preoperative Harris Hip Score was 31 (range, 20-35), and the mean postoperative score was 81 (range, 60-98). At follow-up, all patients reported significant pain relief and functional improvement. All osteotomies appeared to be healed on radiographs by 12 weeks. There were 3 complications. The first complication was a recurrent dislocation resulting from muscle incompetence, which was revised using a constrained liner and a 32-mm head with no further dislocations. The second complication was a breach of the femoral shaft, which was treated operatively using a longer stem. The third complication was a proximal femoral shaft split, which was treated by leaving the cerclage wire in situ. This technique should be considered in cases of congenital dislocation of the hip and when femoral shortening is needed.
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PMID:A new technique of subtrochanteric shortening in total hip arthroplasty: surgical technique and results of 9 cases. 1096 1

The aim of non-pharmacological intervention for osteoporosis is to prevent, treat or alleviate the consequences of osteoporosis, the main one of which is fracture. Non-pharmacological interventions consist of a wide spectrum of treatment modalities to decrease pain, correct postural change, improve mobility, enable the patient to follow a normal social life and prevent (further) fracture. An exercise programme can increase bone mass in adolescents and adults, but in the elderly its main emphasis should be on improving muscle strength and balance in order to decrease the risk of falls. Physiotherapy is commonly prescribed to mobilize the patient after a fracture, to decrease muscle spasm and pain, and to improve balance and co-ordination. An orthesis or back support may be used to correct kyphosis and decrease pain. Medication for pain is often needed and should cover both acute severe pain following fracture and chronic pain caused by postural change. A hip fracture is the most severe consequence of osteoporosis. The risk of hip fracture can be decreased by pharmacological treatment to increase bone mass and bone strength. However, in the very elderly the occurrence of falling may be more important than the failure of bone strength. Hip protectors have recently become available and have been shown to decrease the risk of hip fracture after a fall. These shunt the energy from the trochanter away to the sides. Non-pharmacological approaches to treatment are often neglected in daily practice, the emphasis being instead on treatment with drugs that decrease bone resorption and thereby increase bone strength.
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PMID:Non-pharmacological interventions. 1103 6

Orthopaedic surgeons have traditionally used disease-specific scoring systems that focus on relief of pain and improvement in function. However, these allow little scope for patient assessed outcomes such as quality of life. This study assessed quality of life before and after Total Hip Replacement (THR) using the Short Form 36 (SF-36) questionnaire. 100 patients were interviewed pre-operatively and 9 months to one year post-operatively. Data on waiting times/length of stay/complication rates were collected by reviewing clinical notes. The mean length of stay was 22.0 +/- 10.6 days, with a pre-operative length of stay of 5.0 days. 12 patients in all had a post-operative complication, including one post-operative death. There was a statistically significant improvement in overall SF-36 score (+19%) and in 7 out of the 8 parameters that make up the SF-36 score (p < 0.001). Patients undergoing THR in Navan showed a statistically significant improvement in their quality of life post-operatively. Complication rates were in keeping with international norms. It is apparent that patients receive a high quality of care.
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PMID:Quality of life following total hip replacement. 1110 48


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