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

There has been growing concern regarding the systemic and local effects of metal ions released from metal-on-metal hip resurfacings and total hip replacements, including the development of aseptic lymphocyte dominated vasculitis associated lesions (ALVAL). We describe our experience of treating 13 patients with failed metal on metal bearing hip prostheses secondary to this condition. Hip revision occurred at mean of 45 months following primary surgery. Groin pain was present in all patients. Other common features included large bursal swelling and mechanical symptoms. 3 patients developed their symptoms immediately postoperatively. The mean time to presentation was 21 months. Radiographic abnormalities noted included 3 patients with cup loosening and 2 patients with neck thinning. The mean cup inclination was 52 degrees. Surgical findings included bursal swellings and creamy brown fluid. Osteolysis was rarely seen. 12 revisions were achieved with primary implants and all patients had immediate symptomatic improvement. One patient was left with a pseudoarthrosis due to extensive soft tissue destruction. Diagnosis of ALVAL was confirmed histologically. The diagnosis of ALVAL should be considered in patients with unexplained pain from a metal on metal bearing hip arthroplasty. Surgical findings are typical and symptoms tend to resolve reliably following conversion to an alternative bearing surface.
Hip Int
PMID:Clinical experience of revision of metal on metal hip arthroplasty for aseptic lymphocyte dominated vasculitis associated lesions (ALVAL). 2127 62

Recent orthopaedic literature has implicated femoroacetabular impingement, the pathologic abutment of structural aberrancies in the proximal femur and acetabular rim, as an important cause of groin pain in young individuals and a potential factor in early idiopathic osteoarthritis. The etiology and risk factors for developing cam-type morphology are still unknown. The osseous anatomy of the proximal femur in humans is the culmination of nearly 400 million years of evolution. Coxa recta and coxa rotunda are the two predominant morphologies in modern animals. While the former, characterized by a straight head-neck junction, is often present in cursorial creatures, the latter, [corrected] distinguished by high offset at this junction, is exemplified in most humans. Based on the ontology and phylogeny of the proximal femur, coxa rotunda probably developed from a more primitive coxa recta. We believe that cam-type morphology is neither a redevelopment of coxa recta nor a malformation such as slipped capital epiphysis. The aspherical osteocartilaginous bump is associated with an extended physis and has been noted to appear during mid-adolescence. While this protuberance may contribute to future pathology, the authors feel that increased loading of the hip, not impingement activities, during late childhood and early adolescence predispose patients to develop this morphology.
Hip Int
PMID:More than just a bump: cam-type femoroacetabular impingement and the evolution of the femoral neck. 2169 93

Hip and groin pain are a common complaint among athletes of all ages, and may result from an acute injury or from chronic, repetitive trauma. Hip injuries can be intraarticular, extraarticular, or both. Labral abnormalities may occur in asymptomatic patients as well as in those with incapacitating symptoms and signs. Athletic hip injury leading to disabling intraarticular hip pain most commonly involves labral tear. The extraarticular causes are usually the result of overuse activity, leading to inflammation, tendonitis, or bursitis. In clinical practice, the term athletic pubalgia is used to describe exertional pubic or groin pain.
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PMID:Radiology. 2141 55

We present a novel arthroscopic-assisted technique to graft chondral defects and subchondral cysts of the acetabular socket using a synthetic osteochondral plug. Four patients with groin pain,solitary cysts in the roof of the acetabulum and radiographic evidence of early osteoarthritis were treated. A bone tunnel was prepared from the region of the iliac crest to the acetabular articular surface.A synthetic osteochondral plug was inserted in an ante-grade fashion and positioned flush with the lunate articular cartilage. The minimum follow-up from surgery was 8 months (mean 10 months,range 8 to 11 months). There were no peri-operative complications related to the procedure. All patients reported an improvement in symptoms and function at the latest follow-up. One of the patients underwent a re-look arthroscopy at 5 months for persistent dull groin and buttock pain. Capsular adhesions of the labrum were identified and released. The mean non-arthritic hip score improved from 53.8 (range 43.8 to 70) pre-operatively to 84.6 (range 78.8 to 87.5) at 6 months. Computed tomography and magnetic resonance imaging at 6 months confirmed the stability of the osteochondral plugs and on-going healing. This procedure offers an arthroscopic means to treat patients with solitary acetabular cysts and may prove effective for chondral grafting of denuded acetabular areas in early to moderate degenerative hip disease.
Hip Int
PMID:Arthroscopic grafting of chondral defects and subchondral cysts of the acetabulum. 2181 47

Hip and groin pain is a common condition in professional athletes and may result from an acute injury or from chronic, repetitive trauma. It is responsible for significant morbidity, which leads to time away from training and competition, and may result in a career-ending injury. The anatomic and biomechanical causes for hip and groin injuries are among the most complex and controversial in the musculoskeletal system. This makes clinical differentiation and subsequent management difficult because of the considerable overlap of symptoms and signs. This review article will evaluate several pathologic conditions of the hip and groin in athletes, divided into acute (secondary to single event) and chronic (secondary to altered biomechanical load or repetitive microtrauma) injuries, with an emphasis on imaging in the diagnosis of these injuries. Appropriate use of imaging along with clinical findings can allow accurate diagnosis and subsequent appropriate management of these patients to ultimately allow return to athletic activity.
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PMID:Hip and groin pain in the professional athlete. 2182 Feb 70

We compared 47 patients with groin pain following hip resurfacing to a matched control group. Functional scores and plain radiographs were assessed along with measurement of whole blood cobalt and chromium by inductively coupled mass spectrometry. Symptomatic patients underwent ultrasound scan of the affected hip. Mean functional outcomes were poor in those with pain and good in the control group. Groin pain was associated with valgus stem positioning and lower neck:head ratio (relatively narrow neck) (p=0.03, p=0.04 respectively). We classified patients with groin pain into two groups: biological and mechanical. The biological group had soft tissue abnormalities on USS and higher levels of cobalt and chromium (p=0.04, p=0.05 respectively). The mechanical group had normal USS, lower metal ion levels and more retroverted femoral components (p=0.01).
Hip Int
PMID:Groin pain following hip resurfacing: a case-control study. 2196 Apr 49

Metal-on-metal bearings have become more popular for hip arthroplasty in younger patients in the last 15 years. We present a review of the neurological consequences relating to such bearing surfaces illustrated by an appropriate case report. The mechanisms of increased metal ion production and pseudotumour formation are discussed. If unexplained neurology, hip/groin pain or a localised mass around the hip are present with a metal bearing hip then urgent referral to a specialist orthopaedic surgeon is warranted for consideration of exchange arthroplasty.
Hip Int
PMID:Metal-on-metal bearings, inflammatory pseudotumours and their neurological manifestations. 2247 31

The performance of the Cormet hip resurfacing device was evaluated after a minimum of 5 years in 234 hips. The mean age of the patients was 54 years; there were 135 men and 80 women. The primary diagnosis was osteoarthritis in 78% of the patients. Outcome measures were the Harris Hip Score and implant survival. The overall survival rate was 94% with 12 revisions in women and 3 in men. There were 7 femoral and 5 acetabular failures and two revisions for groin pain. Cumulative survival rate in men and women was 98% and 89%, in patients with a femoral component larger than 44 mm and smaller than 44 mm 97% and 89% respectively. Patients with primary osteoarthritis had a 95% cumulative survival rate at 5 years. The risk of failure was 6.4 times higher in women than in men. Our results suggest that hip resurfacing with the Cormet device is an acceptable alternative for active patients with hip arthritis, but patient selection is crucial for good long-term results.
Hip Int
PMID:Minimum 5-year follow-up after Cormet hip resurfacing. A single surgeon series of 234 hips. 2250 79

Hip labral impingement can cause labral tears and secondary paralabral cyst formation. Femoroacetabular impingement is the main cause of labral impingement, but other conditions such as iliopsoas tendon impingement are described. There is no description of labral cyst resulting from psoas impingement treated arthroscopically in the literature. We present the case of a young sportsman with groin pain caused by psoas impingement with a labral tear and secondary paralabral cyst who was treated arthroscopically by cyst debridement, psoas tenotomy, and labral repair.
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PMID:Hip labral cyst caused by psoas impingement. 2284 Sep 90

Femoroacetabular impingement is a diagnosis that is often missed in patients with chronic groin pain. The condition often appears in young athletes. An anatomic deformity of the femoral head and the acetabular ridge causes an impingement that damages the subchondral tissue. This damage can result in sharp pain in the groin during specific hip movements and the acetabular labrum may also be ruptured. Diagnosing femoroacetabular impingement and a labral tear can be a challenge. We present the case of a 19-year-old male who twisted his right hip joint during a game of football. Physiotherapy only aggravated the pain. Further diagnostics showed femoroacetabular impingement and a labral tear. Arthroscopic intervention in the hip joint by an orthopedic surgeon lead to immediate pain relief, and two years after surgery the patient is still free of pain and has returned playing sport at his previous level. Femoroacetabular impingement can be a cause of chronic groin pain in young athletes. Hip arthroscopy is a safe and effective treatment, enabling the patient to return to playing sport at their previous level.
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PMID:[Femoroacetabular impingement: frequently missed in patients with chronic groin pain]. 2324 8


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