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

Six patients with lumbar fractures were studied at the Pathokinesiology laboratory at Rancho Los Amigos Hospital following posterior Harrington distraction instrumentation to identify changes in posture and gait associated with iatrogenic loss of lumbar lordosis. Three patients, all with painful rods, were treated with standard Harrington instrumentation and full length fusion. Three patients were treated with so-called "rodded long-fused short" procedures. It was thought that rod removal in the latter group would result in restoration of lumbar lordosis with concomitant improvement in posture and gait when compared to the full length fusion group. No significant difference between the two groups was found. Rod removal often resulted in kyphotic collapse at the previous fracture site despite solid posterior arthrodesis with net decrease in lumbar lordosis. Hip hyperextension, when available, was the favored compensatory mechanism for loss of lumbar lordosis. Otherwise, hip flexion and forward lean of the trunk was seen.
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PMID:Gait abnormalities arising from latrogenic loss of lumbar lordosis secondary to Harrington instrumentation in lumbar fractures. 664

Arthroscopy of the hip joint has developed into a useful tool for the hip surgeon. Hip joint anatomy, however, makes special demands of the arthroscopist. He needs to be familiar with the arthroscopic anatomy of the hip and its variations. Moreover, he should have practical training in the technique of hip arthroscopy prior to his first intraoperative experience in order to avoid complications. A complete arthroscopic inspection of the hip can be achieved by using a combined procedure: whereas the central hip compartment can be scoped only by distraction of the joint, the periphery can be better seen without traction. Whether to place the patient supine or lateral is dependent on personal experience. No matter which position is used, the positioning technique has to be exact. The literature has shown that most complications are related to traction. Before the first portal is placed, the joint vacuum force should be broken by distension of air or fluid. This leads to maximum distraction of the joint and reduces the risks of damage to labrum and cartilage during first access to the joint. For a diagnostic round through the central compartment, at least two portals have to be placed. The use of a 3-portal technique increases the range of inspection. Due to the relatively thin soft tissue mantle and greater distance to neurovascular structures, the anterolateral or lateral portal should be used as the first portals to the central compartment. In addition, the anterolateral portal is the standard portal to the periphery of the hip. The posterolateral or anterior portal should be used as a supplementary portal. The following indications have been described for an arthroscopic procedure of the hip: loose bodies, labral lesions, synovial diseases such as chondromatosis and pigmented villonodular synovitis, associated lesions in underlying osteoarthritis, ruptures of the teres ligament, malorientation of the acetabulum and proximal femur and, last but not least, "idiopathic" hip pain. The use of hip arthroscopy in infectious arthritis, avascular necrosis of the femoral head, Perthes' disease, osteochondrosis dissecans and complications after total hip replacement is less frequent. Here, in addition to its diagnostic value, operative arthroscopy of the hip offers removal of loose bodies, resection of the labrum and ligaments, synovial biopsy, partial synovectomy, microfracturing, lavage and placement of intraarticular drainage. The first results of arthroscopic procedures in the hip are promising. In addition to its diagnostic value and contribution to the understanding of intraarticular anatomy and pathology, recent studies have demonstrated the advantages of the arthroscopic treatment of the hip.
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PMID:[Hip arthroscopy. Minimal invasive diagnosis and therapy of the diseased or injured hip joint]. 1138 58

Hip arthroscopy is commonly used both to diagnose and treat different underlying hip conditions. It may be performed either by a supine or lateral approach. A peroneal post is commonly used with a fracture table in both the supine and lateral positions to provide lateralization and traction of the femur. Adequate distraction of the hip joint may be difficult without the peroneal post. We achieved an effect similar to that of a peroneal post using a simple technique of peroneal padding. A long cushioning jelly bag is first wrapped around the peroneal post. It is then fixed by taping and further secured by bandaging. The patient is positioned so that the femur lies against this peroneal padding to provide optimal lateralization of the femur. Distraction of the hip joint is then performed by traction of the femur. We believe peroneal padding is a simple technique that allows adequate lateralization and good positioning of the femur.
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PMID:Peroneal padding: an alternative to a peroneal post in hip arthroscopy. 1460 27

Sixteen children with late onset Perthes' disease were surgically treated at an average age of 12 years 1 month (9 years 4 months to 15 years) by soft tissue release and articulated hip distraction. Two patients had additional diagnosis of Down syndrome and one suffered from geleophysic epiphyseal dysplasia. Fifteen hips were graded Catterall IV and Herring C and one hip was graded Catterall III Herring B. On preoperative arthrograms, 14 patients had a saddle-shape subluxating femoral head with hinge abduction. The distraction discontinued when Shenton line was corrected. The fixation lasted 4-5 months. At a mean follow-up of 2 years 7 months (1-5 years), an improvement of hip range of motion was found in all patients. Hip joint arthrograms upon removal of the fixator showed disappearance of the saddle-shape femoral head in 10 of the 14 patients with this deformation. Shenton line breakage improved from 7.6 mm to 2.1 mm at last follow-up. The epiphyseal index improved by 14%. The average pain score on an analog scale dropped from a preoperative 7.0 to 1.6 at last follow-up (filled in by patients or parents in case of Down syndrome). Separate analysis of data from the group having only Perthes disease (13 children) showed better results. These preliminary data suggest that soft tissue release combined with unloading of the femoral head and restoration of joint space can improve the function and epiphyseal height.
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PMID:Treatment of severe late onset Perthes' disease with soft tissue release and articulated hip distraction: early results. 1508 15

Nine adolescent patients with new onset hip pain and previous Legg-Calve-Perthes disease (LCPD) were evaluated by hip arthroscopy. Eight of the nine patients had previous hip surgery for their LCPD and a pain-free interval averaging over 5 years. Hip arthroscopy was performed in the supine position on a fracture table using a distention distraction technique. Eight of the nine hips had intra-articular abnormalities including; four tears of the ligamentum teres, three femoral head osteochondritis dissecans, two labral tears, two hips with significant synovitis and three hips with other femoral head abnormalities. Seven of the eight hips improved following their arthroscopic treatment and the patients returned to their before-pain activities including sports. Three patients have required subsequent surgery. The abnormal mechanics from residual femoral head deformity may increase the risk of developing a variety of painful lesions. Hip arthroscopy is a safe way to evaluate and treat these intra-articular abnormalities.
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PMID:Arthroscopic findings of the hip in new onset hip pain in adolescents with previous Legg-Calve-Perthes disease. 1581 83

Severe unstable slipped capital femoral epiphysis (SCFE) usually requires some form of reduction before stabilization to avoid loss of motion and to prevent the development of early degenerative arthritis. Gentle manipulation and traction is being used to achieve reduction. The force applied with these techniques is uncontrolled and unpredictable, and may add to the pre-existing risk of avascular necrosis of the femoral head in such cases. The authors report a case of acute on chronic, severe, unstable SCFE in which reduction was satisfactorily achieved by gradual distraction using an external fixator across the hip joint. The patient did not show signs of avascular necrosis or chondrolysis at a follow-up of 38 months. Hip function was excellent with Iowa hip score of 98 at the final follow-up.
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PMID:Unstable slipped capital femoral epiphysis: reduction by gradual distraction with external fixator. A case report. 1620 18

Many pathological entities that previously could be accessed only through large, open incisions now can be treated arthroscopically. Furthermore, arthroscopy has allowed certain conditions to be diagnosed that previously were unrecognized. Arthroscopic hip surgery has become an accepted surgical procedure with well-defined indications and expected outcomes, primarily because of recent advances in surgical instrumentation and techniques. Hip arthroscopy is performed as a same-day procedure using a fracture table to apply distraction to the hip joint. Coordination among surgeons and perioperative nursing staff members is essential for achieving consistent results and minimizing complications during this technically demanding procedure.
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PMID:Arthroscopic hip surgery. 1647 81

Canine hip dysplasia (CHD) is characterized by a malformation of the hip joint that leads to joint laxity and consequential degenerative joint disease. The most widely used method for diagnosis of CHD is the ventrodorsal hip-extended radiologic view, commonly referred to as the Orthopedic Foundation for Animals (OFA) method. The method of the University of Pennsylvania Hip Improvement Program (PennHIP), an alternative technique that is based on hip joint laxity, provides a quantitative assessment, the distraction index (DI), of the likelihood of the development of CHD because of increased laxity in the hip joint. Linear regression analysis showed that, across many breeds of dog, the incidence of CHD, as defined by the OFA, is positively correlated with the mean DI, the determination coefficient (r2) being 26%. We used families of Boykin spaniels (BSs) to determine the level of joint laxity in the breed and to conduct an initial whole-genome screening to identify markers that co-segregate with increased joint laxity. Although there was a positive correlation between the incidence of hip dysplasia and increased joint laxity, we did not find significant linkage in the 28 BSs that underwent genotyping, likely owing to the small size of the pedigree.
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PMID:Clinical and genetic assessments of hip joint laxity in the Boykin spaniel. 1663 48

Hip arthroscopy is technically demanding, with a steep learning curve, and requires special distraction tools and operating equipment. Access to the hip joint is difficult because of the resistance to distraction resulting from the large muscular envelope, the strength of the iliofemoral ligament, and the negative intra-articular pressure. This operation should not be done without specific education in its methods.
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PMID:Hip arthroscopy: indications, outcomes, and complications. 1695 65

Hip palpation has been used to provide semiquantitative information regarding passive joint laxity and susceptibility to hip dysplasia. The purpose of this study was to: (1) evaluate the intra- and inter-examiner repeatability of the hip reduction angle measured at 4 months of age by three examiners using manual goniometry and an electromagnetic tracking system; (2) compare the hip reduction angle measured with manual goniometry to the hip reduction angle measured with the electromagnetic tracking system; and (3) evaluate the hip reduction angle, distraction index and Ortolani manoeuvre at 4 months of age as predictors of the development of hip osteoarthritis at 12 months of age in 11 Labrador Retriever dogs. Intra- and inter-examiner repeatability was demonstrated for both the manual and electromagnetic goniometric measurement of the hip reduction angle (coefficient of variation < 4.3% and < 6.1%; and P = 0.163 and P = 0.836 respectively). The hip reduction angle measured by manual goniometry was moderately correlated to the hip reduction angle measured by the electromagnetic tracking system (r = 0.603, P < 0.0000). The hip reduction angle measured by manual and electromagnetic goniometry was a poor predictor of osteoarthritis at 12 months of age (r = 0.231, P < 0.062, and r = 0.321, P < 0.01). The distraction index was moderately correlated with the development of osteoarthritis by 12 months of age (r = 0.493, P < 0.0000). The Ortolani sign was sensitive (100%) but not specific (41%) for the development of osteoarthritis at 12 months of age. The hip reduction angle did not further quantify the Ortolani manoeuvre as a predictor of osteoarthritis in Labrador Retrievers.
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PMID:Assessment of the hip reduction angle for predicting osteoarthritis of the hip in the Labrador Retriever. 1754 32


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