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

The Swedish National Total Hip Arthroplasty register, which was started in 1979, is one of the oldest national quality registers in the world and consists of over 160,000 primary operations and 12,500 revisions. The register identifies risk factors for poor outcomes related to the patient, implant and surgical techniques. The end-point for failure, i.e., revision, does not provide information about the patient's general health after the primary procedure. The aim of this study was twofold. First, to validate the end-point for failure in the Swedish National Total Hip Arthroplasty register and secondly, to study general health after total hip arthroplasty. We validated the outcome of 1,056 primary THRs randomly selected from the Discharge register in Sweden by comparing the data to the Swedish THA register. These patients had answered the SF-36 and Nottingham Health Profile questionnaires. By comparing the clinical outcome, measured as general health, with the results obtained from the register, we evaluated the importance of the end-point for failure. We found that the end-point was useful, but further evaluations are desirable. Patients operated on with hip replacement do very well up to 10 years postoperatively and those who are not revised have good general health. The findings in this study can be used as a reference for others as it shows results from a national register, with a random selection of the study cohort.
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PMID:Outcome after total hip arthroplasty: Part I. General health evaluation in relation to definition of failure in the Swedish National Total Hip Arthoplasty register. 1102 82

The Swedish National Total Hip Arthroplasty Register contains more than 200,000 primary and secondary hip replacements. The failure end-point definition is revision. The aim of this thesis was to validate the results presented by the register and to study the outcome of hip replacement surgery in Sweden. The hypothesis was firstly that the number of failure reported to the Swedish THA register are valid and secondly that adding clinical and radiographic failure criteria will dramatically decrease the survival rate for THR implants. The study consisted of three parts with 2-10 years follow-up of patients with total hip replacements (THR). In part I, three general health questionnaires (Nottingham Health Profile, SF-36, EuroQol) and two disease-specific instruments (WOMAC, Harris Hip Score) were tested for validity and reliability (n = 62). The results showed the disease specific questionnaires are at least as valid and reliable as the general instruments are. In part II, all THRs reported to the Swedish THA register 1986 to 1994 (84,884 primary and 10,176 revision hip replacements) were compared with the data from the Discharge register and the Cause of Death register in Sweden. 2,604 patients were randomly selected from the Discharge register to determine if they had undergone any revision surgery. The study showed that the Swedish THA register covers 94% of the revisions actually performed in Sweden and the results did not differ significantly from the data in the Discharge register and the results reported by the patients. In part III, 1,056 patients from the selected cohort were studied further concerning general health and disease-specific health, using the Nottingham Health Profile, SF-36 and WOMAC. An age and gender matched subcohort of 344 patients were then examined clinically, using the Harris Hip Score, and radiographically. The clinical and radiographic failure rates were in several tests as high as the revision rates documented in the Swedish THA register. The clinical results were, however, dependent on demographics, the definition of clinical failure and the scoring system used. The results presented by the register with revision as failure end-point give an exact but limited information about the quality of hip replacement surgery in Sweden.
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PMID:On the validity of the results from the Swedish National Total Hip Arthroplasty register. 1113 72

Hip dislocation is one of the most common complications of THA. Good preoperative planning, good postoperative patient education, accurate intraoperative component positioning, rigorous intraoperative testing of hip stability, and good repair of soft tissues during closure all help prevent dislocation. Early postoperative dislocations and first or second dislocations usually are treated with closed reduction and a hip guide brace or hip spica cast, but when dislocation becomes recurrent, surgical treatment usually is needed. When possible, surgical treatment is based on identifying and treating a specific problem leading to the dislocation, such as implant malposition, inadequate soft-tissue tension, or impingement. In selected circumstances, constrained implants or bipolar or tripolar implants provide powerful tools to restore hip stability.
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PMID:Unstable total hip arthroplasty: detailed overview. 1137 23

We compared the clinical and radiographic outcome of 15 hips converted to total hip arthroplasty after failed transtrochanteric rotational osteotomy (THA after TRO) for avascular necrosis of the femoral head (ANFH) with that of a matched control group of 16 hips with primary THA for ANFH. The operating time in THA after TRO was significantly longer than that in primary THA. Perioperative blood loss in THA after TRO was significantly more than that in primary THA. Postoperative complications were observed in 4 hips of THA after TRO. The Harris Hip Score, the stability of implants, and survival rates did not significantly differ in both groups. We conclude that TRO did not influence the outcome of secondary THA at short- and middle-term follow-up.
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PMID:Total hip arthroplasty after failed transtrochanteric rotational osteotomy for avascular necrosis of the femoral head. 1630 91

The Swedish Hip Register was initiated in 1979. The mission of the register is to improve the outcome of THA. The hypothesis is that feedback of data stimulates participating clinics to reflect and improve. In addition to revision surgery, patient-based outcome measures and radiographic results are included to improve sensitivity. All patients who have a total hip arthroplasty answer a questionnaire preoperatively and again after 1, 6, and 10 years postoperatively. The questionnaire includes the Charnley classification, EQ-5D and visual analog scales concerning pain and overall satisfaction and is used by 31 of 81 units. Average costs for the procedure ($11,000) are obtained from a national database. The mean gain in the EQ-5D index after 1 year for 3900 patients was 0.37, giving a low cost of $3000 per quality adjusted life year. Patient satisfaction and pain amelioration generally was high. The national average 7-year survival (revision as endpoint), has improved from 93.5% (+/- 0.15) to 95.8 (+/- 0.15) between the two periods 1979 to 1991 and 1992 to 2003. National implant registers define the epidemiology of primary and revision surgery. In conjunction with individual subjective patient data and radiography they contribute to development of evidence-based THA surgery.
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PMID:Presidential guest address: the Swedish Hip Registry: increasing the sensitivity by patient outcome data. 1633 Sep 81

This study was designed to investigate bone remodelling around the cup in cementless THA. Previous studies indicate an advantage of better sealing of the bone-prosthesis interface by HA/TCP coating of implants, inhibiting polyethylene-induced osteolysis. One hundred patients gave informed consent to participate in a controlled randomized study between porous coated Trilogy versus Trilogy Calcicoat (HA/TCP coated). The cup was inserted in press-fit fixation. The femoral component was a cementless porous coated titanium alloy stem (Bi-Metric), with a modular 28-mm CrCo head. The Harris Hip Score (HHS) and bone mineral density (BMD) determined by DEXA scanning were used to study the effect. Measurements revealed no difference between the two groups after 3 years either in the clinical outcome or in terms of periprosthetic bone density. Patients with a body mass index above normal regained more bone mineral than patients with normal weight. This finding supports the assumption that load is beneficial to bone remodelling.
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PMID:Bone remodelling around HA-coated acetabular cups : a DEXA study with a 3-year follow-up in a randomised trial. 1676 Nov 53

Metal-on-metal total hip resurfacing is a bone-conserving reconstructive option for patients with advanced articular damage. While intended to address several problems with conventional THA, the safety and efficacy is not well established. We therefore retrospectively compared the outcomes of 52 patients (57 hips) with resurfacing arthroplasty to 84 patients (93 hips) with cementless primary THAs. The patients had a minimum 2-year followup (mean 3 years). The patients with resurfacing arthroplasty had a mean age of 47 years (range, 22-64) while those with cementless primary THA had a mean age of 57 years (range, 17-92). After controlling for age, gender, and preoperative differences, the total Harris Hip Scores (HHS), function scores, and pain scores were similar between the two groups. However, the resurfacing group had higher activity scores (14 versus 13, p < 0.001) and range of motion (ROM) scores (5.0 versus 4.8, p < 0.001). The complication rates (5.3% for resurfacing versus 14.0% for THA) and reoperation rates (3.5% for resurfacing versus 4.3% for THA) were similar. The total hip arthroplasty and metal-on-metal resurfacing groups both showed improvement in HHS, pain, activity, and ROM and had similar early complication and reoperation rates.
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PMID:Metal-on-metal hip resurfacing compares favorably with THA at 2 years followup. 1700 69

The success of operative treatment depends on a quick recovery of limb function. Every injury to a muscle or its attachment is associated with decreased muscle strength and disturbed proprioception, which impedes functional recovery. Minimally Invasive Surgery (MIS) is defined as a surgical technique performed through a short skin incision to avoid injury to muscles and tendons. The advantages of MIS over the classic technique in Total Hip Arthroplasty include: faster recovery, shorter rehabilitation and hospital stay, decreased blood loss, less pain and a shorter scar. The anterior approach to the hip, first described by Robert Judet in 1947 as a modified Smith-Petersen approach, follows the principles of MIS. Other approaches advertised as minimally invasive (posterior, lateral, or double incision approach) are associated with muscle and/or tendon injury. Therefore, they should be referred to as Less Invasive Surgery (LIS). Complications of THA performed with the MIS technique occur most often in women with osteoporosis, above 65 years of age, or with a BMI of more than 32. The rate of complications doubles with surgeons performing less than 50 THAs per year. A special set of instruments facilitates implantation of the endoprosthesis and reduces the number of complications. The anterior approach allows for implantation of an endoprosthesis without damage to muscles and their insertions, reduces tissue damage and, more importantly, decreases the intensity of postoperative pain. Should complications occur, the anterior approach has the advantage of allowing simple access to the proximal femur by extending the approach distally, as in the Smith-Petersen technique. However, the technical challenges of MIS and the risk of complications warrant caution.
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PMID:Minimally invasive approaches in total hip arthroplasty. 1760 94

Unlike the knee, range of motion has been of questionable value in evaluating clinical outcome after THA. We retrospectively analyzed the ranges of motion (flexion, abduction, adduction, external rotation, internal rotation, and flexion contracture) of 1383 patients (1517 hips) having primary THA. We recorded Harris hip score components for walking distance, stair climbing, socks and shoes, sitting, pain, presence of limp, and use of support devices. Postoperative hip motion was defined as high (115 degrees of flexion, 25 degrees of abduction, 20 degrees of external rotation, and less than 20 degrees of flexion contracture), average (90 degrees -114 degrees of flexion, 16 degrees -24 degrees of abduction, or 11 degrees -19 degrees of external rotation, and less than 20 degrees of flexion contracture), or low (less than 90 degrees of flexion, 15 degrees or less of abduction, 10 degrees or less of external rotation, or 20 degrees or more of flexion contracture) motion. We correlated this with high, average, or poor postoperative Harris hip scores. Hip motion was found to be correlated with postoperative hip function and may be more useful than previously thought in evaluating hip outcome.
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PMID:The importance of range of motion after total hip arthroplasty. 1809 Apr 72

The High-Activity Arthroplasty Score (HAAS) was specifically developed to assess subtle variations in functional ability after lower limb arthroplasty with particular regard to highly functioning individuals. The score was a 4-item self-assessment measure covering the 4 domains of walking, running, stair climbing, and general activities, with a possible score ranging from 0 to 18 points. The score was validated in 22 patients (total hip arthroplasty [THA], n = 11; total knee arthroplasty [TKA], n = 11) by comparison with the Oxford, Knee Society, Harris Hip, and Short WOMAC scores. The HAAS was then administered to 152 high-functioning arthroplasty patients (THA, n = 99; TKA, n = 53), all younger than 66 years. The HAAS produced a much wider range of scores, allowing greater differentiation of level of function between patients in assessing performance after TKA or THA.
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PMID:Use of a new high-activity arthroplasty score to assess function of young patients with total hip or knee arthroplasty. 2693 89


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