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

As part of the National Study of Primary Hip Replacement Outcome, 402 consultant orthopaedic surgeons from three regions were contacted by postal questionnaire which covered all aspects of total hip replacement (THR). There was a 70% response rate of which 71 did not perform hip surgery, a further 33 refused to take part, leaving 181 valid responses. Preoperative assessment clinics were used by 89% of surgeons, but anaesthetists and rehabilitation services were rarely involved at this stage. Of respondents, 99% used routine thromboprophylaxis, with 79% using a combination of mechanical and chemical methods. Of surgeons, 84% routinely used stockings, whereas 95.5% used chemical prophylaxis, 63% employed low molecular weight heparins. Theatre facilities were shared with other surgical specialties by 6% of surgeons and 18% regularly used body exhaust suits for THR. Antibiotic loaded cement was used by 69% of surgeons, the majority (65%) used a single brand of normal viscosity cement with 9% using reduced viscosity formulations. Modern cementing techniques were commonly used at least in part, 87% used a cement gun and 94% a cement restrictor for femoral cementing. On the acetabulum, 47% pressurised the cement. In all, 36 different femoral stems and 35 acetabular cups were in routine use, but the majority of surgeons (55%) used Charnley type prostheses. Of the surgeons, 57% performed only cemented THR, while 3% exclusively used uncemented THR. Of consultants, 21% followed up their patients to 5 years, the majority discharge patients within the first year. Of concern is a large proportion of surgeons using low molecular weight heparins despite a lack of evidence with regard to reducing fatal pulmonary embolism, and also the small number of surgeons using prostheses of unproven value. Third generation cementing techniques have yet to be fully adopted. The introduction of a national hip register could help to resolve some of these issues.
Ann R Coll Surg Engl 1998 Sep
PMID:Current practice in primary total hip replacement: results from the National Hip Replacement Outcome Project. 984 38

Nearly 1.5 million American men age 65 and older have osteoporosis, and another 3.5 million are at risk. Hip fractures in older men have a higher mortality than in women and represent a growing medical problem. Glucocorticoid treatment, hypogonadism, and excessive alcohol consumption are important secondary etiologies for loss of bone mass in men. Detection of hypogonadism may be difficult, and testosterone replacement is indicated for only a well-defined subset of patients. Because of a lack of data on pathogenesis, risk factors, and therapeutic interventions in men, treatment decisions are usually based on extrapolation from studies in women. None of the medications approved by the FDA for the treatment of osteoporosis in postmenopausal women has been approved for use in older men, but physicians are prescribing bisphosphonates and calcitonin.
Geriatrics 1999 Sep
PMID:Osteoporosis in older men: discovering when and how to treat it. 1049 25

Hip fractures constitute a major health problem. For effective prevention, high-risk groups need to be identified. The objective here was to develop hip fracture risk scores while assessing the added value of bone mineral density relative to more conventional risk indicators. We prospectively followed during 4 years a cohort of 5208 persons (2193 men) aged 55 years and over from the Rotterdam Study, a population-based cohort study conducted in the Netherlands. Risk scores for hip fracture were constructed using several conventional risk indicators requiring interview and anthropometry only, and bone mineral density. During follow-up, 50 persons (14 men) suffered hip fracture. Hip fracture risk was independently determined by age, gender, height, the use of a walking aid, cigarette smoking, and either bone mineral density or weight. We developed two risk scores, with and without bone mineral density. The observed 4-year risk ranged from 3/3389 (0.1%) to 17/169 (10.1%) for the lowest and highest category of the score including bone mineral density, respectively. For the score without bone mineral density, these risks were 8/3117 (0.3%) and 16/144 (11.1%), respectively. The area under the receiver operating characteristic curve indicating discriminatory power was 0.88 for the risk score including, and 0.83 for the score excluding, bone mineral density (p for difference = 0.04). In conclusion, risk scores with and without bone mineral density measurement can be used for hip fracture risk assessment in elderly persons. While the score with bone mineral density has a modestly better performance, the score requiring interview and anthropometry only may be especially useful in primary care settings.
Bone 1999 Sep
PMID:Added value of bone mineral density in hip fracture risk scores. 1049 42

Failure to conservative treatment in patients with less advanced radiographic signs of osteoarthritis of the hip (Danielsson grade 2-5) confronts with the decision of further treatment. Since radiographic imaging has not been proved very useful in demonstrating intraarticular structures and results of hip arthroscopies have been promising, arthroscopies have been performed in 17 hips from November 1997 to September 1998. Arthroscopic findings were exceeding preoperative imaging. In addition to cartilage degeneration, concomitant loose bodies, impinging osteophytes, degeneration of the labrum and synovial disease were found. Removal of loose bodies and osteophytes, partial resection of labral tears and partial synovectomy were performed. 1 month after arthroscopy (n = 15), mean Harris-Hip-Score was increased by 13 points und pain reduced by 39 % on average. 6 months after arthroscopy (n = 9), mean Harris-Hip-Score was increased by 14 points and pain reduced by 32 % on average. In addition to its therapeutic benefit, arthroscopy offers direct visualisation of the hip providing important information for the decision of further treatment.
Orthopade 1999 Sep
PMID:[Arthroscopy for diagnosis and therapy of early osteoarthritis of the hip]. 1052 92

Studies of the etiology of premature osteoarthritis of the hip show that the most common cause is residual childhood hip dysplasia. Hip dysplasia is often asymptomatic in childhood, making detection difficult and creating complex treatment decisions (major surgery in the asymptomatic child). Symptoms do not develop typically until the teenage or early adult years, and surgical correction at this age is often incomplete and complicated. In contrast, if the dysplasia is recognized early, surgical correction can be performed using simpler osteotomies with more predictable results. Our experience with children, adolescents and adults with residual hip dysplasia has led us to adopt a philosophy of early surgical correction which seeks to normalize hip joint morphology by age 5 or 6 years. The reasoning, methods and early results of this approach are reviewed in this paper.
Acta Orthop Belg 1999 Sep
PMID:Early surgical correction of residual hip dysplasia: the San Diego Children's Hospital approach. 1054 50

Hip fracture among the elderly is a large and growing public health issue. Presently, all therapies approved for treatment and prevention of osteoporosis involve pharmacological agents that act systemically. In this study, we evaluated the feasibility of preventing osteoporotic hip fractures with local, rather than systemic, therapy. Our hypothesis is that local therapy to increase bone density may be as effective as systemic therapy in reducing fracture risk. Thus, the goal of this investigation was to use finite element analyses to study the effect of a localized increase in bone density on the strength of an osteopenic, human femur. Finite element predictions of the failure load were made after increasing the bone density within small regions in the proximal femur. The outcome variable from these analyses was the predicted load required to break a femur in a simulated fall to the side with impact on the greater trochanter. Increasing the density by 25% relative to baseline values in a small region (0.86 cm3) of the femoral neck increased the predicted failure load by 6.2%. The same density increase in a much larger region (4.92 cm3) increased the failure load by 15%. Inclusion of more than one region of increased density provided little additional benefit. In comparison, when the density of the entire femur was increased by 5% relative to baseline values, the predicted failure load increased by 5.4%. These findings suggest that agents capable of inducing increased bone density in small regions of the proximal femur have the potential to reduce the risk of hip fracture.
J Orthop Res 1999 Sep
PMID:Effect of local density changes on the failure load of the proximal femur. 1081 38

The purpose of this analysis was to evaluate the relationship between age and the size and distribution of the fat and lean tissue compartments in a population-based sample of women. The study population consisted of the 875 women aged 18-94 y in the Iowa Bone Health Study who reported never smoking. Fat mass and lean mass were measured using dual X-ray absorptiometry. Hip and waist circumference and height were measured using standardized protocols. Regression was used to model the associations among age, composition and topology measures. When fat mass was modeled as a function of hip and waist circumference as well as age, age(2) and height, the age x height and age x waist circumference interaction terms remained in the fitted model and collectively accounted for 91% of the variance. In contrast, the quadratic model of age alone accounted for 8% of the observed variance in fat mass. Lean mass was modeled in two segments, with age dichotomized at 58 y. Age alone did not predict lean mass in women <58 y but did predict lean mass in women >/=58 y, with the modeled relationship including interactions with waist circumference and height. These models accounted for 70% of observed variance in lean mass. Age is associated with body composition but explains <10% of variation. When measures of height and circumferences are available, amounts of lean and fat mass are highly predictable. This is particularly important for lean mass because no other surrogate measures exist for lean mass, whereas there are surrogates for fat mass, including body mass index.
J Nutr 2000 Sep
PMID:The interrelationship between body topology and body composition varies with age among women. 1095 38

We previously have identified murine heparin/heparan sulfate-interacting protein (HIP) identical to mouse ribosomal protein L29 that is, like its human orthologue, distinctively expressed both on the cell surface and intracellularly in different adult tissues and cell types. In the present study, we show that mouse HIP/RPL29 is encoded by a single mRNA and that it is expressed to different extents in most of the tissues of the developing embryo without restriction to a specific cell type. We isolated the single-copy gene coding for murine Hip/Rpl29 among a large number of pseudogenes, established its structure, and assigned its location to distal chromosome 9. Similar to other ribosomal protein promoters, the promoter of Hip/Rpl29 is rich in polypyrimidine tracts, contains binding motifs for ubiquitously expressed transcription factors, and lacks a TATA box. Progressive 5' deletion analyses identified a strong enhancer region that includes CT-rich sequences and a potential consensus binding site for NF-kappaB. These data will provide valuable tools to progress the understanding of HIP/RPL29 function as a ribosomal protein and/or as a regulator of growth and cell adhesion through interaction with heparan sulfate proteoglycans.
Genomics 2000 Sep 01
PMID:Cloning, expression, and chromosome mapping of the murine Hip/Rpl29 gene. 1096 19

The purpose of this study was to determine to what extent hip joint separation occurs during normal gait on a treadmill and an abduction/adduction leg-lift maneuver in patients who have undergone total hip arthroplasty (THA). Eight patients who had a total of 10 successful unconstrained THAs (Harris Hip Scores >90) performed successive gait motions on an electronically powered treadmill and an abduction/adduction leg lift while under fluoroscopy. The fluoroscopic video images were analyzed using a 3-dimensional model-fitting technique that converts 2-dimensional fluoroscopic images into 3-dimensional real-time images. Hip joint separation was determined to be present if the amount of separation was >0.75 mm, the calculated linear error. During both activities, all 10 THAs experienced femoral head/acetabular component separation. For gait, the maximum amount of separation was 2.8 mm, while the minimum amount was 0.8 mm (average, 1.2 mm). For abduction/adduction leg lift, the maximum amount of separation was 3.0 mm, while the minimal amount was 1.7 mm (average, 2.4 mm). It appears that the femoral head separates from the acetabular component but remains in contact with the superior-most tip of the component. Potential detrimental effects resulting from hip joint separation include premature polyethylene wear and component loosening. Wear may be enhanced because of the creation of multidirectional wear vectors or excessive loads resulting from eccentric femoral head pivoting. These data may be valuable in hip simulation studies to better duplicate wear patterns observed in retrieval analysis.
J Arthroplasty 2000 Sep
PMID:An in vivo determination of total hip arthroplasty pistoning during activity. 1174 Jul 71

We reviewed 598 cemented Charnley and Hi-nek total hip arthroplasties at 7 years. Data were obtained from general practitioners, hospital medical notes, microfilm, and patient questionnaires. Outcome measures were revision rates, survival analysis, 12-item Oxford Hip Score, and satisfaction ratings. There were 471 Charnley (79%) and 127 Hi-nek (21%) total hip arthroplasties; 139 deaths (23%) occurred, and 5 (<1%) were lost to follow-up. Characteristics of the Charnley and Hi-nek patient groups were similar, with more information missing for Charnley cases. Revision rates were Charnley, 37 (8%), and Hi-nek, 6 (5%) (not significant). Survival analysis revealed no difference between the 2 groups (P = .23). The patients' median Oxford Hip Score was low/good (19), slightly worse for the Hi-nek group (not significant). Taking all evidence together, neither implant was outperforming the other at 7 years.
J Arthroplasty 2000 Sep
PMID:Issues relating to long-term follow-up in hip arthroplasty surgery: a review of 598 cases at 7 years comparing 2 prostheses using revision rates, survival analysis, and patient-based measures. 1102 46


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