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

We followed up 34 secondary osteoarthritis patients with 38 hips treated by valgus-flexion osteotomy between 1979 and 1985. The average age of the patients at surgery was 45 years and the follow-up period ranged from 5 to 11 years. After surgery, the clinical evaluations were made according to the JOA Hip Score which remained unchanged in all 38 hips for 5 years. After 6 years there were some hips whose score declined with time. It was found that the preoperative extension-flexion range was the factor that was most closely associated with the result of the surgery (p less than 0.01). Radiological examination at 5 years revealed that the joint space had been widely broadened and the trabecular structure nearly normalized in 23 hips (60.5%), while 15 hips (39.5%) showed a slight degree of joint space broadening and were left with sclerosis and pseudocysts. After a lapse of 10 years or more, in 13 hips out of 10 patients, seven were found to have osteoarthritic changes and revision had to be done by THR in 2 patients. Valgus-flexion osteotomy can therefore be said to provide one of the useful means to preserve joints when employed in middle-aged patients with secondary OA.
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PMID:Valgus-flexion osteotomy for middle-aged patients with advanced osteoarthritis of the hip: a clinical and radiological evaluation. 159 92

Thirteen failed stem of Total Hip Replacement were studied: 9 were Charnley THR from an homogeneous series, which gives an incidence of 2.4% of stem fractures with a follow-up of 9-16 years; 4 were Mueller THR. Fatigue fracture of the stem occurred by defective support of the proximal part of the femur, following resorption of the calcar. In all cases reactive tissue to foreign body particles, metal and polyethylene, was found where bone resorption occurred. In Mueller THR wear of the cup produced the large amount of polyethylene particles; in Charnley THR metal particles prevailed and corrosion of the stem is suggested to be the initiating factor.
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PMID:Failure of the stem in total hip replacement. A study of aetiology and mechanism of failure in 13 cases. 340 11

The NH2-terminal sequence of 22 residues of rabbit lung angiotensin-converting enzyme has been determined as (NH2)Thr-Leu-Asp-Pro-Gly-Leu-Leu-Pro-Gly-Asp-Phe-Ala -Ala-Asp-Asn-Ala-Gly-Ala-Arg-Leu-Phe-Ala-. In the course of purification of the enzyme for structural analysis a protein of Mr = 82,000 with angiotensin-converting activity was separated from the major fraction containing the native enzyme (Mr = 140,000). This low-molecular-weight enzyme catalyzed the hydrolysis of the synthetic substrate Hip-His-Leu at a rate 23% of that with the native enzyme, and exhibited a similar Km value as well as behaviors towards various effectors of angiotensin-converting enzyme. Edman degradation of both the native and the 82K enzymes revealed that they contain identical amino acid sequences from the NH2-termini. This result and those of peptide mapping and carbohydrate and amino acid analyses indicate that the 82K enzyme is a fragment derived from the NH2-terminal portion of the native enzyme, and hence contains its catalytic site. Evidence has been obtained indicating that the active fragment was formed from the native enzyme during its elution from the antibody-affinity column with NH4OH: on treatment of the native enzyme (140K Mr) with 1 N NH4OH at room temperature, a cleavage occurred and two proteins with Mr = 82K and Mr = 62K were obtained. The 82K Mr fragment was found to be enzymatically active and to contain the same NH2-terminal sequence as the native enzyme. The other fragment (62K Mr) was devoid of the activity and was shown to derive from the COOH-terminal portion of the native enzyme by the peptide mapping and terminal analyses. Cleavage of a peptide bond with NH4OH is unusual and appears to be specific for the native angiotensin-converting enzyme from rabbit lung.
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PMID:Rabbit pulmonary angiotensin-converting enzyme: the NH2-terminal fragment with enzymatic activity and its formation from the native enzyme by NH4OH treatment. 631 8

The clinical outcome and radiographic results of 90 cemented profile stems, 59 press-fit profile stems and 20 porous-coated profile stems implanted between October, 1987 and December, 1989 were analyzed. All total hip replacements were performed by the same group of surgeons. All used a cementless porous ingrowth acetabular component, and all femoral components were of the same geometrical design. Clinical results were evaluated using the Hip Society/SICOT/AAOS consensus format and were recorded prospectively preoperatively and at 6 months, 1 year, 2 years, 3 years and 4 years postoperatively. Radiographs were evaluated for component migration, subsidence, and cortical and cancellous biologic response as well as zonal analysis of radiolucent lines, using the Muller THR template. The functional results were similar for all three groups with no significant differences at 2 years postoperatively with respect to pain with activity, limp, or support used. However, patient satisfaction tended to be higher for cemented stems than for press-fit or porous-coated stems. Radiographic analysis showed press-fit stems to have a higher incidence (29.5%) of femoral component subsidence (mean 5.7 mm). None of the porous-coated stems subsided. Press-fit and porous-coated stems also demonstrated a higher rate of cortical hypertrophy at mid- and distal stem levels in comparison to cemented components. Press-fit application of the femoral component gives satisfactory clinical results, and the addition of proximal porous coating may confer additional advantages to the technique. Cemented stems enjoy the highest level of patient satisfaction and the most predictable objective clinical results.
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PMID:Two- to four-year experience with cemented, press-fit, and porous coated applications of the profile total hip system. 811 97

47 patients with a cervical hip fracture Garden 3 or 4 and fully ambulatory before the fracture, were randomized to either fixation with Hansson hook-pins (24 patients, median age 79 years) or to a Charnley hip replacement (23 patients, median age 80 years). The patients were followed for 2 years. Social function was evaluated using a standard questionnaire. There were no postoperative deaths and no significant differences in hospital stay. 9/24 patients treated with hook-pins developed healing complications and 2 dislocations occurred in the THR group. After 1 and 2 years, fewer patients treated with hip replacement used outdoor walking aids; they were also more likely to do their own shopping. Hip replacement is a good choice when treating healthy older people with displaced cervical hip fractures, when primary mortality is expected to be low and the risk of healing complications after nailing is high.
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PMID:Social function after cervical hip fracture. A comparison of hook-pins and total hip replacement in 47 patients. 894 44

The purpose of this study was to evaluate whether preoperative gait adaptations persist one year after THR in the same set of subjects. The hypothesis tested was that hip dynamic range of motion and peak external moments during walking return to normal after THR. Hip kinematics and kinetics were measured for 28 subjects before and one year after THR and compared to those of 25 subjects with radiographically normal hips. All THR subjects improved clinically after surgery with Harris hip scores improving from 33-85 (average 53) to 61-100 (average 95) (sign test p<0.001). Preoperatively dynamic hip range of motion (ROM), and all peak external moments were reduced compared to normal (Mann-Whitney p< or =0.040). Improvement was seen in the ROM and all but the frontal plane, and external rotation peak moments (Friedman p< or =0.023). The preoperative and postoperative values of the ROM, and peak flexion, abduction and external rotation moments were all significantly correlated (Spearman p<0.020) indicating a possible learned effect from before THR surgery. Postoperative THR subjects continued to have a significantly lower than normal ROM, and peak adduction and peak internal rotation moments (Mann-Whitney p< or =0.003). Despite good to excellent clinical functional outcome, gait in THR patients does not return to normal by one year after surgery. Aggressive muscle strengthening is currently not emphasized after THR surgery. Some THR patients may benefit from more intensive rehabilitation before and after surgery.
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PMID:Preoperative gait adaptations persist one year after surgery in clinically well-functioning total hip replacement patients. 1764 1

The aim of the study was clinical and X-ray evaluation of two patients treated because of fractures of shaft of femur with coexisting hip joint osteoarthritis with cemented THR. Both patients were treated just after the injury. Reduction of fractures were made to both patients. Stabilization of fracture in one patient was made with metal plate and cables, stabilization with only cables was made to second patient. Exeter THR with standard stem was implanted to first patient, and with long stem to the second one. Both patients have good clinical results - 90 and 92 pts. in Harris Hip Score after 36 and 48 months accordingly. The fracture healed in the first patient. The evidence of fracture healing of the second patient was impossible to examine because of lack of X-ray. Conclusions. 1) The use of THR in the treatment of femoral shaft fractures with coexisting osteoarthritis gives a chance of simultaneous fracture treatment and joint replacement. 2) Fracture stabilization requires the use of metal plates and cables.
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PMID:[Cemented THR in the treatment of femoral shaft fractures with coexisting osteoarthritis. The report of two cases]. 1794 79

Total hip arthroplasty has become one of the most succesful procedure in orthopaedic surgery. More and more active, young patients undergo primary hip replacement. Bone stock preservation is crucial when performing THR in this group of patients. The short stem design allows a methaphyseal intratrochanteric multipoint, strong primary fixation which is very important for this group of patients. The goal is to save bone stock for the revision operation. This study presents early results of Metha short stems prosthesis. Between April 2006-December 2007, 58 short stem (Metha) were implanted. The Harris Hip Score improved from a mean 64.3 before to 89.7 at follow-up. The Metha stem may not be indicated for every hip diseases. There were only two fractures of femur without any further problems. Despite the short follow-up, Metha prosthesis already represent a valuable alternative for younger patients.
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PMID:[Modular short-stem prosthesis in total hip arthroplasty--preliminary report]. 1884 14

Bone stock preservation is crucial when performing THR in young patients. Following this philosophy, an original ultra-short custom-made implant with extensive proximal load transfer was developed. It presents three very innovative features: absence of the diaphyseal portion of the stem, a well defined lateral flare with load transfer on the lateral column of the femur and a very high femoral neck cut. These innovations resulted in a very conservative implant both of the bone stock and the soft tissues. In this study we reviewed the X-rays of 111 patients with 131 primary total hip replacements performed with this implant. The average pain score using the Harris Hip Score system, at an average of five years after surgery, was 42 of 44 points; 95 per cent (124) of the patients had no or slight pain. We had no cases of thigh pain. None of the patients required a femoral stem revision. Two cases had to be re-operated for polyethylene liner exchange but the femoral implant was stable and left in place. At five years, all implants appeared radiographically stable with well maintained proximal bone stock. It was concluded that the geometry of this implant provides significant initial stability, which seems to be preserved throughout a long follow-up period. This study validates the assumption that torsional loads can be controlled even without the diaphyseal portion of the stem and that neck preservation combined with lateral flare support guarantees a more natural loading of the femur.
Hip Int 2006
PMID:Ultra-short stems with proximal load transfer: Clinical and radiographic results at five-year follow-up. 1921 18

We aimed to study the effect of smoking on the complication rate and medium-term functional outcome after total hip replacement. 1767 patients undergoing a cemented THR in one hospital were followed up prospectively at 6, 18, 36, and 60 months. Harris Hip Scores, SF-36 scores and complications were recorded. There was no statistically significant difference in early complications and length of hospital stay between smokers and those patients who had never smoked. Smokers were less likely to require a blood transfusion and showed a statistically lower Harris Hip Score at six months but there was no difference seen at the subsequent time-points to five years after surgery. Smoking did not influence the complication rate or medium-term functional outcome at five years after total hip replacement.
Hip Int
PMID:The complication rate and medium-term functional outcome after total hip replacement in smokers. 1945 2


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