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Arthritis & Rheumatology (Hoboken, N.J.) Jan 2015
Review
Topics: Arthroscopy; Disease Management; Femoracetabular Impingement; Hip Joint; Humans; Physical Therapy Modalities; Prevalence; Radiography
PubMed: 25308887
DOI: 10.1002/art.38887 -
Journal of Orthopaedics and... Aug 2021The acetabular labrum is an important structure that contributes to hip joint stability and function. Diagnosing labral tears involves a comprehensive assessment of... (Review)
Review
The acetabular labrum is an important structure that contributes to hip joint stability and function. Diagnosing labral tears involves a comprehensive assessment of clinical symptoms, physical examinations, imaging examinations, and arthroscopic confirmation. As arthroscopy is an invasive surgery, adjuvant imaging of the acetabular labrum is increasingly imperative for orthopedists to diagnose and assess labral lesions prior to hip arthroscopy for surgical management. This article reviews the current imaging strategies for the evaluation of labrum lesions.
Topics: Acetabulum; Arthroscopy; Cartilage, Articular; Diagnostic Imaging; Hip Joint; Humans
PubMed: 34357462
DOI: 10.1186/s10195-021-00595-7 -
Japanese Journal of Radiology Jan 2023Total hip replacement is one of the most widely performed surgeries. It is stated as the most efficient method of treating end-stage osteoarthritis of the hip joint.... (Review)
Review
Total hip replacement is one of the most widely performed surgeries. It is stated as the most efficient method of treating end-stage osteoarthritis of the hip joint. What is more, it significantly improves the quality of patients' lives, relieves them from pain and restores decreased range of motion, provided that is conducted properly. Aim of this article is to indicate which constituents of prosthetic placement can be easily measured on postoperative radiographs and point out how to interpret obtained results. Multiple mechanical factors, such as center of rotation, femoral offset, acetabular offset, acetabular inclination, acetabular anteversion and leg length discrepancy can be measured on postoperative radiographs. To provide a successful surgery and to acquire both radiological and clinical satisfying results, proper prosthetic placement is crucial. Malpositioning of each element, in varying degrees may lead to dislocation or reoperation.
Topics: Humans; Arthroplasty, Replacement, Hip; Hip Prosthesis; Hip Joint; Acetabulum; Radiography; Retrospective Studies
PubMed: 36063354
DOI: 10.1007/s11604-022-01332-8 -
International Orthopaedics Jun 2012Arthroscopic examination and treatment is an ever-increasing part of modern orthopaedic practice in this age of minimally invasive surgery. Arthroscopic procedures have... (Review)
Review
Arthroscopic examination and treatment is an ever-increasing part of modern orthopaedic practice in this age of minimally invasive surgery. Arthroscopic procedures have been widespread in surgery of the knee and the shoulder for many years; however, the hip until relatively recently, has been largely neglected. Even now hip arthroscopy is not widely available; this may be due to the complexity of the procedure, the requirement of specialist equipment and a reportedly long learning curve. On the other hand, it has gone through a period of rapid growth over the last decade and is being performed in large numbers routinely in some centres around the world. Hip arthroscopy now provides excellent visualisation of not only the articular surfaces of the hip joint but also of the peritrochanteric or extra-articular space around the hip. Pathology of both the femoral head and the acetabulum along with the soft tissues of the hip, namely the ligamentum teres, the acetabular labrum, the synovial folds and synovium, is readily diagnosed. Modern techniques provide therapeutic options for a myriad of conditions and allow modulation of pathological processes early. Additionally hip arthroscopy is a relatively safe procedure with few complications and contraindications. However, the key to good outcomes is in the careful selection of patients and meticulous surgical technique. The aim of this review is to bring the reader up to date with an overview of the evolution of arthroscopy of the hip, review the current practice and explore possible future developments.
Topics: Arthroscopy; Hip Injuries; Hip Joint; Humans; Joint Diseases
PubMed: 22371112
DOI: 10.1007/s00264-011-1459-4 -
Journal of Orthopaedic Research :... Feb 2022Our objectives were to clarify morphology of the hip as well as infinitesimal femoral head movement in specific positions in young and elderly volunteers without joint...
Our objectives were to clarify morphology of the hip as well as infinitesimal femoral head movement in specific positions in young and elderly volunteers without joint degeneration. Both hips of 20 young and 20 elderly healthy volunteers were examined. Magnetic resonance imaging was performed at four different positions for each hip: neutral, 45° flexion, 15° extension, and the Patrick position. Femoral and pelvic bone images were separately extracted when in the neutral position and superimposed over the images of each different position by using voxel-based registration. The distance between the acetabular center and the femoral head center (FHC) at the neutral position was defined as 3D-migration. The distance between FHCs at neutral position and that at each different position was defined as 3D-translation. The x-, y-, and z-axes pointed in the anterior, cranial, and lateral directions, respectively. 3D-migration-y in the elderly was more caudal than that in the young (P < .001). 3D-translation of 45° flexion in the elderly was larger than that in the young with statistical significance (P = .001), while 3D-translation of the Patrick position in the elderly was smaller than that in the young (P = .012). Age was significantly correlated with 3D-translation in 45° flexion (r = .431; P < .001) and that in Patrick (r = -.296; P = .008). These results can be used as a basis for the natural course with aging of morphometry and kinematics of the hip, as well as for potential disease progression in osteoarthritis of the hip.
Topics: Acetabulum; Aged; Biomechanical Phenomena; Femur Head; Hip; Hip Dislocation; Hip Joint; Humans; Range of Motion, Articular
PubMed: 32672868
DOI: 10.1002/jor.24806 -
BMJ Case Reports Jan 2022Synovial chondromatosis is a rare, benign condition occurring due to metaplasia of synovium. A 65-year-old woman presented with pain in her right hip for 6 years. On...
Synovial chondromatosis is a rare, benign condition occurring due to metaplasia of synovium. A 65-year-old woman presented with pain in her right hip for 6 years. On examination, a swelling was palpable at the base of scarpa's triangle and her right hip movements were restricted. Imaging modalities showed ossified nodules in the antero-inferior aspect of the hip joint, joint effusion and arthritic changes. We diagnosed the patient to have synovial chondromatosis with secondary arthritis of the hip joint. We performed a total hip arthroplasty with simultaneous synovectomy and extraction of the osteochondral loose bodies, 5 of which were about 2×2 cm in size. We found that excessive acetabular reaming was required due to craters, the osteochondral masses formed on the acetabular surface. Histopathological analysis confirmed the diagnosis. The patient had an excellent functional outcome and no recurrence 5 years following the surgery.
Topics: Aged; Arthroplasty, Replacement, Hip; Chondromatosis, Synovial; Female; Hip Joint; Humans; Joint Loose Bodies; Synovectomy
PubMed: 35064037
DOI: 10.1136/bcr-2021-246039 -
International Journal of Medical... Sep 2009Infections of the hip joint are usually of bacterial etiology. Only rarely, an infectious arthritis is caused in this localization by viruses or fungi. Native joint... (Review)
Review
Infections of the hip joint are usually of bacterial etiology. Only rarely, an infectious arthritis is caused in this localization by viruses or fungi. Native joint infections of the hip are less common than infections after implantation of prosthetic devices. Difficulties in prosthetic joint infections are, (I) a higher age of patients, and, thus an associated presence of other medical risk factors, (II) often long courses of treatment regimes depending on the bacterium and its antibiotic resistance, (III) an increased mortality, and (IV) a high economic burden for removal and reimplantation of an infected prosthetic device. The pathogenic mechanisms responsible for articular infections are well studied only for some bacteria, e.g. Staphylococcus aureus, while others are only partially understood. Important known bacterial properties and microbiological characteristics of infection are the bacterial adhesion on the native joint or prosthetic material, the bacterial biofilm formation, the development of small colony variants (SCV) as sessile bacterial types and the increasing resistance to antibiotics.
Topics: Anti-Bacterial Agents; Arthritis, Infectious; Hip Joint; Humans; Joint Diseases; Prosthesis-Related Infections; Staphylococcal Infections
PubMed: 19834588
DOI: 10.7150/ijms.6.234 -
Journal of Orthopaedic Surgery (Hong... 2017Histological architecture of normal acetabular labrum regarding free nerve endings (FNEs) and mechanoreceptors (MRs) has been satisfactorily described in the literature.... (Review)
Review
PURPOSE
Histological architecture of normal acetabular labrum regarding free nerve endings (FNEs) and mechanoreceptors (MRs) has been satisfactorily described in the literature. However, the presence of FNEs and MRs in acetabular labrum of hip joint has been analyzed only once in patients with osteoarthritis (OA). Aim of this article is to report histological distribution pattern of FNEs and MRs in acetabular labrum of patients with severe OA, at the same time conducting a comparison with normal acetabular labrum described in the literature.
METHODS
Seven patients with severe hip OA were enrolled in this study. Patient selection was assisted by the utilization of specific clinical scales delineated by the American College of Rheumatology. After successful total hip arthroplasty, tissue samples of acetabular labra of seven patients were histologically processed and stained with the gold standard chloride method, which was subsequently examined under a compound microscope.
RESULTS
FNEs and MRs constituted the major histological structures. Identified MRs included Pacini corpuscles, Ruffini corpuscles, and Golgi-Mazzoni corpuscles. The presence of FNEs was predominant in the middle part of the acetabular labrum, featuring a remarkable decrease in peripheral parts. In contrast, MRs were detected basically in peripheral parts and less in the middle part.
CONCLUSIONS
Differentiation of the distribution pattern of MRs and FNEs in acetabular labrum of hip joint is remarkable between normal patients and patients with severe OA. The abundance of FNEs in the middle part of the pathologic labrum is mainly responsible for the observed discrimination. A "conversion" of MRs to FNEs may occur during OA progression, modulating therefore this pattern as well as the upcoming clinical manifestations.
Topics: Acetabulum; Aged; Arthroplasty, Replacement, Hip; Cartilage, Articular; Female; Fibrocartilage; Hip Joint; Humans; Male; Mechanoreceptors; Nerve Endings; Osteoarthritis, Hip
PubMed: 29017383
DOI: 10.1177/2309499017734444 -
BMC Musculoskeletal Disorders Aug 2023Analysis of the risk factors affecting hip function and complications after femoral neck system (FNS) surgery for femoral neck fractures is of great significance for...
OBJECTIVE
Analysis of the risk factors affecting hip function and complications after femoral neck system (FNS) surgery for femoral neck fractures is of great significance for improving the procedure's efficacy.
METHODS
The data of patients with femoral neck fractures who underwent FNS surgery in our hospital between October 2019 and October 2020 were retrospectively analyzed. Age, gender, time from injury to operation, fracture classification, operation time, fracture reduction, and postoperative weight-bearing time information were set as potential factors that may affect the results. Hip Harris scores were performed at 12 months postoperatively, and postoperative complication data (e.g., femoral head necrosis, nonunion, and femoral neck shortness) were collected. The risk factors affecting hip function and complications after FNS surgery were predicted using linear and logistic regression analyses.
RESULTS
A total of 69 cases of femoral neck fracture were included, with an average age of 56.09 ± 11.50 years. The linear analysis demonstrated that the age and fracture type of the patients were the risk factors affecting the Harris score of the hip joint after FNS surgery. Older patients with displaced femoral neck fractures had an inferior postoperative hip function. In addition, fracture type, reduction of the femoral neck, and postoperative weight-bearing significantly impacted postoperative complications. Displaced fractures, negative fixation, and premature weight-bearing (< 6 weeks) were risk factors for postoperative complications. The Harris score of patients with a shortened femoral neck in the included cases was not significantly different from that of patients without shortening (P = 0.25).
CONCLUSIONS
Advanced age and fracture type are important evaluation indicators of the Harris score after FNS internal fixation of femoral neck fractures in young patients. Fracture type, fracture reduction, and postoperative weight-bearing time are risk factors for complications after FNS.
Topics: Humans; Adult; Middle Aged; Aged; Femur Neck; Retrospective Studies; Femoral Neck Fractures; Risk Factors; Postoperative Complications; Hip Joint
PubMed: 37620843
DOI: 10.1186/s12891-023-06805-z -
American Family Physician Apr 2000Hip pain in athletes involves a wide differential diagnosis. Adolescents and young adults are at particular risk for various apophyseal and epiphyseal injuries due to... (Review)
Review
Hip pain in athletes involves a wide differential diagnosis. Adolescents and young adults are at particular risk for various apophyseal and epiphyseal injuries due to lack of ossification of these cartilaginous growth plates. Older athletes are more likely to present with tendinitis in these areas because their growth plates have closed. Several bursae in the hip area are prone to inflammation. The trochanteric bursa is the most commonly injured, and the lesion is easily identified by palpation of the area. Iliotibial band syndrome presents with similar lateral hip pain and may be identified by provocative testing (Ober's test). A methodical physical examination that specifically tests the various muscle groups that move the hip joint can help determine a more specific diagnosis for the often vague complaint of hip pain. A number of hip conditions are more prevalent in athletes of certain ages. Transient synovitis is a common diagnosis in the very young, Legg-Calvé-Perthes disease causes bony disruption of the femoral head in prepubescents, and slipped capital femoral epiphysis is seen most commonly in obese adolescent males. Femoral neck stress fractures are seen in adult athletes, especially those involved in endurance sports, and can progress to necrosis of the femoral head if not found early. Older athletes may be limited by degenerative joint disease but nonetheless should be encouraged to stay active.
Topics: Adolescent; Adult; Age Factors; Aged; Child; Hip Joint; Humans; Middle Aged; Pain
PubMed: 10779252
DOI: No ID Found