The Hip最新文献

{"title":"Conservative treatment of Legg-Calvé-Perthes condition.","authors":"G D MacEwen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As we continue to learn more about the evolution of Legg-Calvé-Perthes condition, several advantages to early conservative treatment become apparent. First, since it may take as long as 6 months to determine the extent of femoral head involvement in patients who present early in the disease process, nonoperative methods may be used to improve the range of motion and to contain the femoral head within the acetabulum, thus minimizing further deformity. Second, since the duration of treatment need no longer be as extensive as was previously thought, the argument that nonoperative means are unrealistic for patient needs is not valid. Finally, it has been recognized that with moderate sphericity and moderate retention of the shape of the femoral head, as evaluated in relationship to secondary changes in the acetabulum, the patient can reach at least middle age before having significant secondary arthritic problems. A relatively conservative approach is therefore in order for most children whose disease is discovered in the early phases. Of course, it must be recognized that social problems develop in the older child, especially in girls, that contraindicate nonoperative care. Surgical considerations are indicated for many children in the older age group with more than one half of the femoral head involved, as well as in those with unsuccessful nonoperative efforts at containment.</p>","PeriodicalId":77938,"journal":{"name":"The Hip","volume":" ","pages":"17-23"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14948973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prosthetic synovitis.","authors":"N S Eftekhar,&nbsp;S B Doty,&nbsp;A D Johnston,&nbsp;M V Parisien","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The term \"prosthetic synovitis\" is applied to reactive changes resulting from a synovial-like membrane formed between a failed prosthesis (noninfected) and the bone interface. This report is the result of light-microscopic and clinical examination of more than 100 specimens obtained at surgery of failed previous hip replacements. The morphology and cell distribution of those tissues removed at surgery in 51 noninfected cemented total hip operations allowed a quantitative estimate of surface cell population by a \"touch imprint\" technique; qualitative and quantitative estimate (scale, 1 to 4+) of cell population and foreign body materials by light microscopy; and electron microscopy and biochemical analysis of selected samples. Histologic examination included the following cell population, in decreasing order of frequency: acidophilic histiocytes (95%); giant cells (80%); fibronoid material (80%); lymphocyte and plasma cells (26%); and neutrophils (8%). Microscopic examination showed that the largest particles of acrylic cement and shards of high-density polyethylene appeared to be walled off by connective tissue capsules. The majority of smaller particles were incorporated into the histiocyte/macrophage or giant cell population. Histochemistry indicated that these particles elicited \"foci\" of cellular activity within the synovial-like membrane. This increased activity included the appearance of increased endogenous peroxidase activity in those macrophages within the \"foci\"; increased betagalactosidae activity among these histiocytes; and a localization of acid phosphates activity within giant cells along the borders of inclusions within the cell cytoplasm. We conclude that wear products resulting from total hip arthroplasty, including the bone cement, can induce increased lysosomal and proteolytic activity within the histiocyte and giant cell populations. It may be important to emphasize that there were \"reactive foci\" within the membrane and that the entire membrane, even though infiltrated with macrophages, did not respond uniformly to the presence of prosthetic debris. We advance a theory that the first step toward a distractive phenomenon at the interface is micromotion between the cement and bone. Micromotion may be caused by removal of subchondral plate during total hip replacement, leading to fatigue and loss of trabeculae and resultant increase motion, thus bone loss. Bone loss may be the direct result of mechanical injury, increased osteoclasis, or direct lysis of bone by various enzymes released by the interface membrane.</p>","PeriodicalId":77938,"journal":{"name":"The Hip","volume":" ","pages":"169-83"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15051792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambulatory containment treatment in Legg-Calvé-Perthes disease.","authors":"D R Cooperman,&nbsp;S D Stulberg","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77938,"journal":{"name":"The Hip","volume":" ","pages":"38-62"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14948982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision of femoral component loosening with titanium ingrowth prosthesis and bone grafting.","authors":"R B Gustilo,&nbsp;R F Kyle","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77938,"journal":{"name":"The Hip","volume":" ","pages":"342-6"},"PeriodicalIF":0.0,"publicationDate":"1984-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17456266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early results of the RM-isoelastic cementless total hip prosthesis: 300 consecutive cases with 2-year follow-up.","authors":"R Bombelli,&nbsp;M Gerundini,&nbsp;J Aronson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77938,"journal":{"name":"The Hip","volume":" ","pages":"133-45"},"PeriodicalIF":0.0,"publicationDate":"1984-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17585681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term follow-up of hip arthrodesis performed in young patients.","authors":"P D Sponseller,&nbsp;A A McBeath,&nbsp;M Perpich","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77938,"journal":{"name":"The Hip","volume":" ","pages":"43-53"},"PeriodicalIF":0.0,"publicationDate":"1984-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17304584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computer modeling of surgery and a consideration of the mechanical effects of proximal femoral osteotomies.","authors":"R A Brand,&nbsp;D R Pedersen","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77938,"journal":{"name":"The Hip","volume":" ","pages":"193-210"},"PeriodicalIF":0.0,"publicationDate":"1984-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17585685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cementless revisions of failed total hip replacement: ceramic Autophor prosthesis.","authors":"H Mittelmeier","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77938,"journal":{"name":"The Hip","volume":" ","pages":"312-21"},"PeriodicalIF":0.0,"publicationDate":"1984-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17585691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisions with cemented long-stem prostheses.","authors":"R H Turner,&nbsp;A D Scheller,&nbsp;R H Emerson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The purpose of this paper was to describe the surgical techniques for removing and replacing failed femoral prosthetic components. We have also tried to develop a rationale for the use of long-stem femoral components to maximize femoral fixation and to protect the femur from future stresses. It is our recommendation that the revision femoral implant should be anchored into at least 100 mm of healthy bone distal to any previous metal, cement, perforation, or fracture. The surgical techniques described are demanding and require careful practice and preparation on the part of the surgical team. Distal intermedullary plugging and precise biphased cementing techniques are advocated to achieve microinterlock in the distal femur and to provide bulk filling of the proximal femur.</p>","PeriodicalId":77938,"journal":{"name":"The Hip","volume":" ","pages":"322-41"},"PeriodicalIF":0.0,"publicationDate":"1984-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17456265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The infected total hip arthroplasty: current concepts in treatment.","authors":"R H Fitzgerald","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77938,"journal":{"name":"The Hip","volume":" ","pages":"347-58"},"PeriodicalIF":0.0,"publicationDate":"1984-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17456267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}