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Hip Score (hip + score)
Kinds of Hip Score Selected AbstractsEquity and need when waiting for total hip replacement surgeryJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2004Ray Fitzpatrick PhD Abstract Objectives, To explore sociodemographic and health status factors associated with waiting times both for first outpatient appointment and for total hip replacement surgery (THR). Methods, A survey of THR in five former English regions was conducted between September 1996 and October 1997. Every patient listed for THR was asked to fill out a questionnaire preoperatively. This questionnaire included the 12-item Oxford Hip Score (OHS) questionnaire and two questions on the length of time patients waited for an ,outpatient ,appointment ,and ,subsequently ,for ,their operation. Results, From multiple logistic regression analyses, region, private vs. public sector, housing tenure and preoperative OHS were all independently associated with a waiting time for an outpatient appointment for >,3 months. Region, housing tenure and gender were also independently associated with a wait of ,,6 months on the surgical waiting list. Conclusions, A large proportion of patients had long waiting times both for an outpatient appointment and while on a surgical waiting list. There were significant differences in waiting time according to social, geographical and health care system factors. Patients with a worse pain and disability at surgery waited longer for an outpatient appointment. The longer patient waited, the worse was their pain and disability, suggesting that patients were not prioritized by these criteria. Benefits of prioritizing should be tested. [source] Use of volumetric computerized tomography as a primary outcome measure to evaluate drug efficacy in the prevention of peri-prosthetic osteolysis: A 1-year clinical pilot of etanercept vs. placeboJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 6 2003Edward M. Schwarz Although total hip replacement (THR) is amongst the most successful and beneficial medical procedures to date, long-term outcomes continue to suffer from aseptic loosening secondary to peri-prosthetic osteolysis. Extensive research over the last two decades has elucidated a central mechanism for osteolysis in which wear debris generated from the implant stimulates inflammatory cells to promote osteoclastogenesis and bone resorption. The cytokine tumor necrosis factor alpha (TNF,) has been demonstrated to be central to this process and is considered to be a leading target for intervention. Unfortunately, even though FDA approved TNF antagonists are available (etanercept), currently there are no reliable outcome measures that can be used to evaluate the efficacy of a drug to prevent peri-prosthetic osteolysis. To the end of developing an effective outcome measure, we evaluated the progression of lesion size in 20 patients with established peri-acetabular osteolysis (mean = 29.99 cm3, range = 2.9,92.7 cm3) of an uncemented primary THR over 1-year, using a novel volumetric computer tomography (3D-CT) technique. We also evaluated polyethylene wear, urine N-telopeptides and functional assessments (WOMAC, SF-36 and Harris Hip Score) for comparison. At the time of entry into the study baseline CT scans were obtained and the patients were randomized to etanercept (25 mg s.q., twice/week) and placebo in a double-blinded fashion. CT scans, urine and functional assessments were also obtained at 6 and 12 months. No serious adverse drug related events were reported, but one patient had to have revision surgery before completion of the study due to aseptic loosening. No remarkable differences between the groups were observed. However, the study was not powered to see significant drug effects. 3D-CT data from the 19 patients was used to determine the mean increase in lesion size over 48 weeks, which was 3.19 cm3 (p < 0.0013). Analysis of the urine N-telopeptides and functional assessment data failed to identify a significant correlation with wear or osteolysis. In conclusion, volumetric CT was able to measure progression of osteolysis over the course of a year, thus providing a technology that could be used in therapeutic trials. Using the data from this pilot we provide a model power calculation for such a trial. © 2003 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source] Roentgen stereophotogrammetric analysis and clinical assessment of unipolar versus bipolar hemiarthroplasty for subcapital femur fracture: a randomized prospective studyANZ JOURNAL OF SURGERY, Issue 4 2010Benjamin Jeffcote Abstract Background:, Hemiarthroplasty is a well-established treatment for displaced subcapital fracture, but controversy exists about the optimal implant type. Bipolar hemiarthroplasty has proposed advantages over unipolar hemiarthroplasty in terms of better clinical results and decreased wear of acetabular cartilage. Methods:, This study is a randomized prospective study of 51 patients (52 hips) receiving either bipolar or unipolar hemiarthroplasty for displaced subcapital fractures. The outcome measurements were clinical scores and Roentgen stereophotogrammetric analysis (RSA) analysis to determine the rate of acetabular wear. Results:, Twenty-three patients completed 2-year follow-up. The RSA data demonstrated that there was slightly less acetabular wear by bipolar prostheses than by unipolar. The combined mean three-dimensional wear of the bipolar prostheses was 0.6 mm compared with 1.5 mm for the unipolar prostheses (P= 0.04). The bipolar group generally achieved higher scores in terms of the Harris Hip Score, Western Ontario and McMaster University Index of Osteoarthritis (WOMAC) questionnaire and 6-min walk test. These results were statistically significant at 3 months but not at 12 and 24 months. Conclusion:, This study suggests that while the bipolar prosthesis performs slightly better than the unipolar in terms of acetabular cartilage wear and clinical outcomes, it remains debatable whether the benefits are worth the increased cost of the prosthesis. [source] Metaphyseal-Loading Anterolaterally-Flared Femoral Stem in Cementless Total Hip Arthroplasty: Five- to Eleven-Year Follow-Up EvaluationARTIFICIAL ORGANS, Issue 5 2010Hideo Kawahara Abstract Using a nonlinear three-dimensional finite element analysis simulating loading conditions, we designed a new type of proximal-fitting, anterolaterally-flared, arc-deposit hydroxyapatite-coated anatomical femoral stem (FMS-anatomic stem; Japan Medical Materials, Osaka, Japan) for cementless total hip arthroplasty (THA) for Japanese patients with dysplastic hip osteoarthritis. The aim of the present study was to analyze the clinical and radiographic outcomes of the new stem. We reviewed 143 consecutive patients (164 hips; 13 men, 14 hips; 130 women, 150 hips; age at surgery, 56.6 ± 7.6 years, mean ± SD, range, 30,74) who underwent cementless THA using the FMS-anatomic stem at a single institution, with a follow-up period of 7.6 ± 1.6 years (range, 5.3,11.0). Harris Hip score improved from 46.1 ± 12.6 before surgery to 90.0 ± 8.9 points post-THA. The 7.6-year survival rate of the stem was 99.0% after revision for aseptic loosening. Radiographs at follow-up confirmed the stability of the femoral stems within the femoral canal in all cases, with sufficient bone ingrowth. None of the patients had subsidence of the stem exceeding 2.0 mm within the femoral canal or changes in varus or valgus position of more than 2.0°. The FMS-anatomic stem provided excellent results in patients with dysplastic hip osteoarthritis. Our analysis confirmed reduced radiolucency around the stem in Gruen zones, minimal subsidence, appropriate stress shielding, and promising medium-term stability within the femoral canal in our patients. [source] Free vascularized fibular grafting for treatment of osteonecrosis of the femoral head secondary to hip dislocationMICROSURGERY, Issue 5 2009Grant E. Garrigues M.D. Traumatic dislocation of the hip results in osteonecrosis of the femoral head (ONFH) or avascular necrosis (AVN) in ,40% of patients. This high-energy event causes an ischemic insult to the femoral head that may lead to ONFH. Here, we investigate use of Free-Vascularized Fibular Grafting (FVFG) in patients with ONFH after traumatic hip dislocation. Thirty-five patients with FVFG for this indication were reviewed (average follow-up 3.3 years, range 1,21). We reviewed patient injury statistics, demographics, preoperative radiographs, pre- and postoperative Harris Hip scores, complications, and rate of conversion to total hip arthroplasty (THA). The majority (81%) of our patients were young males (22 years) with ONFH diagnosed an average of 2 years after injury. The average preoperative Harris Hip score was 64.9 which improved by over 10 points to 76.1 at 1-year follow-up. Seven of 35 patients required conversion to THA at an average of 45 (13,86) months postoperation. After a maximum follow up of 21 years, the remainder of the patients retained their native hips and Harris Hip scores tended to show improved hip function. © 2009 Wiley-Liss, Inc. Microsurgery, 2009. [source] Estimation of heritability for hip dysplasia in German Shepherd Dogs in FinlandJOURNAL OF ANIMAL BREEDING AND GENETICS, Issue 2 2000M. Leppaänen The heritability of hip dysplasia in the German Shepherd Dog was estimated by applying the animal model and the Restricted Maximum Likelihood (REML) method to a data-set which consisted of the hip scores of 10 335 dogs. Fixed effects of the model were the month and the year of birth, screening age, the panelist responsible for screening and the origin of the animal's sire. The litter and the breeder had only minor effects on hip joints. Heritability estimates were moderate (0.31,0.35). The moderate heritability, which was found in this study, enables a much better genetic gain in the breeding programme, if proper evaluation methods, such as BLUP animal model, and effective selection is used instead of phenotypic selection. Zusammenfassung Schätzung der Heritabilität der Hüftgelenksdysplasie beim Deutschen Schäferhund in Finnland. Die Heritabilität der Hüftgelenksdysplasie beim Deutschen Schäferhund wurde mit Hilfe des Tiermodells und der Restricted Maximum Likelihood (REML) Methode anhand von Hüftgelenksgutachten von 10 335 Hunden geschätzt. Als fixe Effekte wurden im Modell ,Geburtsmonat' und ,-jahr', ,Röntgenalter', Einfluß des ,Gutachters' und ,Herkunft des Vaters' berücksichtigt. Die Effekte ,Wurf' und ,Züchter' hatten nur einen geringen Einfluß auf die Hüftgelenke. Die Heritabilitätsschätzungen betrugen 0.31 bis 0.35. Die in dieser Studie geschätzten Heritabilitäten ermöglichen es, zusammen mit geeigneten Methoden, wie beispielsweise dem BLUP-Tiermodell und einer effektiven Selektion, einen schnelleren Zuchtfortschritt zu erreichen, als nur phänotypisch zu selektieren. [source] INCIDENCE AND OUTCOMES OF KNEE AND HIP JOINT REPLACEMENT IN VETERANS AND CIVILIANSANZ JOURNAL OF SURGERY, Issue 5 2006Vanessa Wells Background: This article describes the incidence of total knee and hip replacement, and compares post-surgery health status outcomes in veterans and civilians. Methods: The numbers of male veterans and civilians who had a knee and/or a hip replacement in South Australia (1994,2002) were obtained. Standardized morbidity ratios, and odds ratios for age group by veteran/civilian interactions, were calculated. Presurgery and 1-year post-surgery Medical Outcomes Short Form (36) Health Survey, Knee Society and Harris hip scores were completed. Independent samples t -tests were used to compare presurgery scores. ancova models were used to determine any differences between veterans and civilians post-surgery. Results: For veterans, standardized morbidity ratios were 0.987 and 0.715 for knee and hip replacements, respectively (P < 0.0001). Veterans' odds ratios for knee and hip replacements were significantly lower in the 65- to 74-year age group (P < 0.001), similar in the 75- to 84-year and above 85-year age groups for hip replacement, but significantly higher in the above 85-year age group for knee replacement (P < 0.001). Presurgery, veterans reported significantly lower scores (P < 0.003) for knee function. After knee replacement, veterans reported significantly lower Medical Outcomes Short Form (36) Health Survey scores for bodily pain, physical functioning, role , physical, role , emotional, social functioning and physical component summary (P < 0.033). Significantly lower physical functioning, role , physical and physical component summary scores (P < 0.02) were reported by veterans post-surgery for hip replacement. Conclusion: Veterans are delaying joint replacement. Presurgical knee function is worse in veterans. Post-surgery, the veterans are worse off in a number of health status outcomes. [source] | ||||||||||