Morphological patterns of the hip joint structure in students of choreography schools and young athletes involved in sports associated with the art of movement

Students of choreography schools and young athletes involved in sports associated with the art of movement usually have dysplastic hip joints with normal acetabular coverage and femoral Coxa valga, whose normal limits require further discussion. We have identified 5 X-Ray morphological patterns of the hip joint structure typical of such individuals, and analyzed their association with professional qualities. Key words: hip dysplasia, dysplastic constitution, Coxa valga, young athletes, rhythmic gymnastics, choreography, ballet

PRELIMINARY ASSESSMENT OF PATIENT SATISFACTION AND FUNCTIONAL IMPROVEMENT AFTER HIP REPLACEMENT SURGERY USING OXFORD HIP SCORE AND RELATED FACTORS

Objectives: Preliminary assessment of patient satisfaction and functional improvement after hip replacement surgery by self-reported measure Oxford Hip Score and several related factors. Methods: descriptive, cross-sectional, prospective study on patients received hip replacement surgery at the Orthopaedics Center, Hue Central Hospital due to severe pain and functional limitation from 10/2014 to 04/2015. Results: 20 patients participated in the study with a mean age of 69.75 (male 52.15 and female 73.63). The main cause of hip replacement surgery is fracture (55%) and aseptic necrosis of the femoral head (30%). The percentageof poor OHS level is 85% in preoperative assessment. Mean OHS scoredat 3 month and 6 monthpostoperatively increased over 19 points, with a good and very good OHS level 50% and 60% respectively; the difference was statistically significant (p <0.05). The percentage of patients with poor function level at 6 month remained 30%. The proportion of patients achieved very satisfied and completely satisfied at 6 month is 80%. There are many factors affecting the degree of functionnal recovery and patient satisfaction after hip replacement therapy, but because of small number of subjects in our study, there is no clear statistical significance. Conclusion: Using the self-assessment scale Oxford Hip Score is a simple andcosteffective method with high validity and reliability for monitoring long-term changes of the hip joint function after hip replacement surgery. The high proportion of poor hip function level at 6 month after operation in our study may be due to many causes such as old age, co-morbidities, low preoperative OHS, complications after surgery, inadequate postoperative rehabilitation. Key words: Hip replacement therapy, pain, functions, self-reported measure, Oxford Hip Score, exercise, rehabilitation.

Incorporation Of Interference Fit And Cyclic Loading In Simulation Algorithm For Better Prediction Of Micromotion Of Femoral Stems

Pelonggaran aseptik adalah salah satu daripada sebab utama pembedahan ulangan tulang paha. Ini berlaku disebabkan kegagalan untuk mendapatkan cengkaman pertama yang kuat. Pergerakan antara implan dengan tulang melebihi had tertentu menghalang pertumbuhan tulang dan mengakibatkan pembentukan tisu berbentuk fiber. Dalam kajian ini, satu algoritma dicadangkan untuk meramal pergerakan implan dan seterusnya ketidakstabilan implan. Dengan menggunakan beban fisiologi, pergerakan implan relatif kepada tulang dikira menggunakan algoritma. Implan yang menggunakan sistem cengkaman tekanan telah dibentuk dan beban ulangan dikenakan untuk memberi simulasi yang sebenar. Satu ujikaji ‘in–vitro’ telah dilaksanakan terhadap empat tulang paha manusia untuk mengesahkan algoritma yang dicadangkan. Keputusan ujikaji telah mengesahkan pergerakan implan yang dijangka oleh algoritma ini. Kata kunci: tulang paha, algoritma cengkaman, pengesahan ujikaji Aseptic loosening is one of the major causes for revision surgery in hip arthroplasty. This has been attributed to failure in achieving strong primary fixation. Interface micromotion beyond a certain threshold limit inhibits bone ingrowth and favours the formation of fibrous tissue. In this study, an algorithm was constructed to predict micromotion and therefore instability of femoral stems. Based on common physiological loading, micromotion is calculated throughout the bone–implant interface. Press fit stem insertion was modelled using interference fit and cyclic loading was used to better simulate actual loading configuration. An in–vitro micromotion experiment was carried out on four human cadaveric femurs to validate the micromotion algorithm. A good correlation was obtained between finite element predictions and the in–vitro micromotion experiment. Key words: hip arthroplasty, primary stability, micromotion algorithm, experimental validation, finite element

Early Preoperative Thromboprophylaxis with Klexane® in Hip Fracture Surgery: A Placebo-Controlled Study

The aim of this study was to evaluate any possible benefits of early thromboprophylactic treatment in the preven tion of deep vein thrombosis (DVT) in high-risk hip fracture patients. Within 30 months, 239 patients were included in a double-blind placebo-controlled study. With the diagnosis of hip fracture confirmed, patients received either 40-mg Enoxa parin s.c. or placebo once daily until operation. Postoperatively, all patients received 40-mg Enoxaparin s.c. once daily until phlebography. Phlebography was first performed on the oper ated leg, and with no thrombosis detected, the other leg was investigated as well. The two groups did not differ demograph ically. Eighty-five patients were excluded. Eight patients died during the study period. The remaining 146 patients had as cending phlebography performed and 24 patients (16.4%) de veloped DVT. Nine (12%) of 75 patients in the Klexane® and 15 (21 %) of 72 patients in the placebo group developed DVT. The risk ratio was 0.58 (95% confidence limits 0.27-1.25) and p = .15 (X2 test). There was no difference in perioperative bleeding or transfusion requirements. We conclude that Klex ane® is an effective and safe thromboprophylactic agent in hip fracture patients. Key Words: Hip fracture—Thrombopro phylaxis—Low—molecular heparin.

Hemireplacement Arthroplasty with Unipolar vs Bipolar Prosthesis for Displaced Hip Fractures in Elderly

Background: Hip fractures are common occurrence in elderly with various methods of treatment practiced for its management. Hemireplacement with different types of prosthesis is most widely practiced, and cemented bipolar prosthesis being the current trend. The aim of this study is to compare the outcome of unipolar prosthesis which is the current practice at our hospital, with the bipolar prosthesis. Methods: This was a prospective study patients aged over 65 years with displaced femoral neck or trochanteric fracture underwent hemireplacement arthroplasty, cemented unipolar prosthesis was used in 18 patients and in 16 bipolar prosthesis was used. Functional outcome using Harris Hip Score and mobility score was compared between two groups. Results: The two groups of patients did not differ in their pre-injury characteristics (age, sex,fracture pattern, ASA grading, co-morbidity, mode of injury and pre-injury ambulatory status) and peri-operative parameters such as duration of operation, blood loss, hospital stay. One year after operation, there was no statistical difference in the functional parameters such as Harris Hip Score, mobility score and rate of complication in both the groups. Conclusions: Early results suggest that Cemented unipolar prosthesis are equally effective as compared to bipolar for the treatment of displaced hip fractures in elderly patients, in Nepalese context. Key words: hip fracture; hemiarthroplasty; harris hip score. DOI: 10.3126/jnhrc.v7i2.3022 Journal of Nepal Health Research Council Vol.7(2) Apr 2009 131-134