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Biology of Joints
Published in Verna Wright, Eric L. Radin, Mechanics of Human Joints, 2020
In each case, several factors interact to maintain stability while the forces of muscle power and or gravity drive the joint through its required range of motion. The simplest of these stabilizing factors is shape (7). In the hip, for instance, not only gravity but also the force of virtually all muscles crossing the joint serve to drive the femoral head “ball” into its acetabular “socket.” This design permits a wide range of motion in three different axes (flexion-extension, abduction-adduction, and rotation), while still ensuring complete stability under virtually any stress. A wide range of variations among other convex-concave articulations serves the goal of enhanced stability. Particularly striking are the ankle mortise, where the adjacent fibula provides lateral stability, and the elbow joint, where a particularly deep ulnar concavity accommodates the distal humerus.
Advances in Avascular Necrosis of the Hip joint
Published in K. Mohan Iyer, Hip Joint in Adults: Advances and Developments, 2018
Another differential diagnosis is a subchondral insufficiency fracture of the femoral head that can be seen in elderly people, usually followed by a small trauma such as a hip sprain or leaning forwards or after a long walk. The reason for the fracture is osteoporosis or osteopenia, which can happen in elderly women or organ transplantation patients [58,59]. It would be difficult to diagnose from FHON. The most important findings are in MRI. In the area of the fracture there is a band-like lesion with a low-intensity signal. However, unlike FHON, this lesion is irregular, disconnected, parallel and convex to the surface of cartilage, while in FHON the band is continuous and completely clear and is shaped concavely to the cartilage surface and is getting away from it. Diagnosis can sometimes be difficult, although the treatment of choice in both cases would be arthroplasty.
Fractured neck of femur
Published in S Asbury, A Mishra, KM Mokbel, M Fishman Jonathan, Principles of Operative Surgery, 2017
S Asbury, A Mishra, KM Mokbel, M Fishman Jonathan
An intracapsular fracture is likely to cause disruption to the blood supply, particularly if displaced. There are two treatment options. Femoral head replacement is used in most patients with displaced fractures or pathological fractures. This is performed with a hemiarthroplasty (cemented or uncemented) or total hip replacement.Internal fixation with cancellous screws is used in undisplaced fractures and displaced fractures in patients under 70 years of age. Young patients benefit from preservation of the femoral head, and if the diagnosis is made less than 6 hours after injury an emergency internal fixation can be attempted.
Calcified cartilage differs in patients with end-stage primary osteoarthritis and secondary osteoarthritis due to rheumatoid arthritis of the hip joint
Published in Scandinavian Journal of Rheumatology, 2022
R Jensen, AF Christensen, LB Hartlev, JS Thomsen, LWT Boel, M Laursen, PH Revald, C Varnum, KK Keller, E-M Hauge
Immediately after removal, the femoral heads were fixed in 70% ethanol and processed according to a design-based stereological sampling scheme as previously described in detail (3, 18, 19). In brief, the entire femoral heads were rotated around a vertical axis, which was perpendicular to the anatomical top of the femoral head. After choosing a random starting point, the femoral head was sawn using a diamond precision-parallel saw (Exakt Apparatebau, Norderstedt, Germany) into 7-mm-thick parallel slices, which were halved, and alternating left and right half slices were randomly selected for microscopic evaluation (19, 20). Depending on the size of the femoral head, a total of five to seven 7-mm-thick halved parallel slices were collected from each of the trial subjects. Each of the five to seven 7-mm-thick halved parallel slices was embedded undecalcified in methylmethacrylate and cut into 7-µm-thick histological sections, using a Jung model K microtome (R. Jung, Heidelberg, Germany) equipped with a tungsten microtome knife. The sections were mounted and stained with either May–Grünwald toluidine blue (19) for assessment of the articular and calcified cartilage or Masson–Goldner trichrome for assessment of the bone tissue in the femoral head (Figure 1A–C).
The effect of gait training with low-intensity neuromuscular electrical stimulation of hip abductor muscles in two patients following surgery for hip fracture: Two case reports
Published in Physiotherapy Theory and Practice, 2022
Kazuya Takeda, Soichiro Koyama, Koji Shomoto, Kosuke Ushiroyama, Yuki Naoi, Tomoko Nagai, Hiroaki Sakurai, Yoshikiyo Kanada, Shigeo Tanabe
Moreover, Takeda et al. (2020b) examined whether the RFD of hip abductor muscles was increased by sub-motor threshold NMES to GM during gait in healthy adults. The protocol consists of 20 minutes of gait training with or without NMES to GM. The stimulus intensity of NMES was set to sub-motor threshold. The results indicated that the RFD of hip abductor muscles was increased by gait with NMES compared to without NMES. The author suggested that this method is useful for the effective use of a limited amount of training time because gait training is one of the most commonly used exercises for patients with hip abductor muscle weakness (Hesse et al., 2003; Tinetti et al., 1999). However, the effect of this combined treatment in hip fracture patients who have undergone femoral head replacement for hip fracture is not clear. To the best of our knowledge, there are no reports of gait training with sub-motor threshold NMES to the GM in patients following femoral head replacement for hip fracture. The aim of this case report was to investigate the effects of gait training with sub-motor threshold NMES to GM on RFD of hip abductor muscles in two patients following femoral head replacement for hip fracture compared to gait training without NMES.
Effects of pericapsular soft tissue and realignment exercises for patients with osteoarthritis of the hip and Harris Hip Score below 60 points
Published in Current Medical Research and Opinion, 2022
Kazuo Hayashi, Toshiharu Tsunoda, Yuki Tobo, Fumiaki Ichikawa, Takayuki Shimose
Participants meeting any of the following criteria were excluded:Patients with osteonecrosis of the femoral head.Patients with a subchondral insufficiency fracture of the femoral head.Patients with Perthes disease.Patients with rheumatoid arthritis.Patients with infection.Patients in whom malignant diseases were suspected at the hip joints or around the hip.