1/6. Clinical outcomes following manual physical therapy and exercise for hip osteoarthritis: A case series.STUDY DESIGN: Case series describing the outcomes of individual patients with hip osteoarthritis treated with manual physical therapy and exercise. CASE DESCRIPTION: Seven patients referred to physical therapy with hip osteoarthritis and/or hip pain were included in this case series. All patients were treated with manual physical therapy followed by exercises to maximize strength and range of motion. Six of 7 patients completed a Harris Hip Score at initial examination and discharge from physical therapy, and 1 patient completed a Global Rating of Change Scale at discharge. OUTCOMES: Three males and 4 females with a median age of 62 years (range, 52-80 years) and median duration of symptoms of 9 months (range, 2-60 months) participated in this case series. The median number of physical therapy sessions attended was 5 (range, 4-12). The median increase in total passive range of motion of the hip was 82 degrees (range, 70 degrees-86 degrees). The median improvement on the Harris Hip Score was 25 points (range, 15-38 points). The single patient who completed the Global Rating of Change Scale at discharge reported being "a great deal better." Numeric pain rating scores decreased by a mean of 5 points (range, 2-7 points) on 0-to-10-point scale. DISCUSSION: All patients exhibited reductions in pain and increases in passive range of motion, as well as a clinically meaningful improvement in function. Although we can not infer a cause and effect relationship from a case series, the outcomes with these patients are similar to others reported in the literature that have demonstrated superior clinical outcomes associated with manual physical therapy and exercise for hip osteoarthritis compared to exercise alone.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/6. Intraoperative measurement of rotational stability of femoral components of total hip arthroplasty.High out-of-plane forces acting on the hip joint can produce important rotational micromotion of the femoral component. This micromotion at the prosthesis interface may be detrimental to the stability of the implant. In cementless femoral implants this could prevent bone ingrowth, and in the cemented component this could cause generation of particulate debris, lysis, and loosening. The introduction of the torque wrench micrometer for assessment of intraoperative femoral component stability can quantify the initial stability of primary cementless femoral components and critically evaluate the stability (at either the initial or revision arthroplasty) of both cemented and cementless femoral components. It allows the surgeon to produce a known torque in the direction and magnitude of the out-of-plane forces that load the hip in vivo.- - - - - - - - - - ranking = 0.66666666666667keywords = motion (Clic here for more details about this article) |
3/6. Distraction arthroplasty of the hip by bicentric femoral head prosthesis.Distraction arthroplasty of the hip with bicentric femoral head prosthesis was performed on 18 hips with advanced secondary osteoarthritis. This method of hip arthroplasty consists of reconstruction of the deformed acetabulum into the dome-shaped acetabulum, replacement of the femoral head by the bicentric femoral head prosthesis, and postoperative continuous long-axis traction to the lower extremity. Postoperative physical therapy is performed on the assumption that the articular cartilage is formed in a narrow empty space between the articular surfaces made by continued application of distraction to the hip. In distraction arthroplasty, the hip may regain a wide range of painless motion. Roentgenographically, the dome-shaped acetabulum was covered by a narrow radiolucent zone backed with a dense bone plate. The functionally remodeled structure of the hip was maintained during the follow-up period of six months to four years 11 months.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
4/6. Bipolar hip arthroplasty without acetabular bone-grafting for dysplastic osteoarthritis. Results after 6-9 years.The authors report the clinical and radiographic results of 36 bipolar hip arthroplasties after performing excavation of the steep and shallow acetabulum without acetabular bone-grafting for dysplastic osteoarthritis. The procedures were carried out between 1981 and 1985. Survivorship analysis showed that 84.6 of the bipolar hip arthroplasties were retained for 8 years. Twenty-nine patients, which were followed for 6-9 years after surgery, were reviewed. Severity of acetabular dysplasia was classified according to the method of Crowe. Class 1 included 17 hips and class 2 included 12 hips. The average preoperative clinical score was 49 points. The average postoperative clinical hip score improved to 87 points after 6 years. Twenty-seven of the 29 hips assessed were classified as either excellent or good by Charnley's function score. Stress fracture, due to excessive acetabular excavation at the time of surgery, and femoral component loosening were major symptomatic complications. The cessation of radiographic evidence of migration of the bipolar socket was recognized in 25 of 29 procedures at 6 years after surgery (86.2%). Cineradiographic study demonstrated that the abduction motion under standing position for 20 of 24 hip joints functioned dominantly at the inner-bearing and metallic-stem interface.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
5/6. Joint-preserving operations for elderly patients with advanced and late-stage coxarthritis.Forty-one hips in 38 elderly patients with osteoarthritis of the hips, operated on with joint preserving techniques at the age of 55 years or more, were analyzed clinically radiologically. Bilateral involvement was seen in 13 cases. Ten hips were operated on after this study, before the patients were 55 years old, or no operation has yet been done. The average age at operation was 59 years, and the average preoperative hip scores (Merle d'Aubigne) were as follows: pain 2.8; range of motion (ROM) 4.4; gait 3.4. Average preoperative hip flexion and abduction were 88 degrees and 20 degrees respectively. Mean follow-up period was 57 months, and mean final hip scores were: pain 5.1; ROM 4.6; gait 4.0. Significant improvement was seen in pain and gait scores but no improvement in ROM scores. Excellent and good scores were achieved in half of the cases. Failure was seen in four cases. Hip pain recurred in nine patients. Five out of these patients were classified as atrophic according to Bombelli's classification of osteoblastic response of osteoarthritis of the hip. The responsiveness of the femoral head influenced the clinical results of the joint-preserving operations.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
6/6. Case study: physical therapy management of hip osteoarthritis prior to total hip arthroplasty.It is important that we have information on the role of physical therapists in the treatment of patients with osteoarthritis of the hip prior to total hip arthroplasty. This article describes the management of a patient with limited range of motion of the right hip due to osteoarthritis. The patient made a significant improvement with decreased pain, increased range of motion of the right hip, increased periarticular muscle strength, improved gait, and improved mobility. One year later, the patient had a right total hip arthroplasty. The rationale of the management of patients with osteoarthritis of the hip is discussed. In addition, the role of physical therapists in the management and treatment of patients with osteoarthritis prior to total hip arthroplasty is discussed.- - - - - - - - - - ranking = 0.66666666666667keywords = motion (Clic here for more details about this article) |