Higher Hip Research Articles

Sex-based differences in and risk factors for metabolic syndrome in adults aged 40 years and above in Northeast China: Results from the cross-sectional China national stroke screening survey

ObjectivesLow levels of income and education are risk factors for metabolic syndrome in the population of Northeast China, which has a high incidence of metabolic syndrome and cardiovascular diseases. This...

Inertial measurement units for the detection of the effects of simulated leg length inequalities

BackgroundLeg length inequalities (LLI) are a common condition that can be associated with detrimental effects like low back pain and osteoarthritis. Inertial measurement units (IMUs) offer the chance to analyze daily activities outside a laboratory. Analyzing the kinematic effects of (simulated) LLI on the musculoskeletal apparatus using IMUs will show their potentiality to improve the comprehension of LLI.MethodsTwenty healthy participants with simulated LLI of 0-4 cm were analyzed while walking with an inertial sensor system (MyoMotion). Statistical evaluation of the peak anatomical angles of the spine and legs were performed using repeated measurement (RM) ANOVA or their non-parametric test versions (Friedman test).ResultsLumbar lateral flexion and pelvic obliquity increased during the stance phase of the elongated leg and decreased during its swing phase. The longer limb was functionally shortened by higher hip and knee flexion, higher hip adduction, dorsiflexion, and lower ankle adduction. Finally, the shorter leg was lengthened by higher hip and knee extension, hip abduction, ankle plantarflexion, and decreased hip adduction.ConclusionWe found differing compensation strategies between the different joints, movement planes, gait phases, and amounts of inequality. Overall the shorter leg is lengthened and the longer leg is shortened during walking, to retain the upright posture of the trunk. IMUs were helpful and precise in the detection of anatomical joint angles and for the analysis of the effects of LLI.

Does Cup Position at the High Hip Center or Anatomic Hip Center in THA for Developmental Dysplasia of the Hip Result in Better Harris Hip Scores and Revision Incidence? A Systematic Review.

One goal of THA is to restore the anatomic hip center, which can be achieved in hips with developmental dysplasia by placing cups at the level of the native acetabulum. However, this might require adjuvant procedures such as femoral shortening osteotomy. Another option is to place the cup at the high hip center, potentially reducing surgical complexity. Currently, no clear consensus exists regarding which of these cup positions might offer better functional outcomes or long-term survival. We performed a systematic review to determine whether (1) functional outcomes as measured by the Harris hip score, (2) revision incidence, and (3) complications that do not result in revision differ based on the position of the acetabular cup (high hip center versus anatomic hip center) in patients undergoing THA for developmental dysplasia of the hip (DDH). We performed a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, including studies comparing the functional outcomes, revision incidence, and complications of primary THA in dysplastic hips with acetabular cups placed at the high hip center versus those placed at the anatomic hip center, over any time frame. The review protocol was registered with PROSPERO (registration number CRD42020168183) before commencement. Of 238 records, eight comparative, retrospective nonrandomized studies of interventions were eligible for our systematic review, reporting on 207 hips with cups placed at the high hip center and 268 hips with cups at the anatomic hip center. Risk of bias within eligible studies was assessed using the Risk Of Bias In Non-randomized Studies of Interventions tool. Due to low comparability between studies, data could not be pooled, so these studies were assessed without summary effects. Six studies compared Harris hip scores, two of which favored high hip center cup placement and three of which favored anatomic hip center cup placement, although none of the differences between cohorts met the minimum clinically important difference. Five studies reliably compared revision incidence, which ranged from 2% to 9% for high hip center at 7 to 15 years and 0% to 5.9% for anatomic hip center at 6 to 16 years. Five studies reported intra- and postoperative complications, with the high hip center being associated with higher incidence of dislocation and lower incidence of neurological complications. No clear difference was observed in intraoperative complications between the high hip center and anatomic hip center. No obvious differences could be observed in Harris hip score or revision incidence after THA for osteoarthritis secondary to DDH between cups placed at the anatomic hip center and those placed at the high hip center. Placement of the acetabular cup in the high hip center may lead to higher risk of dislocation but lower risk of neurologic complications, although no difference in intraoperative complications was observed. Surgeons should be able to achieve satisfactory functional scores and revision incidence using either technique, although they should be aware of how their choice influences hip biomechanics and the need for adjunct procedures and associated risks and operative time. These recommendations should be considered with respect to the several limitations in the studies reviewed, including the presence of serious confounding factors and selection biases, inconsistent definitions of the high hip center, variations in dysplasia severity, small sample sizes, and follow-up periods. These weaknesses should be addressed in well-designed future studies. Level III, therapeutic study.

CORR Insights®: Does Cup Position at the High Hip Center or Anatomic Hip Center in THA for Developmental Dysplasia of the Hip Result in Better Harris Hip Scores and Revision Incidence? A Systematic Review.

CORR Insights®: Does Cup Position at the High Hip Center or Anatomic Hip Center in THA for Developmental Dysplasia of the Hip Result in Better Harris Hip Scores and Revision Incidence? A Systematic Review.

Three-dimensional gait of patients with developmental dysplasia of hip undergoing total hip arthroplasty with high hip center

Three-dimensional gait of patients with developmental dysplasia of hip undergoing total hip arthroplasty with high hip center

Physical training of karatekas at the stage of sports improvement

Purpose: theoretically and experimentally substantiate the model of the development of physical qualities of karatekas in the conditions of the training process in a sports school. Material and methods: young men (25 people) of 10th - 11th grades of Lutsk secondary schools took part in the study. Research methods: data analysis of special scientific and methodical literature, pedagogical methods, methods of mathematical statistics. Results: each training block includes 3 test exercises that were included in the karate training process. First and after the block was included in the training process, the young men, who were engaged in the experimental group, performed tests, and the results were collected. The results of the conducted pedagogical experiment revealed the effectiveness of the proposed model for the development of physical qualities of karatekas in the training process. Analysis of the data characterizing the state of physical fitness and physical development allows us to state that there is a significant improvement in indicators in the experimental group as compared to the control group.
 The results obtained, both in general and with special physical fitness in the experimental group, show that significant differences are observed in the tests: "running in place with a high hip lift", "running from a high start to 30 meters", "bending forward from a position lying on his stomach”,“raising straight legs to the sides”, “raising straight arms up while lying on his stomach”, “shuttle”running 3x10 m, “jumping with 180º rotation”, “three forward turns while maintaining balance”. In terms of physical readiness indicators in the experimental group, the results are higher than in the control group. The increase in results in the test "running in place with a high hip lift" was 17.88 % in the experimental group, 6.6 % - in the control; in the test "running 30 meters" - 14.4 % - in the experimental group, in the control group - 4.8 %; in the test "lifting from parterre to standing" - 30.8 % - in the experimental group, 7.9 % - in the control; in the test "bending forward from a sitting position, legs apart" - 25.0 % - in the experimental group, 93.0 % in the control; in the test "dilution of straight legs to the sides" - 35.0 % in the experimental group, 17.4 % - in the control; in the test "raising arms up from a prone position" - 43.6 % in the experimental group, 19.7 % in the control group.
 These tests determined those physical qualities that were purposefully developed in the training process of the experimental group separately according to the developed block model of the development of physical qualities. In terms of physical development, significant differences are observed in the experimental group in the indicator - the strength of the right and left hand, where the increase in results is 7.9 %, respectively; in the control group, there is an increase in the indicator of the strength of the right hand - 1.3 %. Conclusions: training blocks are implemented in one of three parts of training sessions, depending on the quality being developed, based on the active use of the in-line method of motor actions fulfillment and includes specially selected complexes of test exercises aimed at speed, flexibility, dexterity. The development of physical qualities among karatekas in the traini ng process provides effective indicators of physical fitness, testifies to the feasibility of using the proposed model to improve the process of physical training in sports schools.

Risk Factors for Spinal Structural Damage in a Chinese Cohort With Ankylosing Spondylitis.

A cross-sectional study was conducted in 270 Chinese patients with ankylosing spondylitis (AS) in order to identify potential risk factors for severity of spinal structural damage. Two hundred seventy AS patients fulfilled the Modified New York Criteria. Computed tomography (CT) was used to scan sacroiliac and hip joints, and radiography was used to scan anteroposterior and lateral lumbar spine, as well as lateral cervical spine. Bath Ankylosing Spondylitis Radiology Index and modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) were scored in duplicate. One hundred eighty-three patients had low mSASSS (mSASSS, <10), and 87 patients had high mSASSS (mSASSS, ≥10). Univariate analysis revealed that AS age of onset, body mass index (BMI), smoking duration, duration of symptoms, diagnostic delay, hip involvement, and sacroiliitis grade were significantly associated with the risk of having high mSASSS after adjustment (all p's < 0.05). Hip involvement interacted significantly with BMI and smoking duration in a graded manner. Particularly, relative to patients with low BMI-negative hip involvement, those with high BMI-negative hip involvement, low BMI-positive hip involvement, and high BMI-positive hip involvement had a 1.94-fold, 3.29-fold, and 5.07-fold increased risk of high mSASSS (95% confidence interval, 0.84-4.47, 1.37-7.89, and 1.97-13.06, p = 0.118, 0.008, and 0.001, respectively). Finally, a nomogram graph based on 7 significant risk factors was generated with substantial prediction accuracy (concordance index, 0.906). We have identified 7 potential risk factors for the severity of spinal structural damage in Chinese AS patients. Importantly, positive hip involvement, combined with high BMI or long smoking duration, was associated with a remarkably increased risk of having severe spinal structural damage.

Characterization of indigenous cattle genotypes based on linear body traits in the humid tropics

Selection for trait of interest is a major problem in cattle production when faced with the challenge of varied growth traits in different genotypes. Low understanding of the production potentials of these cattle breeds constitute problems in effective improvement of physical body characteristics. A total of 18 cattle was used to characterize the Nigerian local cattle genotypes based on quantitative traits. Three genotypic groups {White Fulani (WF), N'Dama (ND) and White Fulani x N'Dama (WFxND)} crosses were used for the experiment. Experimental design was a completely randomized design (CRD) with genotypic group as major factor of interest. Quantitative traits measured were body length (BDL) (cm), hip height (HHT) (cm), heart girth (HG) (cm), horn length (HL) (cm), tail length (TL) (cm), ear length (El) (cm) and neck length (NL). Results showed that there were significant differences (p&lt;0.05) in body length in weeks 99 – 111 and 112 – 124 with the White Fulani and N'Dama genotypes having longer bodies. The values ranged from 33.00 to 39.29cm in WF, 39.49 to 39.59cm in N'Dama and, 18.25 to 32.90 in WF x ND. There were significant (p&lt;0.05) differences in hip height of cattle in age interval of 99-111 and 112-124 weeks of age, with the White Fulani and N'Dama genotypes having highest hip. The genotypes showed significant (p&lt;0.05) differences in heart girth in 99 and 124 WOAwith the White Fulani and N'Dama genotypes having widest heart girth. The genotypes showed significant (p&lt;0.05) differences in horn length in all the weeks with White Fulani showing superiority. The genotype had longer horns in the White Fulani and followed by WF x ND across the week intervals. The values ranged from 14.99 to 15.20cm in WF, 5.75 to 10.19cm in N'Dama and, 3.00 to 4.29 in WF x ND. The tail length of the three genotypes showed significant (p&lt;0.05) differences in 99-111 and 112-124 WOA. Higher values were obtained in White Fulani genotype which showed longer tails than the N'Dama and WF x ND. There were significant (p&lt;0.05) differences in neck length of the cattle genotypes in 112-124 WOA. Higher values were obtained in White Fulani genotype which showed longer neck than the N'Dama and WF x ND. White Fulani could be used to enhance growth of Nigerian indigenous cattle in the study area. The present findings could assist in the design of long-term genetic improvement programmes for cattle production in Nigeria.

Designing a Rotary Composter Tool With an Ergonomic Approach to the Organic Garbage Processing Process

Garbage is one of the problems facing the Indonesian society. The production of garbage resulting from various individual activities is increasing each day. University of Ahmad Dahlan (UAD) Yogyakarta as one of the colleges in Yogyakarta has the potential to produce garbage of large amounts. Under the strategic plan of environmentally insightful campus development, garbage processing will be carried out by the institutions of University of Ahmad Dahlan and academic civitas. The average garbage produced by UAD 4 campus activities is 170 kg/day with an organic waste composition of 22.57 kg and non-organic 147.43 kg. During this time the garbage was directly distributed to the Piyungan landfill without being processed first, as the campus party had not been available garbage processing devices. The purpose of the study was to design organic garbage processing tools into compost fertilizers. The study used an ergonomic approach by utilizing anthropometric data in the determination of size from the design. Anthropometric data used in this study are Tinggi Bahu Duduk (TBD) or Shoulder High Sitting, Lebar Pinggul (LP) or Hip Width, Pantat Popliteal (PP) or Popliteal Butt, Tinggi Siku Berdiri (TSB) or Standing Elbow Height, Panjang Lengan Bawah (PLB) or Lower Arm Length, Lebar Bahu Atas (LBA) or Upper Shoulder Width, and Tinggi Lutut (TL) or Knee Height. The result of the study was an ergonomic Rotary Composter tool design operated by one person manually with dimensions 115 cm long, 148 cm wide, 115 cm tall, 60 cm barrel diameter, seat rest height 58.75 cm, 41.23 cm seat width, seat base length 45.39 cm, the distance between seats, tool height 114.94 cm, with tool 37.33 cm wide, seat rest 50 cm, 13 cm, seat width, and seat height 59.08 cm.

Survival Analysis of Total Hip Arthroplasty for High Hip Dislocation Secondary to Developmental Dysplasia or Septic Arthritis of the Hip

BackgroundThis retrospective study was conducted to know clinical and radiographic outcomes, complication rate, and survival of THA in patients with high hip dislocation secondary to developmental dysplasia(DDH) or septic arthritis of the hip(SSH). MethodsBetween March 2005 and September 2014, there were consecutive series of 53 THAs in patients with a highly dislocated hip secondary to DDH or SSH. Of these, 48 hips (DDH 24 and SSH 24) were reviewed at a mean follow-up of 7.9 years(range, 5.0-14.3 years). The mean age at the time of THA was 39.1 years(range, 18.0-59.0 years). ResultsIntraoperative blood loss, total drainage and blood transfusion amounts, and mean time to greater trochanter union were significantly lower in the DDH group than in the SSH group (P = .001, P = .039 and P = .014, and P = .015, respectively). No significant difference in Kaplan–Meier survivorship was observed between groups (log-rank, P = .343). The survival rates with an endpoint of cup aseptic loosening in cases with a cemented cup at 7.9 and 10 years (68.1% and 60.5%, respectively) were significantly lower than those in cementless cup cases (100%) at the same checkpoints (P = .019).. ConclusionWe found similar clinical outcomes between the DDH and SSH groups. However, due to poor bone quality and a lack of containment, cementless acetabular cups could not be performed in more than 50% of patients. Our experience shows that revision cementless fixation cup was possible due to reconstitution of the acetabulum in cases with failed cemented fixation.

Hip arthroplasty - study correlating intra operative stable range of motion with postoperative functional activity

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Squatting and sitting cross-legged is a part of lifestyle both for employment and for daily ablutions. When these activities can be allowed after hip arthroplasty is not documented. The aim of this study is to identify if patients having good intra-operative stability with the posterior approach, can start high flexion activities early.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; In this retrospective study, all hip arthroplasty patients done from 2013-2017 were considered for inclusion. Patients were evaluated for intra-operative stable range of motion and patients who were stable were encouraged to do cross-legged sitting from 2 weeks after surgery and squatting from 6 weeks after surgery. The follow-up visits were at 6-weeks, 3-months and 1-year after surgery. Parameters assessed were Harris hip score, short form survey-12 (SF-12) score, limb length discrepancy, range of motion and ability to sit cross-legged and squat. All the patients were again called for a follow-up visit and the parameters were reassessed.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Sixty patients were included in the study. Mean follow-up was 2 years 3 months. Mean Harris hip score and SF-12 showed improvement from 64.8 and 19.5 at 3 months to 88.3 and 37.8 respectively at last follow-up. At the end of 3 months, 85% patients could sit cross-legged and 50% could squat. At one year, the corresponding figures were 85% and 70%.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; If intra-operative range of motion testing is satisfactory, early initiation of high flexion hip activities is safe.&lt;/p&gt;

Hypovitaminosis D, Dyslipidaemia and Thyroid Dysfunction Among Adolescents and Their Associations With Raised Blood Pressure in a North Eastern City of India

Background: Raised blood pressure (BP) has been found to be associated with serum levels of vitamin D3, lipid profile and thyroid hormones among adults. But limited information is available regarding such associations in adolescents. Objectives To estimate the prevalence vitamin D3 deficiency, dyslipidaemia and thyroid dysfunction among secondary school students of Agartala municipal corporation area and to study their associations with raised BP. Methods: This school based cross-sectional study was conducted during April 2018 to December 2018 among 1000 students studying in different secondary level schools located in Agartala municipal corporation area chosen by multi stage sampling technique ensuring proportionate representation in the sample. Result: Prevalence of vitamin D3 deficiency, thyroid dysfunction and dyslipidaemia were found to be 79.4%, 62.8% and 37.5% respectively. Out of total, 58.1% of the study subjects had raised BP, 34.1% were fatty, 16.7% were overweight, 5.3% were obese and 48.3% had high waist hip ratio (WHR). Among all, 82.27% subjects with high BMI, 70.97% fatty subjects and 69.05% subjects with either low or normal WHR had significantly elevated BP (p 0.05). Binary logistic regression has identified higher BMI, higher body fat content, high WHR, habit of consuming extra salt and fast food on regular basis as the significant determinants of raised BP in this population (p<0.05). Conclusion: Though vitamin D deficiency, thyroid dysfunction and dyslipidaemia are prevalent among adolescents of Northeast India, they did not emerge as significant determinants of blood pressure in them. Funding Statement: Department of Health Research (DHR), Ministry of Health & Family Welfare, Govt. of India, New Delhi through Multidisciplinary Research Unit, AGMC. Declaration of Interests: There is no conflict of interest. Ethics Approval Statement: Informed written consent document for participation in this study was handed over to participating students for obtaining consent from their guardians. This study was approved by the institutional ethics committee of Agartala Government Medical College.

Do standardized hip fracture care programs decrease mortality in geriatric hip fracture patients?

There is mounting support for the implementation of a standardized hip fracture program (SHFP) for geriatric patients. However, the current evidence to assess geriatric hip fracture outcomes following treatment in a SHFP is limited to small, single-center, observational studies. Using a large, multinational dataset, this study aims to assess whether enrollment in a SHFP was associated with improved 30-day patient-important outcomes in geriatric hip fracture patients. The secondary aim was to evaluate if the SHFP treatment effect varies by baseline mortality risk.An observational cohort study was conducted using data from the National Surgical Quality Improvement Program (NSQIP) for the years of 2016 and 2017. The study included 17,395 geriatric hip fracture patients over the age of 65. Over half (54%) of patients were enrolled in a SHFP on admission to hospital. The primary outcome was 30-day mortality. Secondary outcomes included 30-day reoperation and readmission. Multivariable logistic regression was used to estimate treatment effects, adjusting for race, anesthesia technique, and baseline mortality risk. The heterogeneity of treatment effect was determined by stratifying patients into quartiles based on their baseline mortality risk.The overall 30-day mortality risk was 6.6%. Enrollment in a SHFP did not reduce the 30-day risk of mortality (risk difference (RD): -0.2; 95% CI: -0.7, 0.3; p = 0.48), reoperation (RD: -0.2%; 95% CI: -0.6, 0.3; p = 0.36) or readmission (RD: -0.4%; 95% CI: -0.1, 0.4%; p = 0.20) when analyzed as a single sample. However, there were greater differences in the SHFP treatment effects when stratified by their preoperative mortality risk. Specifically, a 2.0% (95% CI: 4.2, 0.0%; p = 0.06) reduction in mortality was observed in the patients in the highest risk quartile for mortality and a 1.7% (95% CI: -3.2, -0.2%; p = 0.02) reduction in the medium-high risk quartile.The NSQIP data suggest that SHFPs do not significantly improve the short-term outcomes for the average geriatric hip fracture patient. However, a SHFP may significantly reduce the risk of 30-day mortality in higher risk patients. Therefore, the efficiency of SHFPs could potentially be improved with targeted deployment to high risk geriatric hip fracture patients.

Associations between age-related changes in bone microstructure and strength and dietary acid load in a cohort of community-dwelling, healthy men and postmenopausal women

The importance of dietary acid load (DAL) in the pathogenesis of osteoporosis is still debated. Age-related changes in bone microstructure and strength in relation to DAL remain largely unexplored. We investigated the associations between changes in areal and volumetric bone mineral density (BMD), bone microstructure and strength, fracture risk, and DAL in a prospective cohort of 65-y-old healthy men and postmenopausal women. Potential renal acid load (PRAL; mEq/d) was calculated as a DAL proxy to characterize participants' diet as alkaline (Alk-D; PRAL < -5), neutral (Neut-D; -5≤PRAL≤5), or acidic (Acid-D; PRAL >5). We measured areal BMD (aBMD) by DXA, and distal radius and tibia bone microstructure using high-resolution peripheral quantitative computed tomography, at baseline (n=853) and after 6.1±1.4 y (n=708). Bone strength was estimated using finite element analyses at baseline and after 3.0±0.5 y (n=613). Prevalent and incident fractures were recorded. The majority of the participants (59%) had an Alk-D, while 23% had a Neut-D, and 18% an Acid-D. Baseline aBMD and bone microstructure and strength did differ or were slightly better in women or men with an Acid-D versus those consuming an Alk-D or Neut-D. Indeed, women with an Acid-D had higher trabecular number (P=0.010 vs. Alk-D; P=0.001 vs. Neut-D), while men had higher hip and radius aBMD (P=0.008 and 0.024 vs. Neut-D, respectively) and radius strength (P=0.026 vs. Neut-D). Over the follow-up, women in the Acid-D group experienced lower cortical and endocortical bone loss at the radius than did the Alk-D and Neut-D groups (cortical thickness, P=0.008 and<0.001; trabecular area, P=0.001 and<0.001, respectively). No association between fractures and PRAL was observed. These null or favourable associations between baseline values or changes in aBMD, bone microstructure and strength, and DAL in this cohort of 65-y-old healthy individuals do not support adverse DAL-mediated effects on bone. This trial was registered at http://www.isrctn.com as ISRCTN11865958.

Predictive capacity of obesity indices for high blood pressure among southern Ethiopian adult population: a WHO STEPS survey

BackgroundWorld Health Organization (WHO) consultation experts recommend countries to have guidance to identify public health action points suitable for their country. The objective of the study was to evaluate different obesity indices to predict high blood pressure and its optimal cutoff values among the adult population.MethodA total of 3368 individuals age from 25 to 64 years were included in this study. Data was collected based on the WHO Stepwise approach. Body mass index (BMI), waist circumference (WstC), waist to hip ratio (WHpR) and waist to height ratio (WHtR) were measured and calculated. High blood pressure was considered for those with systolic blood pressure above 135 mmHg, diastolic blood pressure above 85 mmHg or taking antihypertensive medications. To generate cutoff values, the receiver operator characteristic curve was generated with the maximum Youden index.ResultWomen had a significantly higher hip circumference (P = 0.003), BMI (P = 0.036) and WHtR (P < 0.001) than men. Men had significantly higher WHpR (P = 0.027) than women. There were significantly higher BMI, WstC, WHpR, and WHtR among those with high blood pressure. The cutoff values for BMI, WstC, WHpR and WHtR were 22.86 kg/m2, 84.05 cm, 0.91 and 0.50 for men and 24.02 kg/m2, 79.50 cm, 0.91 and 0.51 for women, respectively.ConclusionBMI, WstC, WHpR, and WHtR are a useful predictor of high blood pressure among adults’ rural residents of southern Ethiopia. As the sensitivity for the cutoff values of most of indices were low, further surveys in different settings may need to be done before a conclusion can be drawn on whether or not to review the anthropometric cut offs for high blood pressure in Ethiopia.

A propensity score-matched analysis between patients with high hip dislocation after childhood pyogenic infection and Crowe IV developmental dysplasia of the hip in total hip arthroplasty with subtrochanteric shortening osteotomy

BackgroundWhether satisfactory clinical and radiological outcomes of total hip arthroplasty (THA) with subtrochanteric shortening osteotomy (SSO) in high hip dislocation after childhood pyogenic infection can be achieved as in Crowe IV developmental dysplasia of the hip (DDH) remains unclear.MethodsBetween September 2009 and December 2016, 151 primary THAs performed at our institution using similar SSO technique and prosthetic design were retrospectively reviewed. After excluding patients who met exclusion criteria, 29 patients were identified as high dislocation (Crowe IV) after childhood infection (HDACI) and 107 as Crowe IV developmental dysplasia of the hip (DDH). Propensity score matching was used to select 29 Crowe IV DDH patients as a control group for the HDACI group with comparable preoperative conditions. Clinical and radiological outcomes and complication were compared and analyzed. The mean follow-up duration of the 2 groups was 5.0 years.ResultsThe mean Harris hip score (HHS) and the mean score in range of motion (ROM) domain of the modified Merle d’Aubigné-Postel (MAP) were 84.6 and 4.5 in the HDACI group, compared with 88.3 and 4.9 in the DDH group; there was significant difference between the 2 groups in these parameters (P = 0.015 and 0.035, respectively). Meanwhile, in the HDACI group, the median time of osteotomy union was 4 months and osteotomy nonunion rate was 3%; no significant difference was detected in the median time of osteotomy union and osteotomy nonunion rate between the 2 groups (P = 0.388 and 1.000, respectively). And no significant difference was found in the rate of complications between two groups.ConclusionsHDACI patients who received THA combined with SSO could achieve similar satisfactory results as DDH patients in Crowe type IV. The fixation technique of autogenous cortical bone struts had a positive influence on osteotomy healing of SSO in this specific setting.

Sagittal spinal alignment after total hip arthroplasty for neglected high hip dysplasia: does changing the distorted mechanics of the hip normalize spinal alignment?

The false acetabulum lies more laterally and posteriorly compared with the true acetabulum. Spatial orientation of the pelvis is significantly altered in patients with neglected high hip dysplasia. There has been no study to investigate how pelvic or sagittal spinal alignment change after true acetabulum gains function with hip arthroplasty. The aim of this study was to investigate the effect of total hip arthroplasty with femoral shortening on spinopelvic parameters in patients with neglected high hip dysplasia. Twenty patients with Crowe type 3 or 4 hip dysplasia, who underwent total hip arthroplasty with femoral shortening in our institution were evaluated preoperatively after completion of rehabilitation and return to their normal daily life. Sagittal alignment (sacral slope, pelvic incidence, global tilt, segmental lordosis, segmental kyphosis, GAP score) and coronal alignment angles (coronal tilt, Cobb angle) of patients were measured by two independent observers. Twenty patients underwent hip arthroplasty with femoral shortening followed up for a minimum of 12months. We found higher preoperative global lordosis (68.7 ± 9.7) and sacral slope (52.1 ± 8.8) angles, but the pelvic incidences (57.9 ± 10.1) were in the normal range. No statistically significant difference in any sagittal spinopelvic parameters between pre- and postoperative measurements was detected. GAP scores also did not change significantly (p = 0.231). Coronal plane parameters (Cobb angle, coronal pelvic tilt) were the only parameters in which a statistical change was observed (p = 0.02, p = 0.05, respectively). Lumbar lordosis and sacral slope values are outside standard ranges in patients with neglected dysplasia of the hip. The reconstruction of the distorted mechanics of the hip joint does not normalize sagittal pelvic and spine anatomy however improvements in coronal alignment were observed. Disease specific values of sagittal spinal alignment should be used in the treatment of lumbar degenerative problems in patients with neglected high hip dysplasia. IV.

An oblique osteotomy is better for subtrochanteric shortening in total hip arthroplasty for high hip dislocation: a mechanical comparison of four techniques.

Subtrochanteric femoral shortening is used during total hip arthroplasty for high hip dislocation in developmental dysplasia of hip patients. We mechanically tested the stability of various commonly used subtrochanteric osteotomy techniques. As the equivalent of a femoral stem placed in a shortened femur without any stable fixation at the osteotomy line, 2 polyvinylchloride pipes were loosely intertwined. 4 different osteotomies (Z-subtrochanteric osteotomy, oblique-45° osteotomy, double Chevron-90° and 120° subtrochanteric osteotomy) were simulated. Torsional and axial loads were applied, and torsional stiffness was calculated for each test model. Z, double Chevron-90° and 120° subtrochanteric osteotomy models demonstrated lower mean torsional stiffness than oblique-45° osteotomy. With the highest torsional stiffness oblique-45° provides the best stability for treatment of high dislocation hips when a subtrochanteric osteotomy is added. This matches our previous clinical experience. Oblique osteotomy may also provide higher contact surfaces in the osteotomy lines to promote bone healing.

“I am not Jasmine; I am Aladdin”: How Youth Challenge Structural Inequity through Critical Hip Hop Literacies

Abstract Previous research on Hip Hop Education has advocated for the inclusion of critical media literacy in schools and for the recognition of Hip Hop music and culture as a central component of young people’s literate and social identities (e.g. Hall, 2017; Kelly, 2020; McArthur, 2016). This article places critical Hip Hop literacy at the intersections of media education, social justice education, and culturally sustaining pedagogies by discussing the role of Hip Hop literature and culture as a form of text that can foster young people’s critical consciousness development in the secondary classroom. Through analysis of data collected in a high school Hip Hop Literature and Culture class, this qualitative case study examines how critical Hip Hop literacy practices can support youth sociopolitical development in racially diverse classrooms and schools. The results of this study reveal the need for schools to support students in identifying, analyzing, and challenging structures of oppression through the development of critical Hip Hop literacies.

Long-term results of medial open reduction surgery on pelvic and hip kinematics in children with developmental hip dislocation:A pilot study

Total hip arthroplasty in severe dysplasia is challenging due to diminished periacetabular bone stock and the highly placed femoral head. Although anatomical reconstruction of the hip, with required interventions such as subtrochanteric osteotomy and graft usage, is the main aim of the procedure, good long-term clinical outcomes of the high hip center technique have also been reported. Information regarding the effect of hip center placement on gait characteristics is limited; therefore, the aim of this study is to analyze the differences in gait parameters between the high hip center technique and anatomical reconstruction of the hip.Twenty patients (40 hips) with bilateral Crowe type III-IV developmental dysplasia of the hip who underwent bilateral total hip arthroplasty and completed at least 2 years of follow-up were included. Group 1 comprised 10 patients (20 hips) who underwent anatomical hip center reconstruction, while group 2 comprised 10 patients (20 hips) who underwent high hip center reconstruction. The gait characteristics of patients were examined through markers placed in certain anatomical regions, the cameras placed around, and the force plates embedded in the walking platform.There was no significant difference in the gait characteristics according to the location of the hip rotation center. The mean temporospatial, kinematic, and kinetic values were similar between the groups. The most prominent difference was in the peak dynamic hip extension, which was lower in group 2 (−9.71° ± 7.46°) compared to group 1 (−6.80° ± 11.44°), although it was not statistically significant (P = .09).The bilateral high hip center technique can provide similar gait characteristics as anatomical reconstruction and may be preferred in particularly difficult cases based on the surgeon’s decision.