Hip Joint Research Articles

Kinematic Analysis of Elite Indian National-level Sprinters: a Comprehensive Analysis

A comprehensive research study was undertaken involving ten national-level sprinters selected purposively from the athletics ground of Jawaharlal Nehru Stadium in New Delhi. The primary objective was to identify the key angles influencing movement during predefined steps in sprinting. The age range of the participants was 19 to 27 years, and the selection process followed purposive sampling. Descriptive statistics were employed to interpret the collected data, providing a summary of the sprinters' performances. The study considered various biomechanical aspects, including angles related to knee movement, hip articulation, and other relevant variables. The correlation between angular and linear variables was explored, and KINOVEA software was utilized for precise angle measurements, ensuring high accuracy in recording sprinters' movements. This technological approach facilitated a thorough examination of the kinematic aspects of their performance. Data collection employed a judgmental sampling method, and the results revealed significant relationships. Notably, there was a significant correlation between the angle at the right ankle joint and the angle at the right wrist joint at the 1st step. Additionally, a significant correlation was observed at the right knee joint at the 3rd step, indicating its contribution to the athletes' overall performance.

Arthroscopic Management of Pigmented Villonodular Synovitis of the Hip: A Systematic Review.

Background/Objectives: Pigmented villonodular synovitis (PVNS) is a benign proliferation of synovial tissue that can cause joint damage. The hip, although less commonly affected than the knee, presents a challenging diagnosis and treatment, with magnetic resonance imaging (MRI) as the gold standard for detection. Surgical excision, arthroscopic or open, is the main treatment approach, but there is no consensus on the best strategy for the hip. The aim of this systematic review is to evaluate the clinical outcomes, complications, and revision rates associated with arthroscopic hip surgery for PVNS. Methods: A systematic review was performed following the PRISMA guidelines. Relevant studies were identified by searching four databases: PubMed, Scopus, Embase, and Medline. Selected articles were evaluated according to the criteria of levels of evidence (LoE). For retrospective studies, the Coleman Methodology Score (mCMS) was used. This systematic review was registered with the International Prospective Register of Systematic Reviews. Results: Six studies satisfied the criteria; these involved 77 patients (48% male, 52% female) with a mean age of 26.4 years and a mean follow-up of 54.3 months. MRI and biopsy confirmed the diagnoses, and arthroscopic synovectomy was the primary treatment. Success rates ranged from 80% to 100%, with a recurrence rate of 7.8%, 1.3% requiring revision surgery, and eight (10.4%) patients in three studies reporting conversion to THA. Complications included mild effusions and residual synovitis. All patients who underwent a subsequent total hip arthroplasty were affected by advanced osteoarthritis. Conclusions: Our systematic review reveals that the use of hip arthroscopy in diagnosing and treating PVNS has shown satisfactory results without increasing the risk of recurrence or complications and can return patients to their former activity levels, provided their preoperative osteochondral status is good and there is early management of PVNS of the hip joint.

Personalized Stem Length Optimization in Hip Replacement: A Microscopic Perspective on Bone—Implant Interaction

Total hip replacement (THR) surgery involves the removal of necrotic tissue and the replacement of the natural joint with an artificial hip joint. The demand for THR is increasing due to population aging and prolonged life expectancies. However, the uniform length and shape of artificial hip joints can cause stress shielding, leading to implant loosening and femoral fractures. These issues arise because these designs fail to account for the unique anatomical and biomechanical characteristics of individual patients. Therefore, this study proposes and validates a method to optimize stem length by considering bone microstructure and daily load. The results demonstrated that the optimal stem length varies with loading conditions and significantly reduces stress in the cortical bone while maintaining an appropriate strain energy in the cancellous bone, thereby preventing bone loss. These findings underscore the importance of patient-specific stem design for improving implant stability and clinical outcomes.

Hip Dysplasia in Adults: Surgical Correction vs. Conservative Treatment Options

Introduction: Developmental Dysplasia of the Hip (DDH) is an anatomical deformation resulting from abnormal formation of the structures that make up the hip joint. Due to abnormal biomechanics patients with hip dysplasia usually develop radiographic osteoarthritis. Aim of the study: Despite the introduction of screening tests in children, DDH remains an issue among adults. For this group of patients, it is essential to begin treatment as early as possible to prevent early-onset osteoarthritis of the hip joint. In adults it is often too late to implement non-invasive methods such as braces or orthoses. Therefore, in this study, we aim to describe other treatment options for adults with DDH, considering both surgical and non-surgical methods. In the following work, we present both the advantages and complications associated with these surgical methods. Additionally, we describe the non-surgical alternative method of progressive resistance training (PRT) and consider the possibilities of combining it with surgical techniques. We also discuss the potential for pharmacological treatment. Material and Methods: Review of studies available through open-access sources on PubMed, Google Scholar, and the National Library of Medicine. Conclusions: The decision to quickly implement an appropriate treatment plan is crucial for improving the patient's quality of life. The choice of treatment method should consider the patient's age and the severity of the disease. Adults with DDH are most often qualified for surgical procedures, which include periacetabular osteotomy (PAO) and total hip replacement (THR). However, for some patients, surgical procedures may be contraindicated or impossible, and in such cases, other non-invasive methods, such as resistance training or appropriate pharmacotherapy, should be considered. Keywords: hip joint, osteoarthritis, surgery, conservative therapy, hip, Surgical Correction

Feasibility of mNGS in joint replacement patients exhibiting elevated ESR and CRP levels without an underlying diagnosis

ObjectiveThe aim of this study is to investigate the viability of performing initial artificial joint replacement surgery in patients presenting with unexplained elevations in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels.MethodsA cohort of 22 patients, comprising 11 cases each for knee and hip joint replacements, who underwent initial artificial joint replacement surgery between November 2020 and January 2022, was recruited. All patients exhibited elevated levels of ESR and CRP prior to surgery, the etiology of which remained undetermined. Intraoperatively, joint effusion and periarticular tissues were preserved for subsequent bacterial culture and metagenomic next-generation sequencing (mNGS). Postoperatively, a combination of intravenous and local antibiotics was administered for anti-infective management. In cases where bacterial culture and/or mNGS yielded positive results, patients were diagnosed with periprosthetic joint infections (PJI) and underwent one-stage revision; conversely, negative findings led to the discontinuation of intravenous and local antibiotics therapy.ResultsAmong the cohort of 22 patients, bacterial cultures yielded negative results, while mNGS identified bacterial infection in 14 patients (63.63%), viral infection in 1 patient (4.55%), and yielded negative results in 7 patients (31.82%). All surgical incisions achieved per primam. Subsequent follow-up assessments conducted for more than 1 year postoperatively revealed absence of PJI among the patients, all of whom exhibited satisfactory progress in their rehabilitation exercises. Notably, the Knee Society Score (KSS) for knee joint patients significantly improved from a preoperative mean of 48.7 ± 3.3 points to 84.3 ± 2.2 points postoperatively, whereas the Harris Hip Score for hip joint patients increased significantly from preoperative mean of 50.6 ± 3.6 points to 87.1 ± 1.6 points (P < 0.01).ConclusionIn cases where patients present with unexplained elevations in ESR and CRP levels, primary artificial joint replacement can be undertaken following a one-stage revision approach for PJI.

Establishing the Reliability of the GaitON® Motion Analysis System: A Foundational Study for Gait and Posture Analysis in a Healthy Population.

Gait and posture analysis plays a crucial role in understanding human movement, with significant applications in rehabilitation, sports science, and clinical settings. The GaitON® system, a 2D motion analysis tool, provides an accessible and cost-effective method for assessing gait and posture. However, its reliability in clinical practice, particularly for intra-rater consistency, remains to be evaluated. This study aims to assess the intra-rater reliability of the GaitON® system in a healthy population, focusing on gait and posture parameters. A total of 20 healthy participants (10 males and 10 females) aged 18 to 50 years were recruited for the study. Each participant underwent gait and posture assessments using the GaitON® system on two separate occasions, spaced one week apart. Video recordings from anterior and posterior views were used to analyze gait, while images from anterior, posterior, and lateral views were captured to assess posture with markers placed on key anatomical landmarks. The reliability of the measurements was analyzed using intraclass correlation coefficients (ICC), a standard error of measurement (SEM), and the smallest detectable difference (SDD) method. The GaitON® system demonstrated excellent intra-rater reliability across a wide range of gait and posture parameters. ICC values for gait parameters, including hip, knee, and ankle joint angles, ranged from 0.90 to 0.979, indicating strong consistency in repeated measurements. Similarly, ICC values for posture parameters, such as the head alignment, shoulder position, and ASIS alignment, were above 0.90, reflecting excellent reliability. SEM values were low across all parameters, with the smallest SEM recorded for the hip joint angle (0.37°), and SDD values further confirmed the precision of the system. The GaitON® system provides reliable and consistent measurements for both gait and posture analysis in healthy individuals. Its high intra-rater reliability and low measurement error make it a promising tool for clinical and sports applications. Further research is needed to validate its use in clinical populations and compare its performance to more complex 3D motion analysis systems.

Optimal sliding distance in femoral neck system for displaced femoral neck fractures: a retrospective cohort study

BackgroundDisplaced femoral neck fractures frequently result in considerable patient morbidity, with complications such as postoperative femoral neck shortening occurring in up to 39.1% of cases. This shortening is associated with reduced hip function and mobility. The Femoral Neck System (FNS), which allows for controlled sliding to facilitate fracture reduction and healing, may mitigate these issues. However, the ideal sliding distance to balance fracture healing and minimize complications is not well defined.MethodsWe performed a retrospective cohort study of 179 patients who underwent FNS fixation for displaced femoral neck fractures at our institution from September 2019 to September 2023. Patients were categorized into three groups based on the intraoperative sliding distance allowed by the FNS: the Minimal Slide group (≤ 5 mm), the Moderate Slide group (> 5 to ≤ 10 mm), and the Extensive Slide group (> 10 to 20 mm). Primary outcomes included postoperative femoral neck shortening, the incidence of moderate to severe shortening, time to fracture union, and hip joint function as assessed by the Harris Hip Score (HHS) and the Parker Mobility Score. Secondary outcomes included complication rates such as implant cut-out, nonunion, avascular necrosis of the femoral head, and the need for secondary surgery.ResultsThe Extensive Slide group of moderate to severe shortening at 32.31%, which was 1.59-fold and 8.88-fold that of the Moderate Slide (20.34%) and Minimal Slide group’s (3.64%), respectively (P < 0.01). The sliding predominantly occurred within the first three months postoperatively and had substantially ceased by six months. At one year postoperatively, the median shortening was 2.7 mm (IQR, 0.7 to 3.5 mm) for the Minimal Slide group, a value that was notably lower compared to the 3.2 mm (IQR, 2.4 to 4.6 mm) for the Moderate Slide group and the 3.5 mm (IQR, 1.3 to 8.1 mm) for the Extensive Slide group. The average time to achieve union was similar across all groups, with no significant differences. Functional outcomes, as assessed by the Harris Hip Score (HHS) and the Parker Mobility Score, the Harris Hip Score (HHS) demonstrated statistical significance, the Parker Mobility Score did not reach statistical significance.ConclusionsRestricting FNS slide to ≤ 5 mm in surgery may reduce shortening, improve hip function, and not hinder fracture healing or implant stability. Considering the key 3-month sliding timeline postoperatively is advisable in clinical practice. Further research with a broader patient cohort is vital to confirm these findings and to anchor them in evidence-based practice.

Functional Recovery After Hip Arthroplasty with a Minimal Invasive or Classical Approach Eight Years After Intervention

Background: The aim of this study was to investigate differences in functional recovery eight years after total hip arthroplasty in patients who underwent hip joint surgery using two different approaches: the classic lateral approach and the anterolateral minimally invasive surgical approach. Methods: Eight years after the hip replacement, 68 subjects, 32 in the classic and 36 in the minimally invasive group, underwent follow-up measurements involving the Harris Hip Score (HHS), range of motion, strength of the abductor muscles, 50-m walk time, body mass index (BMI), physical activity questionnaire, and visual analogue scale (VAS) pain during general activities. Results: Higher HHS (p &lt; 0.001), hip abduction (p &lt; 0.001), and hip flexion (p = 0.018) range of motion values were obtained in the minimally invasive approach group. A correlation between physical activity (PA) and the hip abduction muscle strength in the classic group (r = 0.43; p = 0.011) and a correlation between PA and the HHS in the minimally invasive group (r = 0.34, p = 0.041) was found. BMI was correlated with the 50-m walk time in both groups (classical: r = 0.39; p = 0.027; minimally invasive r = 0.35; p = 0.030); meanwhile, in the minimally invasive group, BMI was negatively correlated with hip flexion (r = −0.37; p = 0.020). Conclusions: Eight years after total hip arthroplasty, performed using either an anterolateral minimally invasive or lateral approach, there was no difference in the patients’ functional outcome in relation to BMI. The minimally invasive approach benefits patients by granting them better functional abilities. A clinical difference was found in the HHS, in favour of the minimally invasive group.

Lower limbs kinematic analysis during a jump landing task in soccer players with unilateral anterior cruciate ligament reconstruction

BackgroundFatigue leads to an acute decline in muscle strength, altered patterns of lower extremity muscle activation, changes in hip and knee kinematics. In terms of the effects of fatigue on knee joint kinematics during plyometric training, there is still a lack of knowledge regarding kinematic differences between athletes who passed the ACL reconstructions rehabilitation period and healthy athletes. Therefore, this study aimed to compare lower limb joint kinematic parameters between reconstructed cruciate ligament and healthy control soccer players during jump landing in a fatigued setting.MethodsLower limb kinematic parameters were recorded in 20 professional soccer players (age, 24.95 ± 2.92 years; body mass, 77.20 ± 12.88 kg; height, 1.77 ± 3.19 m) during jump landing task before and after the fatigue protocol. The control group consisted of healthy subjects and the experimental group consisted of subjects with ACL reconstruction by thigh transplantation. Kinematic data was recorded with 4 cameras to measure lower limb angles at first foot contact and maximum range of motion.ResultsThe results showed that before fatigue, there was only a significant difference between the two groups in the maximum range of motion of the non-involved hip joint (P = 0.022) and angle of the involved hip at first contact (P = 0.049). In other data on joint range of motion or initial contact angle, no significant difference was observed between the two groups (P > 0.05). After fatigue protocol, there was a significant difference in initial foot contact in non-involved (P = 0.030), and involved (P = 0.020) hip joint angles between the two groups. However, no significant difference in initial contact angle or range of motion of other joints was observed between the groups.ConclusionsThis study shows that plyometric fatigue does not contribute to numerous changes in contact angles and range of motion in lower extremity joints in healthy soccer players and those with a history of cruciate ligament repairs.

Research on the difference of stroke characteristics and stroke effect between different stroke duration of table tennis players

This study aimed to explore the differences in joint kinematic characteristics and stroke effect between fast and slow strokes of table tennis players. Thirty-four table tennis players were randomly selected as participants for this experiment. A high-speed infrared motion capture system was used to collect kinematic data of the right-side upper and lower limb joints during strokes. Simultaneously, a high-speed camera was used to measure the stroke effect. According to the duration of a stroke, the stroke data were classified into two types: fast-stroke and slow-stroke using a two-step clustering algorithm. The duration of the three phases of fast-stroke was shorter, with faster ball speed and stronger spin. Compared with slow-stroke, fast-stroke exhibited shorter displacements in the three lower limb joints and faster linear velocities in the three upper limb joints. In addition, the motion angles of the knee and ankle joints were smaller, while the angles of the hip, shoulder, and elbow joints were larger, with higher angular velocities. Increasing the extension speed of the lower limbs, the flexion speed of the elbow joints, and the wrist movement speed can achieve fast strokes, enhancing ball speed and spin. Small and quick hip joint movement can effectively transfer energy to the upper limbs, increasing the movement speed of the elbow and wrist joints, thus improving the ball speed and spin of the stroke.

Hip preservation in crisis: total hip replacement for osteoid osteoma-induced degeneration in a young adult

Osteoid osteoma is a small, benign tumor known for causing severe pain, especially at night. Intra-articular osteoid osteomas are rare and often misdiagnosed due to overlapping symptoms with other joint disorders like osteoarthritis or synovitis. These tumors require advanced imaging for accurate diagnosis and may necessitate surgical intervention when conservative treatments fail. A 22-year-old female presented with a four-year history of left hip and loin pain, initially treated with NSAIDs. Her symptoms progressively worsened, leading to imaging studies that revealed a sclerotic lesion in the hip joint. A biopsy confirmed osteoid osteoma, and due to the extent of joint damage, total hip replacement (THR) was performed. Postoperative recovery was excellent, with full functional restoration and no complications. This case illustrates the diagnostic and therapeutic challenges of intra-articular osteoid osteomas. THR proved to be a successful treatment in restoring function and alleviating pain, underscoring the need for early diagnosis and individualized surgical management in advanced cases.

Functional evaluation of unstable intertrochanteric fractures treated with proximal femoral nailing

In this study the functional outcome of proximal femoral nailing (PFN) in patients with unstable intertrochanteric fractures is studied and outcome is assessed with Modified Harris Hip Score. A post-operative analysis of unstable intertrochanteric fractures treated with PFN is done for its functional assessment. Various national &amp; international studies are taken into consideration and our institutional study is compared with them. Between September 2020 to March 2022, 20 patients with unstable intertrochanteric fractures of the hip joint who were operated with PFN were functionally and clinically evaluated as per the Modified Harris Hip Score. Patients who satisfied the inclusion criteria were included in the study and follow-up was done up to 9 months. Fracture pattern, operative details and post-operative complications were documented. This study of 20 patients of unstable intertrochanteric fractures fixed with PFN showed excellent results in 9 patients (45 %), good functional outcome in 6 patients (30 %) and fair functional outcome in 3 patients (15 %). 2 patients showed a poor outcome accounting for 10%. The study showed that PFN is a reliable and effective device for the treatment of unstable intertrochanteric fractures. It provides a satisfactory fixation, but success is dependent mainly on fracture type, bony architecture, operative technique, postoperative care and rehabilitation. In view of the fewer post-operative complications, early union of fracture, early weight bearing and early return to work, we concluded the PFN to be a versatile, stable and acceptable implant in fixation of unstable intertrochanteric fractures which leads to a better functional outcome.

Comparative study of total hip arthroplasty with and without femoral osteotomy in Crowe Ⅳ developmental dysplasia of the hip

To compare the clinical effects of total hip arthroplasty(THA) with and without femoral osteotomy in Crowe Ⅳ developmental hip dislocation(DDH). The data on 46 patients who underwent THA for unilateral Crowe Ⅳ DDH between 2012 and 2017 were analyzed retrospectively. They were divided into two groups according to the different surgical methods. There were 24 patients in the osteotomy group, 3 males and 21 females, with an average age of (47.3±9.0) years old ranged from 34 to 57 years old;and 22 patients in the non-osteotomy group, 2 males and 20 females, with an average age of (51.6±8.3) years old ranged from 40 to 61 years old. The operative time, bleed loss, postoperative drainage volume, postoperative complications, ROM of hip, Harris hip score, limb length discrepancy(LLD), and radiological data were recorded. The femoral dislocation height and the implantation depth of sleeve were measured. All patients were followed up. The mean follow-up time was (3.8±1.2) years ranged from 2 to 6 years in the osteotomy group and (3.2±0.9) years ranged from 1 to 5 years in the non-osteotomy group. The operative time(136.8±18.9) min, bleed loss (709.8±89.4) ml, postoperative drainage volume(308.8±98.2) ml of osteotomy group were all significantly greater than those of non-osteotomy group(100.7±15.8)min, (516.5±103.3) ml, (245.3±79.3) ml (P<0.05). The Harris score at the latest follow up was significantly increased compared with preoperative score in two groups (P<0.05), but there was no significant difference between two groups (P>0.05). The LLD at last follow up was significantly increased compared with preoperative LLD in two groups, the LLD in non-osteotomy group(0.7±0.2) cm showed signifcant smaller than the two osteotomy group(1.2±0.4) cm. Between osteotomy and non-osteotomy groups, the preoperative range of motion of hip joint [(89.5±19.7) °vs (102.5±16.8) °], the preoperative height of dislocation of femoral head [(4.56±0.61) cm vs (3.10±0.73) cm], the proximal implant depth of S-ROM [(0.93±0.36) cm vs (1.67±0.28) cm] was significantly different (P<0.05). Eleven patients in the osteotomy group still had claudication, and 4 patients in the non-osteotomy group had mild claudication (P<0.05). In non-osteotomy group, 3 patients developed nerve injury (1 patient of sciatic nerve, 2 patients of femoral nerve) and 1 case developed periprosthetic fracture. In osteotomy group, 2 case of dislocation and 2 cases of periprosthetic fractures. Whether osteotomy or not can achieve satisfactory results for treating Crowe type Ⅳ DDH and significantly improve LLD. However, osteotomy is more complex and time-consuming, limb length difference is greater, and the incidence of claudication is higher. Furthermore, patients with smaller preoperative hip mobility, higher femoral dislocation, limb lengthening≥4 cm and severely narrow femoral proximal canals are prone to be peformed with subtrochanteric osteotomy.

A study of functional outcome of intertrochanteric fractures operated with intraheal proximal hip stabilizing nail-multicentric study

Background: Modalities of fixation in intertrochanteric fractures have been a topic of debate since times immemorial. Our special aims at comparing the functional outcome of Intraheal™ proximal hip stabilizing nail (PHSN, GPC Medical Limited) fixation in 200 patients of intertrochanteric fractures. Methods: 200 patients of intertrochanteric fracture fulfilling the inclusion criteria were included in our study. Preoperative AP and Lateral views of hip joint were taken for all patients. In post-operative period, the patients were reviewed at 2 weeks, 1 month, 3 months, 6 months, and 12 months by the operating surgeon. Functional assessment, radiological assessment of bony union and complications were evaluated in follow up period. Results: 200 patients underwent Intraheal™ proximal hip stabilizing nail fixation. They were followed-up the patients at 2 weeks, 1, 3, 6 and at 12 months postoperatively AP and lateral pelvic X-rays were obtained at each follow-up, and implant position changes, all complications, and fixation failures were recorded. We included a total of 200 patients meeting the criteria in this study and follow up was done till 12 months postoperatively. Intra-operative complications, time of hospital stay, Varus fixation and fracture displacement were assessed. Conclusion: Advantages noted with PHSN fixation were excellent Harris hip score, lesser screw cutout, early union rate. However, PHSN had greater incidence of anterior thigh pain at all intervals of follow-up. There were no significant local wound complications or duration of hospital stay.

Clinical characteristics and prognosis of interstitial lung disease in systemic juvenile idiopathic arthritis: a two-center retrospective observational cohort study

BackgroundInterstitial lung disease (ILD) is a serious complication in systemic juvenile idiopathic arthritis (SJIA). This study aimed to identify the clinical characteristics and prognosis of SJIA-ILD.MethodsA two-center retrospective cohort study was conducted on patients newly diagnosed with SJIA in China from October 2010 to December 2021. Clinical characteristics, laboratory parameters, outcomes, and relapse rates were compared between ILD and non-ILD groups.ResultsA total of 176 children with SJIA were included, including 35 in ILD group and 141 in non-ILD group. The median age at onset of SJIA was 5.8 years (range 4.4–9.5) in patients with SJIA-ILD. It exhibited higher incidences of cervical spine (28.6%) and hip involvement (40.0%) in ILD group (P = 0.031 and P = 0.029, respectively). The incidence of macrophage activation syndrome (MAS) in ILD group reached up to 40%, significantly elevated than that in non-ILD group (P = 0.047). Children with ILD demonstrated a stronger inflammatory response and were more prone to developing lymphopenia (P = 0.009), requiring more combination therapy (P = 0.006) to control disease activity. 54.3% of patients received biologic therapies, with only three patient receiving biologics (one with IL-6 blockade, two with TNF inhibitor) prior to ILD onset and none receiving IL-1 blockade. The median follow-up duration was 6.0 years (range 3.9–9.5). The proportions of patients with SJIA-ILD achieving clinical inactive disease without glucocorticoids within 6 to 12 months of the treatment were significantly lower than control group (45.7% vs. 70.2%, P = 0.006). In ILD group, only 54.3% of patients achieved complete remission, and 17.1% were in a non-remission state, among whom two deaths from respiratory failure. There was no significant difference in disease relapse rates between the two groups (P > 0.05).ConclusionsPatients with SJIA-ILD exhibited heightened inflammation, increased hip joint and cervical spine involvement, and were more susceptible to developing lymphopenia and MAS, suggesting a relatively poor prognosis. They required a prolonged time to control inflammation and more aggressive treatment strategies to achieve inactive status. The unsatisfactory rate of complete remission highlighted an urgent need for focused clinical strategies.

Change in Femoral Offset after Closed Reduction and Dynamic Hip Screw Osteosynthesis Via Lateral Approach in Patients with Medial Femoral Neck Fracture: A Retrospective Analysis.

Closed reduction and dynamic hip screw (DHS) osteosynthesis are preferred as joint-preserving therapy in case of medial femoral neck fractures (MFNFs). A change in the femoral offset (CFO) can cause gait abnormality, impingement, or greater trochanteric pain syndrome. It is unknown whether the femoral offset (FO) can be postoperatively fully restored. The aim of the study was to investigate the extent of a possible CFO in hip joints after DHS osteosynthesis in the case of an MFNF. In this retrospective study, 104 patients (mean age: 71.02 years, men: n = 50, women: n = 54) with MFNF who underwent closed reduction and DHS osteosynthesis were analyzed by postoperative x-rays to assess CFO between the operated (OS) and nonoperated joint side (NOS). The studies covered the time period 2010-2020. A statistical comparison was performed between the mean values of FO between OS and NOS, taking into account patient age, gender, and fracture severity. All operated hip joints showed a CFO. In 76.0% (79 of 104), the FO decreased (FOD), and in 24.0% (25 of 104), the FO increased (FOI). A critical CFO (>15% CFO) was detected in 52.9% (55 of 104). In hip joints with postoperative FOD, the mean FO between NOS (49.15 mm [±6.56]) and OS (39.32 mm [±7.87]) and in hip joints with postoperative FOI the mean FO between NOS (41.59 [±8.21]) and OS (47.27 [±6.68]) differed significantly (p < 0.001). Preoperative FO (rS: -0.41; p > 0.001) and caput-collum-diaphyseal angle (CCD; rS: 0.34; p > 0.001) correlated with postoperative CFO. FOD was found in hip joints with a preoperative FO >44 mm and CCD <134° vice versa FOI in hip joints with a preoperative FO <44 mm and CCD >134°. Closed reduction and DHS osteosynthesis in patients with MFNF result in a clustered significant CFO. The individual FO should be taken into account pre- and intraoperatively to avoid a postoperative extensive CFO.

Biomechanic Differences Between Anticipated and Unanticipated Volleyball Block Jump: Implications for Lower Limb Injury Risk

Volleyball is a high-intensity sport characterized by repetitive jumping, sudden directional changes, and overhead movements, all of which significantly increase the risk of injuries, particularly to the shoulders, knees, and ankles. Despite the frequency of injuries caused by actions like blocking and spiking, there has been limited research focused on the specific biomechanical risk factors unique to volleyball. This study aimed to investigate the lower limb biomechanics during block jumps in both the dominant and non-dominant directions, under both anticipated and unanticipated conditions, in fifteen elite male volleyball players. Kinematic and kinetic data from the ankle, knee, and hip joints were recorded. Our results revealed statistically significant differences between the dominant and non-dominant directions at the ankle, knee, and hip joints. The non-dominant direction exhibited a greater ankle dorsiflexion angle and velocity, as well as higher knee flexion angle, velocity, moment, power, and abduction moment, along with increased hip flexion angle and power. Additionally, unanticipated movements led to increases in vertical ground reaction force (vGRF), hip extension moment, and flexion power, while ankle dorsiflexion plantarflexion velocity and knee flexion power decreased. It appears that movements in the dominant direction were stiffer and less cushioned, potentially increasing the risk of injury. While the non-dominant direction provided better shock absorption, it also elevated the knee valgus moment, which could increase the load on the knee. Furthermore, in unanticipated situations, athletes with short reaction times, unable to quickly adjust their automated movement patterns, faced a higher risk of limb overuse, thereby increasing the likelihood of injury. In practice, coaches should consider differences in limb coordination and movement direction, incorporating unilateral preventive exercises to reduce the risk of injury.

Hip Manipulation Increases Electromyography Amplitude and Hip Joint Performance: A Double-Blind Randomized Controlled Study

(1) Background: Activation of the gluteus medius (GM) muscle while minimizing the involvement of the tensor fascia latae (TFL) is crucial in treating many lower limb and lumbar spine injuries. Previous studies have demonstrated the effectiveness of joint manipulations in regulating muscle activity. The main objective of this study was to evaluate the effects of hip joint manipulation (HJM) on the muscle strength and activity (GM and TFL) of hip abductors in asymptomatic young participants. (2) Methods: The study followed a double-blind randomized controlled design. Thirty healthy, physically active women and men, free from spinal and lower limb injuries, voluntarily participated. The participants were allocated to two groups: those allocated to the HJM intervention and those in the control group receiving a sham intervention. They were assessed before and after the intervention using surface electromyography to measure muscle activation (EMGRMS) of the GM and TFL during maximal voluntary isometric hip abduction. (3) Results: HJM resulted in a significant increase in EMGRMS amplitude solely within the GM muscle (p &lt; 0.01); (4) Conclusions: This study suggests that HJM may increase EMGRMS amplitude in the GM muscle; however, the effects are neither statistically nor clinically significant when compared to the control group for most of the muscles analyzed.

Effects of Mild Fatigue on Biomechanics of Single Leg Landing in Young Male Volleyball Players.

To investigate the effects of mild fatigue on the biomechanics of the lower limbs of young male volleyball players while performing single leg landing tasks. A total of ten young male volleyball players were recruited as participants in this study. After the single leg landing was performed, we compared the performance between those with and without fatigue (post- and non-fatigue, respectively). Kinematics and kinetics were collected using instruments, and related captured data were imported into OpenSim to analyze the hip, knee, and ankle joints. We found that the ankle dorsiflexion angle at initial contact was significantly decreased in the post-fatigue group compared to the non-fatigue one. Meanwhile, the peak gluteus maximus force, peak gluteus medius force, peak tibialis posterior force, and peak gastrocnemius force significantly increased. There were no significant differences in the hip and knee joint flexion angles as well as the quadriceps and biceps femoris long head forces between the two groups. Mild fatigue can affect the performance of single leg landing, and players need to control the lower limbs by generating a higher muscle force to cope with the instability induced by fatigue. In a fatigued state, following initial contact with the ground, a decreased ankle dorsiflexion angle necessitates an increase in gastrocnemius and tibialis posterior muscle force to maintain stance during landing.

The impact of neurological impairment and tone on hip joint development.

The purpose of this study was to define how different force environments by neuromuscular diagnosis (hypertonic versus hypotonic) impact the growth and morphology of the proximal femoral and acetabular regions relative to typically developing children. Children with cerebral palsy and spinal muscular atrophy were compared with typically developing children aged 6 months to 11 years. Routine pelvic radiographs were evaluated using measures of hip geometry for the proximal femur and acetabulum. The data were analyzed using general linear models to estimate the developmental patterns according to age and diagnosis. One hundred eighty-four children met the inclusion criteria: 58 spastic cerebral palsy Gross Motor Function Classification System I-V (263 hips), 32 spinal muscular atrophy (79 hips)), and 94 typically developing (187 hips) were included with a mean age of 4.9 ± 3.1 years. Using spinal muscular atrophy as a reference, significant differences in proximal femoral development included long thin versus short neck (p < 0.01) and round versus flat epiphysis (p = 0.001). A thin neck-wide epiphysis was found in spinal muscular atrophy versus thick neck-small epiphysis for typically developing (p < 0.05). The ratio of acetabular width to proximal femoral epiphysis width differed significantly for typically developing (p = 0.001) compared with cerebral palsy and spinal muscular atrophy. There was a negative correlation between migration percentage and acetabular width to epiphysis width in children with cerebral palsy, but no correlation in children with spinal muscular atrophy. Hip geometry was impacted by the force environment experienced during growth. These findings emphasize the crucial roles of gross motor function, muscle tone, and strength differences in determining hip morphology. III, retrospective case control.