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1.
Rev. cuba. ortop. traumatol ; 35(2): e198, 2021. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1357330

ABSTRACT

La artroplastia de cadera es uno de los tratamientos quirúrgicos más exitosos en la cirugía ortopédica. Actualmente existe un mayor interés en el abordaje anterior para artroplastias de cadera determinado por la creencia de que al ser intermuscular puede provocar una disminución del dolor, una recuperación más rápida, mejor estabilidad de la cadera y menor riesgo de luxación después de la cirugía comparativamente. Es propósito de este artículo revisar la historia del abordaje anterior de la articulación de la cadera, su vía intermuscular de acceso y los principales beneficios que posee. Popularizado por Smith-Petersen en 1917, el abordaje anterior de la cadera debe su primera referencia escrita a Carl Hueter. Todos los abordajes de la cadera han demostrado ser seguros y eficaces, con ventajas y desventajas. Se requieren estudios a largo plazo de un mayor número de pacientes para demostrar un beneficio de costo y una mayor calidad en la atención médica(AU)


Hip replacement is one of the most successful surgical treatments in orthopedic surgery. There is currently greater interest in the anterior approach to hip arthroplasties determined by the belief that being intramuscular it can lead to less pain, faster recovery, better hip stability and comparatively less risk of dislocation after surgery. The purpose of this article is to review the history of the anterior approach to the hip joint, its intramuscular access route and its main benefits. Popularized by Smith-Petersen in 1917, the anterior approach to the hip owes its first written reference to Carl Hueter. All hip approaches have been shown to be safe and effective, with advantages and disadvantages. Long-term studies of larger numbers of patients are required to demonstrate cost benefit and higher quality of medical care(AU)


Subject(s)
Humans , Surgical Procedures, Operative , Orthopedic Procedures/history , Hip Joint
2.
Medicina UPB ; 40(2): 33-40, 13 oct. 2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1342178

ABSTRACT

Objetivo: caracterizar desde el punto de vista microbiológico las infecciones periprotesicas (IP) de los pacientes sometidos a remplazo articular de rodilla o cadera, en la IPS universitaria Clínica León XIII, y evidenciar los patrones más comunes de resistencia a los antibióticos, en el periodo 2015-2018. Metodología: se recolectó información de 25 pacientes llevados a remplazo articular de rodilla o cadera en la IPS universitaria, sede Clínica León XIII, durante el periodo de 2015-2018, que desarrollaron IP. Se obtuvo información sobre características demográfica, clínicas y patrones de resistencia (según antibiograma), y sobre los criterios usados para diagnosticarla. Los datos se registraron, según la naturaleza y distribución de la variable, en medias o medianas para las variables cuantitativas, y en frecuencias para las cualitativas. Resultados: entre 2015 y 2018 se realizaron 541 remplazos articulares, la incidencia de infección periprotésica fue de 4.6% (25 pacientes), 22 casos (88%) con crecimiento microbiológico. El germen más frecuente fue el S. aureus, con patrón alto de resistencia para meticilina (SAMR), en el 44%. Seguido por K. pneumoniae, con un patrón de resistencia por producción de betalactamasas de espectro extendido (BLEE) de 83%. Ninguno tuvo resistencia a los carbapenémicos. Conclusiones: los resultados son similares a los reportados en la literatura internacional. Sigue siendo el S. aureus el principal causante de la infección periprotésica, seguido de los gérmenes gram negativos.


Objective: to microbiologically characterize the periprosthetic infections (PI) of patients undergoing knee or hip joint replacement at IPS Universitaria Clínica León XXIIIin the period 2015-2018, and to demonstrate the most common antibiotic resistance patterns. Methodology: the information was collected from 25 patients undergoing knee or hip joint replacement at IPS Universitaria Clínica León XXIII during the period 2015-2018 who developed PI. Data was obtained on demographic, clinical characteristics, and antibiotic resistance patterns (according to antibiograms), as well as on the diagnostic criteria used to diagnose it. The data was recorded, according to the nature and distribution of the variable, in means or medians for the quantitative variables, and in frequencies for the qualitative variables.Results:between 2015-2018, 541 joint replacements were performed. There was an incidence of periprosthetic infection in 25 patients (4.6%), 22 of whom (88%) had micro-biological growth. The most frequent germ was S. aureus, which had a high resistance pattern for methicillin-resistant S. aureus (MRSA) in 44%, followed by K. pneumoniaewith a positive extended spectrum beta-lactamase (ESBL) in 83%. None of them showed resistance to carbapenems.Conclusions: the results found are similar to those reported in the international lite-rature. This investigation evidenced that S. aureus continues to be the main cause of periprosthetic infection, followed by gram-negative germs.


Objetivo: caracterizar do ponto de vista microbiológico as infecções periprotéticas (IP) dos pacientes submetidos à artroplastia articular do joelho ou do quadril, na IPS universitário, Clínica León XIII, e demonstrar os padrões mais comuns de resistência aos antibióticos, em o período 2015-2018.Metodologia: foram coletadas informações de 25 pacientes encaminhados para prótese de joelho ou quadril no IPS universitário, sede da Clínica León XIII, no período 2015-2018, que desenvolveram IP. Foram obtidas informações sobre as características demográfi-cas, clínicas e padrões de resistência (de acordo com antibiograma) e sobre os critérios usados para diagnosticá-la. Os dados foram registrados, de acordo com a natureza e distribuição da variável, em médias ou medianas para as variáveis quantitativas e em frequências para as qualitativas.Resultados: entre 2015 e 2018, foram realizadas 541 substituições articulares, a incidência de infecção periprotética foi de 4,6% (25 pacientes), 22 casos (88%) com crescimento microbiológico. O germe mais frequente foi S. aureus, com alto padrão de resistência à meticilina (MRSA), em 44%. Seguido por K. pneumoniae, com padrão de resistência devido à produção de beta-lactamase de espectro estendido (ESBL) de 83%. Nenhum apresentou resistência aos carbapenêmicos.Conclusões: os resultados são semelhantes aos relatados na literatura internacional. S. aureus continua a ser a principal causa de infecção periprotética, seguido por germes gram-negativos.


Subject(s)
Humans , Prostheses and Implants , Drug Resistance, Microbial , Methicillin-Resistant Staphylococcus aureus , Hip Joint , Infections , Joints , Knee , Anti-Bacterial Agents
3.
Rev. Asoc. Argent. Ortop. Traumatol ; 86(4) (Nro Esp - ACARO Asociación Argentina para el Estudio de la Cadera y Rodilla): 455-462, 2021.
Article in Spanish | LILACS, BINACIS | ID: biblio-1353946

ABSTRACT

Introducción: La mala alineación de los tallos femorales no cementados sigue siendo un tema controvertido. Algunos autores han comunicado una inadecuada osteointegración y hundimiento en los tallos en varo y otros no encontraron dichos efectos adversos, pese a la incorrecta alineación. Los objetivos de este estudio fueron determinar la prevalencia de tallos no cementados con cobertura total de hidroxiapatita en deseje coronal y mostrar los resultados clínico-radiográficos a largo plazo. materiales y métodos: Estudio retrospectivo entre 2006 y 2009. Se analizaron 220 reemplazos totales de cadera primarios con tallos no cementados con cobertura completa de hidroxiapatita. La alineación coronal fue analizada con radiografías anteroposteriores de ambas caderas en 10° de rotación interna. Se registraron datos, como osteointegración, hundimiento, osteólisis femoral proximal e hipertrofia cortical. Para el análisis clínico se utilizó el Harris Hip Score. El análisis de supervivencia contempló la necesidad de revisión por cualquier causa. Resultados: La prevalencia de tallos en deseje fue del 32,3%, con mayoría de implantes en varo (73,3%). El Harris Hip Score tuvo un incremento estadísticamente significativo (41,05 ± 6,5 vs. 90,05 ± 2,5; p <0,01). El 73,1% de los tallos desarrollaron una fijación ósea estable. Se observó osteólisis femoral proximal en el 3% de los casos. Hubo un 3% de fracturas periprotésicas femorales. La supervivencia de la prótesis fue del 100% a los 10.9 años. Conclusión: Los tallos no cementados con cobertura total de hidroxiapatita toleran adecuadamente la alineación coronal en varo/valgo a largo plazo. Nivel de Evidencia: IV


Introduction: Coronal malalignment of non-cemented stems remains controversial. It's been reported that femoral stems implanted with varus or valgus developed subsidence and lack of integration with femoral bone. The purpose of this study was to calculate prevalence of coronal malalignment in cementless, fully coated with hydroxialapatyte (HA) femoral stems focusing in their long-term clinical and radiographic outcomes. Materials and methods: A retrospective study was performed, assessing 220 primaries total hip replacements with non-cemented, fully coated with HA, femoral stems between 2006 and 2009. Coronal alignment was assessed with hips antero-posterior views with 10º of internal rotation of lower limbs. We registered data about subsidence, proximal femoral osteolysis and cortical hipertrophy. Functional outcomes were assessed with Harris Hip Score (HHS). Free revision rate implant survival was calculated. Results: Prevalence of femoral stems with malalignment was 32.3%. HHS showed an statistically significant increase after surgery (41.05 ± 6.5 versus 90.05 ± 2.5; p <0.01). There were 73.1% of femoral stems that achieved a bone stable fixation. We observed proximal femoral osteolysis in 3.0% of the patients and there were 3% of periprosthetic fractures. Free-revision survival rate was 100% at 10.9 years of follow-up. Conclusion: Cementless, fully coated with HA femoral stems with varus/valgus malalignment achieves good long-term clinical and radiographic outcomes. Level of Evidence: IV


Subject(s)
Middle Aged , Aged , Prosthesis Design , Treatment Outcome , Arthroplasty, Replacement, Hip , Hip Joint/surgery
4.
Article in Spanish | LILACS, BINACIS | ID: biblio-1353913

ABSTRACT

Las fracturas por insuficiencia subcondral son una causa poco frecuente de cadera dolorosa. A diferencia de las fracturas traumáticas agudas, las fracturas por insuficiencia del acetábulo son menos frecuentes que las femorales. Ocurren habitualmente en mujeres posmenopáusicas con comorbilidades. Su diagnóstico inicial suele ser dificultoso y la sospecha clínica es de gran importancia. La resonancia magnética es una herramienta fundamental para detectar este cuadro. Subestimar estas lesiones puede llevar al desarrollo de una artrosis rápidamente progresiva y al reemplazo articular como desenlace. Se presenta el caso de una paciente de 68 años con una fractura por insuficiencia subcondral del acetábulo a quien se le indicó una artroplastia total de cadera no cementada. Nivel de Evidencia: IV


Subchondral insufficiency fractures are a rare cause of hip pain. Unlike acute traumatic fractures, acetabulum insufficiency fractures are less common than femoral fractures. They commonly occur in postmenopausal women with comorbidities. Its initial diagnosis is usually difficult and clinical suspicion is of great importance. Magnetic resonance imaging (MRI) is a fundamental tool for the detection of this pathology. Underestimating these injuries can lead to the development of rapidly progressive osteoarthritis and joint replacement as an outcome. We present the case of a 68-year-old patient with a subchondral insufficiency fracture of the acetabulum who underwent uncemented total hip arthroplasty. Level of Evidence: IV


Subject(s)
Aged , Osteoarthritis, Hip , Fractures, Stress , Arthroplasty, Replacement, Hip , Hip Joint/pathology , Acetabulum/injuries
5.
Rev. Asoc. Argent. Ortop. Traumatol ; 86(4) (Nro Esp - ACARO Asociación Argentina para el Estudio de la Cadera y Rodilla): 553-559, 2021.
Article in Spanish | LILACS, BINACIS | ID: biblio-1353957

ABSTRACT

Las lesiones del labrum de la cadera con sustancia insuficiente se pueden tratar con técnicas de aumento, de reconstrucción o con trasplante de tejidos. Si el remanente labral es muy escaso, las opciones reconstructivas serían las más adecuadas. Se presenta el caso de una paciente de 40 años con dos cirugías artroscópicas previas fallidas por lesión labral, que fue sometida a una luxación controlada de cadera, siguiendo la técnica original descrita por Ganz, y a la resección del ligamento redondo de la cabeza femoral para cubrir el defecto del labrum. Según nuestro conocimiento, se trata del primer reporte de reconstrucción labral utilizando el ligamento redondo de la cabeza femoral en nuestro medio. Pese a los resultados poco alentadores en pacientes con cirugías previas, la reconstrucción labral utilizando el ligamento redondo ha mostrado ser una alternativa viable. Nivel de Evidencia: IV


Labral tears with insufficient substance can be treated with augmentation techniques, reconstruction, or grafting techniques. If the remnant labrum is very scarce, reconstructive options would be the most appropriate. We present the case of a 40-year-old female patient who had undergone two failed hip arthroscopies due to labral tears. Following the original technique described by Ganz, a surgical hip dislocation was performed, and the Ligamentum Teres Capitis was resected to cover the labral defect. To our knowledge, this is the first report of labral reconstruction using the Ligamentum Teres Capitis in our literature. Despite poorly reported outcomes in patients with previous procedures, surgical repair using the Ligamentum Teres Capitis has proven to be a viable option. Level of Evidence: IV


Subject(s)
Adult , Reconstructive Surgical Procedures , Femur/surgery , Hip Joint/surgery
6.
Article in Spanish | LILACS, BINACIS | ID: biblio-1353910

ABSTRACT

Introducción: Debido al crecimiento exponencial del número de artroplastias de cadera, se espera una mayor cantidad de re-visiones en las próximas décadas. Los vástagos cónicos estriados modulares se han vuelto populares en la última década por sus resultados favorables. El objetivo de este estudio es evaluar los resultados, las complicaciones y la tasa de supervivencia de estos vástagos en las revisiones de cadera, con un seguimiento a mediano plazo. materiales y métodos: Estudio multicéntrico, retrospectivo. Se incluyeron 182 pacientes a quienes se les realizó una cirugía de revisión de cadera entre 2007 y 2017. Se colo-caron 185 vástagos cónicos estriados de fijación distal. El déficit de stock óseo femoral se clasificó según Paprosky y Burnett; y las facturas periprotésicas, según la clasificación de Vancouver. Se evaluó a los pacientes clínicamente con el Harris Hip Score (HHS) y con radiografías a los 3 meses y anualmente para evaluar la estabilidad del vástago, la subsidencia y el aflojamiento, así como la consolidación de la osteotomía. Resultados: Seguimiento medio 55.18 meses. El HHS posoperatorio tuvo una media de 80,28 (DE = 12,8, IC95% 78,5-82,97). No hubo complicaciones posoperatorias en el 75,4% de los pacientes. Las complicaciones más frecuentes fueron inestabilidad (7,6%) y subsidencia del implante (11,5%). Al final del seguimiento, el 95,05% de los pacientes tenía un implante estable. Conclusiones: Los vástagos cónicos estriados modulares de fijación distal proporcionan una solución confiable, reproducible y duradera para el manejo de revisiones de componentes femorales a medio plazo. Nivel de Evidencia: IV


Background: The number of arthroplasties performed every year is increasing; therefore, a greater number of revisions is expected in the coming decades. Modular fluted tapered stems have become the gold standard for their results in different series of patients. The objective of this article is to evaluate the results, complications and the survival rate of these stems in hip revisions with a medium-term follow-up. Materials and Methods: Retrospective, multicenter analysis. One hundred eighty-two patients who had undergone hip revision surgery between 2007 and 2017 were included. One hundred eighty-five modular fluted tapered stems were placed. Femoral bone stock defects were classified according to Paprosky and Burnett; and periprosthetic femur fractures according to Vancouver classification. Patients were evaluated clinically with Harris Hip Score (HHS) and radiographically 3 months after surgery and every year to assess stem stability, subsidence and loosening, as well as osteotomy healing. Results: Average follow-up was 55.18 months. Postoperative HHS had an average of 80.28 (SD = 12.8, 95% CI = [78.5, 82.97]). There were no postoperative complications in 75.4% of the patients. The most frequent complications were instability in 7.6% and implant subsidence in 11.5%. At the end of the follow-up, 95.05% of the patients had a stable implant. Conclusion: Modular fluted tapered stems provide a reliable, reproducible solution for the management of femoral component revisions at medium-term. Level of Evidence: IV


Subject(s)
Middle Aged , Aged , Postoperative Complications , Reoperation , Prosthesis Failure , Treatment Outcome , Arthroplasty, Replacement, Hip , Hip Joint/surgery
7.
Artrosc. (B. Aires) ; 28(1): 34-39, 2021.
Article in Spanish | LILACS, BINACIS | ID: biblio-1252441

ABSTRACT

Introducción: En sus comienzos, la artroscopía de cadera evidenciaba mejores resultados en pacientes jóvenes con síndrome de fricción femoroacetabular (SFFA), pero con el tiempo las indicaciones se extendieron. Actualmente, pacientes de edad avanzada, con bajo grado de daño condral, sin artrosis severa, también presentan buenos resultados funcionales. El propósito de este estudio es analizar los resultados clínicos y funcionales de los pacientes con edad igual o mayor de cincuenta años que fueron tratados con una artroscopía de cadera con un diagnóstico de SFFA.Materiales y métodos: se incluyeron pacientes a partir de los cincuenta años con diagnóstico de síndrome de fricción femoroacetabular (SFFA), a los que seles realizó artroscopía de cadera y que completaron un seguimiento mínimo de tres años. Se registró la presencia de Pincer y CAM. Además, se evaluó el grado de artrosis y daño condral según la escala de Tönnis, y Outerbridge, respectivamente. Resultados: fueron medidos mediante el HHS, HOS y VAS. Se utilizó test de Spearman para evaluar el grado de correlación. Se realizó un análisis de regresión lineal para determinar asociación entre edad y HHS/VAS.La serie finalmente quedó conformada por cuarenta y un pacientes, con una edad promedio de 54.6 ± 3.9 (50 ­ 64) con un seguimiento promedio de 4.2 años (3 ­ 5.5). Discusión: se demostró una mejoría estadísticamente significativa en el score de Harris Hip y escala visual análoga (EVA) del dolor postoperatorio (73.6 ± 6.4 versus 88.1 ± 5.1; p <0.01 y 7.2 ± 1.3 versus 2.4 ± 2.0; p <0.01).Conclusión: la artroscopía de cadera es un procedimiento con muy buenos resultados clínicos y funcionales en pacientes mayores de cincuenta años. Nivel de evidencia: IV


Introductión: Hip arthroscopy has been reported to achieve great clinical outcomes in young people, and over time, this procedure expanded its indications. Currently, elderly patients, with no or minimum chondral injury, also achieves great results. The purpose of this retrospective study was to assess patients over fifty years old, with femoro-acetabular impingement syndromethat underwent reported hip arthroscopy.Materials and methods: all patients underwent hip arthroscopy due to FAI syndrome and completed three years minimum follow-up. Tönnis osteoarthritis and Outerbridge chondral damage scales were used. Surgery outcomes were assessed with HHS, HOS and VAS. Correlation was assessed by Spearman test. Linear regression analysis was performed to evaluate grade of association between age and HHS/VAS.Results: forty-one patients underwent full analysis, with a mean age of 54.6 ± 3.9 (50 ­ 64) and a mean follow up of 4.2 (3 ­ 5.5) years. Discussion: we observed statistically significant improvement of HHS and VAS after surgery (73.6 ± 6.4 versus 88.1 ± 5.1; p <0.01 and 7.2 ± 1.3 versus 2.4 ± 2.0; p <0.01).Conclussion: hip arthroscopy achieves good clinical outcomes in patients over fifty years. Level of Evidence: IV


Subject(s)
Middle Aged , Arthroscopy/methods , Treatment Outcome , Femoracetabular Impingement , Hip Joint
8.
Article in Chinese | WPRIM | ID: wpr-879468

ABSTRACT

Since the concept of "safe area" put forward by Lewinnek, it has been widely recognized. While in recent years, many scholars have found that even if the acetabular prosthesis was placed on the "safe area", there were still many unexplained dislocation after total hip arthroplasty. And scholars began to question whether the "safe area" is really suitable for all patients. Spinal degeneration, deformity, lumbar fusion, etc. will lead to spine sagittal imbalance and changes in pelvic activity, which could lead to changes in acetabular orientation, and ultimately lead to edge loading, wear, impact, and even dislocation after total hip replacement. From the perspective of wear, impact and dislocation, it is determined by the functional positioning of the acetabular cup, not the anatomical positioning. The anatomical positioning and functional positioning of the neutral pelvic acetabular cup in the standing position can be considered equivalent. For pelvic rotation more than 20°, functional placement needs to be considered. In recent years, as the understanding of the internal relationship between the spine-pelvis-hip joint has become more and more profound, some scholars further classify the hip-spine relationship according to whether the spine is stiff or deformed, and propose corresponding acetabulums according to different types of hip-spine relationships The function of placement, so as to achieve a stable artificial hip joint. Therefore, it is of great significance to fully assess whether the patient's sagittal plane is balanced before surgery to guide artificial hip replacement surgery.


Subject(s)
Acetabulum/surgery , Arthroplasty, Replacement, Hip , Hip Joint , Hip Prosthesis , Humans , Spine
9.
Article in Chinese | WPRIM | ID: wpr-879382

ABSTRACT

OBJECTIVE@#To evaluate the clinical effects of tranexamic acid in arthroscope for femoroacetabular impingement.@*METHODS@#Totally 34 patients (34 hips) with femoroacetabular impingement underwent hip arthroscopy from June 2016 to December 2018, were randomly divided into two groups named as tranexamic acid group and control group, 17 patients in each group. In TXA group, there were 10 males and 7 females, aged from 20 to 49 years old with an average of (32.1±7.6) years old;15 mg/kg TXA was intravenous drops before operation incision performed at 10 min. In control group, there were 11 males and 6 females, aged from 20 to 49 years old with an average of (30.9±6.2) years old;100 ml normal saline was intravenous drops before operation incision performed at 10 min. Introopertaive and total bloodloss between two groups were compared. Visual analogue scale (VAS) at 3 and 7 days after opertaion were used to evaluate pain relief of hip joint. Modified Harris Hip Score(mHHS) of hip joint at 3, 6, 9 and 12 weeks after oeprtaion were applied to evaluate clinical effects.@*RESULTS@#All patients were obtained follow up over 12 weeks. Incision healed well without infection and deep vein thrombosis. There were no statistical difference in opertaion time bewteen two groups(@*CONCLUSION@#Preoperative application of tranexamic acid could effectively reduce blood loss in arthroscopy for femoroacetabular impingement, thereby improving surgical field of vision, reducing difficulty of surgical operation, which could promote early and rapid rehabilitation of hip function.


Subject(s)
Adult , Aged , Arthroscopes , Arthroscopy , Blood Loss, Surgical , Female , Femoracetabular Impingement/surgery , Hip Joint/surgery , Humans , Male , Middle Aged , Tranexamic Acid , Treatment Outcome , Young Adult
10.
Article in Chinese | WPRIM | ID: wpr-888334

ABSTRACT

OBJECTIVE@#To explore the feasibility and clinical effects of arthroscopic treatment for the calcific tendinitis at soft tissues around hip.@*METHODS@#A total of 16 patients diagnosed as the calcific tendinitis at soft tissues around hip from May 2013 to July 2018 were retrospectively analyzed. All the 16 patients received arthroscopic procedures. There were 10 males and 6 females with an average age of 35 to 63 (44.50±6.67) years old and 9 left hips, 6 right hips were involved. The course of disease were 1 to 8(3.18±1.97) days. Clinical effects were evaluated with visual analogue scale(VAS), modified Harris hip scores (HHS), nonarthritic hip score (NAHS) and imaging examinations before operation, 1 day after operation and the final follow-up.@*RESULTS@#All 16 patients successfully finished the arthroscopic procedures in 0.5 to 1.2 (0.75±0.21) hours. Primary healing of incision were obtained without any complications of infection, wound hematocele and neurovascular injury. All 16 patients received an average postoperative follow-up of 6 to 12 (9.6±2.3) months. Before operation, the VAS were 7.88±0.72, modified HHS were 29.25±3.23, NAHS were 27.42±3.08. The 1st day postoperative VAS were 2.19±0.66, modified HHS were 82.56± 5.64, NAHS were 82.11±2.94, all the difference were statistically significant between before and 1 day after operation (@*CONCLUSION@#Arthroscopic treatment for the calcific tendinitis at soft tissues around hip is effective.It has advantages of minimal invasive, rapid pain relief, rapid hip joint function recovery and definite clinical effects.


Subject(s)
Adult , Arthroscopy , Female , Follow-Up Studies , Hip/surgery , Hip Joint/surgery , Humans , Male , Middle Aged , Retrospective Studies , Tendinopathy/surgery , Treatment Outcome
11.
Article in Chinese | WPRIM | ID: wpr-888212

ABSTRACT

The rotation center of traditional hip disarticulation prosthesis is often placed in the front and lower part of the socket, which is asymmetric with the rotation center of the healthy hip joint, resulting in poor symmetry between the prosthesis movement and the healthy lower limb movement. Besides, most of the prosthesis are passive joints, which need to rely on the amputee's compensatory hip lifting movement to realize the prosthesis movement, and the same walking movement needs to consume 2-3 times of energy compared with normal people. This paper presents a dynamic hip disarticulation prosthesis (HDPs) based on remote center of mechanism (RCM). Using the double parallelogram design method, taking the minimum size of the mechanism as the objective, the genetic algorithm was used to optimize the size, and the rotation center of the prosthesis was symmetrical with the rotation center of the healthy lower limb. By analyzing the relationship between the torque and angle of hip joint in the process of human walking, the control system mirrored the motion parameters of the lower on the healthy side, and used the parallel drive system to provide assistance for the prosthesis. Based on the established virtual prototype simulation platform of solid works and Adams, the motion simulation of hip disarticulation prosthesis was carried out and the change curve was obtained. Through quantitative comparison with healthy lower limb and traditional prosthesis, the scientificity of the design scheme was analyzed. The results show that the design can achieve the desired effect, and the design scheme is feasible.


Subject(s)
Arthroplasty, Replacement, Hip , Artificial Limbs , Biomechanical Phenomena , Hip Joint , Hip Prosthesis , Humans , Prosthesis Design , Range of Motion, Articular , Walking
12.
Pesqui. vet. bras ; 41: e06757, 2021. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1287507

ABSTRACT

Like canids, crab-eating foxes may probably be predisposed to similar orthopedic diseases of domestic dogs, such as hip dysplasia. However, for the adequate hip dysplasia diagnosis in wild animals, the normality characteristics of each species must be determined. This study aimed to estimate radiographic and computed tomographic (CT) values of hip joint laxity in healthy crab-eating foxes. Fifteen intact crab-eating foxes, eight males and seven females, ages 1 to 5 and mean body mass of 6.66kg were used. Norberg angle (NA) was calculated from ventrodorsal hip-extended radiographs. To calculate the dorsolateral subluxation (DLS) score, the center distance (CD) index, the lateral center edge angle (LCEA), and the dorsal acetabular rim angle (DARA), measurements obtained from transverse CT images were used. No statistically significant differences were observed between the right and left sides in the radiographic and tomographic parameters. The mean NA was 107.57°. The mean DLS score, the CD index, the LCEA, and the DARA were 60.79%, 0.16, 98.25° and 13.47°, respectively. The data obtained are helpful in characterizing mean values of the hip joint in healthy crab-eating foxes, and can contribute to the knowledge of the species.(AU)


Como canídeos, os cachorros-do-mato podem estar predispostos a doenças ortopédicas semelhantes aquelas de cães domésticos, tais como a displasia coxofemoral. No entanto, para o diagnóstico adequado da displasia coxofemoral em animais selvagens, os padrões de normalidade de cada espécie precisam ser determinados. Sendo assim, o presente estudo teve como objetivo estimar os valores radiográficos e tomográficos (TC) da lassitude da articulação coxofemoral em cachorros-do-mato hígidos. Foram utilizados quinze cachorros-do-mato não castrados, oito machos e sete fêmeas, com idades entre 1 e 5 anos e massa corporal média de 6,66kg. O ângulo de Norberg (NA) foi calculado a partir de radiografias na projeção ventrodorsal com os membros estendidos. Para calcular o escore de subluxação dorsolateral (DLS), o índice de distância central (CD), o ângulo da margem central lateral (LCEA) e o ângulo da borda dorsal acetabular (DARA), foram utilizadas as mensurações obtidas a partir de imagens transversais da TC. Não foram observadas diferenças estatísticas entre os lados direito e esquerdo nos parâmetros radiográficos e tomográficos. A média do NA foi de 107,57°. As médias do escore do DLS, do índice de CD, e dos ângulos LCEA e DARA foram, respectivamente, 60,79%, 0,16, 98,25° e 13,47°. Os dados obtidos são úteis para a caracterização dos valores médios referentes à articulação coxofemoral de cachorros-do-mato e podem contribuir para o conhecimento da espécie.(AU)


Subject(s)
Animals , Hip Joint , Joints , Animals, Wild , Canidae
13.
Article in Chinese | WPRIM | ID: wpr-921942

ABSTRACT

OBJECTIVE@#To explore the clinical efficacy of focused extracorporeal shock wave therapy with centrifugal exercise in the treatment of greater trochanteric pain syndrome.@*METHODS@#From September 2017 to June 2019, 53 eligible cases of greater trochanteric pain syndrome were randomly divided into observation group (29 cases) and control group (24 cases). In observation group, there were 8 males and 21 females, aged from 38 to 62 years old with an average of (49.96±6.39) years old; the course of disease ranged from 6 to 13 months with an average of (8.58±1.99) months;treated with focused extracorporeal shock wave therapy with centrifugal exercise. In control group, there were 5 males and 19 females, aged from 39 to 62 years old with an average of (52.79±5.86) years old;the course of disease ranged from 6 to 14 months with an average of (9.04±2.51) months;treated with centrifugal exercise alone. Visual analogue scale (VAS) and hip Harris score were measured before ESWT treatment and at 1, 2, and 6 months to evaluate relieve degree of pain and functional recovery of hip joint, respectively.@*RESULTS@#At 1 month after treatment, there were no significant differences in VAS, hip Harris score and treatment success rate (all @*CONCLUSION@#In treatment of greater trochanteric pain syndrome, focused extracorporeal shock wave therapy with centrifugal exercise could significantly relieve symptoms of lateral hip pain, improve functional recovery of hip joint with good safety. This treatment strategy is worthy of application and promotion in clinical practice.


Subject(s)
Adult , Arthralgia , Bursitis , Extracorporeal Shockwave Therapy , Female , Hip , Hip Joint , Humans , Male , Middle Aged , Treatment Outcome
14.
Article in Chinese | WPRIM | ID: wpr-921939

ABSTRACT

OBJECTIVE@#To compare the clinical outcomes and complications of hip arthroscopic treatment for femoroacetabular impingement (FAI) performed with either Inside-out or Outside-in approach.@*METHODS@#The clinical date of 48 patients with FAI treated by hip arthroscopy surgery and follow-up from June 2016 to June 2019 were retrospectively analyzed. According to the different operative methods, the patients were divided into two groups. Inside-out group, from central compartment to peripheral compartment;Outside-in group, from peripheral compartment to central compartment. There were 14 males and 10 females in Inside-out group with an averageage of (39.8±7.6)years old, 13 males and 11 females in Inside-out group with an average age of (39.5±9.1)years old in Outside-in group. There was no significant difference in age, gender, body mass index, side, impingement type, medical history and follow-up time between the two groups. The complication occurrence rate, modified Harris hip score (mHHS)and nonarthritic hip score (NAHS) were compared between these two groups.@*RESULTS@#The mHHs and NAHS scores of the two groups were significantly higher than those before operation, but there was no significant difference between the two groups (@*CONCLUSION@#Both hip arthroscopic surgery methods can obtain satisfactory clinical efficacy in the treatment of FAI, but the incidence of postoperative complications of Outside-in surgical method is lower. The out-side in method can be preferentially selected for the patients with the indications of operation.


Subject(s)
Adult , Arthroscopy , Female , Femoracetabular Impingement/surgery , Follow-Up Studies , Hip Joint/surgery , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome
15.
Rev. bras. ortop ; 55(6): 722-727, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1156204

ABSTRACT

Abstract Objective To evaluate the clinical and radiographic results as well as complications related to patients undergoing arthroscopic treatment of subspine hip impingement. Methods We retrospectively evaluated 25 patients (28 hips) who underwent arthroscopic treatment of subspine impingement between January 2012 and June 2018. The mean follow-up was 29.5 months, and the patients were evaluated clinically by using the Harris hip score modified by Byrd (MHHS), the non-arthritic hip score (NAHS), and in terms of internal rotation and hip flexion. In addition, the following items were evaluated by imaging exams: the center-edge (CE) acetabular angle, the Alpha angle, the presence of a sign of the posterior wall, the degree of arthrosis, the presence of heterotopic hip ossification, and the Hetsroni classification for subspine impingement. Results There was an average postoperative increase of 26.9 points for the MHHS, 25.4 for the NAHS (p < 0.0001), 10.5° in internal rotation (p < 0.0024), and 7.9° for hip flexion (p < 0.0001). As for the radiographic evaluation, an average reduction of 3.3° in the CE angle and of 31.6° for the Alpha angle (p < 0.0001). Eighteen cases (64.3%) were classified as grade 0 osteoarthritis of Tönnis, and 10 (35.7%) were classified as Tönnis grade 1. Two cases (7.1%) presented grade 1 ossification of Brooker. Most hips (n = 15, 53.6%) were classified as type II of Hetsroni et al. Conclusion In the present study, patients undergoing arthroscopic treatment with subspine impingement showed improvement in clinical aspects and radiographic patterns measured postoperatively, with an average follow-up of 29.5 months.


Resumo Objetivo Avaliar os resultados clínicos e radiográficos assim como as complicações relacionadas a pacientes submetidos ao tratamento artroscópico do impacto subespinhal do quadril. Métodos Foram avaliados retrospectivamente 25 pacientes (28 quadris) submetidos ao tratamento artroscópico de impacto subespinhal entre janeiro de 2012 e junho de 2018. O seguimento médio foi de 29,5 meses, e os pacientes foram avaliados clinicamente pelo Harris hip score modificado por Byrd (MHHS), o non-arthritic hip score (NAHS), e quanto à rotação interna e flexão do quadril. Além disso, foram avaliados por exames de imagem: o ângulo center-edge (CE) acetabular, o ângulo alfa, a presença de sinal da parede posterior, o grau de artrose, a presença de ossificação heterotópica do quadril e a classificação de Hetsroni para Impacto Subespinhal. Resultados Observou-se aumento médio pós-operatório de 26,9 pontos para o MHHS, 25,4 para o NAHS (p < 0,0001), 10,5° na rotação interna (p < 0,0024) e 7,9° para flexão do quadril (p < 0,0001). Quanto à avaliação radiográfica, observou-se redução média de 3,3° no ângulo CE e de 31,6° para o ângulo alfa (p < 0,0001). Foram classificados 18 casos (64,3%) como artrose grau 0 de Tönnis e 10 (35,7%) como Tönnis 1. Dois casos (7,1%) apresentaram ossificação grau 1 de Brooker. A maioria dos quadris (n = 15; 53,6%) foi classificada como tipo II de Hetsroni et al. Conclusão No presente estudo, os pacientes submetidos a tratamento artroscópico de impacto subespinhal apresentaram melhora nos aspectos clínicos e nos padrões radiográficos aferidos pós-operatoriamente, com seguimento médio de 29,5 meses.


Subject(s)
Humans , Male , Female , Adult , Osteoarthritis , Osteogenesis , Arthroscopy , Rotation , Ossification, Heterotopic , Femoracetabular Impingement , Hip Joint
16.
Rev. cuba. ortop. traumatol ; 34(2): e290, jul.-dic. 2020. tab, ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1156595

ABSTRACT

RESUMEN Introducción: Existe un aumento de la evidencia de que la estructura geométrica de la anatomía de la cadera juega un importante papel en la etiología de la fractura. Objetivo: Sistematizar los conocimientos más actuales referentes a las características anatómicas de los parámetros radiográficos de la articulación de la cadera, y su relación con la fractura. Métodos: Se realizó una investigación documental, con los artículos científicos publicados en las bases de datos médicas informáticas como PubMed, Ebsco y SciELo en los últimos 5 años. Resultados: La mayoría de las publicaciones analizan el ángulo cervicodiafisario y el eje de la cadera. Otras medidas analizadas son el eje femoral, la longitud y el ancho del cuello femoral, así como medidas acetabulares. No existe un consenso en la medida del largo del cuello femoral o del eje femoral, a pesar de ser un componente importante de la estructura. El conocimiento de las particularidades de la anatomía y de las características biomecánicas de la cadera permite establecer una base para la comprensión de los factores que afectan esta articulación. Conclusiones: Los estudios que se han realizado sobre las características de los componentes estructurales, demuestran que existe una asociación entre sus dimensiones y la ocurrencia de fractura de cadera, en algunos casos independientes de la densidad mineral ósea(AU)


ABSTRACT Introduction: There is increasing evidence that the geometric structure of the hip anatomy plays an important role in the etiology of the fracture. Objective: To systematize the most current knowledge regarding the anatomical characteristics of the radiographic parameters of the hip joint, and their relationship with the fracture. Methods: A documentary research was carried out, with the scientific articles published, in the last 5 years, in medical computer databases such as PubMed, Ebsco and SciELo. Results: Most of the publications analyze the cervicodiaphyseal angle and the axis of the hip. Other measurements analyzed are the femoral axis, the length and width of the femoral neck, as well as acetabular measurements. There is no consensus on the length of the femoral neck or the femoral shaft, despite being an important component of the structure. Knowledge of the particularities of the anatomy and biomechanical characteristics of the hip allows to establish basis for understanding the factors that affect this joint. Conclusions: The studies that have been carried out on the characteristics of the structural components show that there is association between their dimensions and the occurrence of hip fracture, in some cases independent of bone mineral density(AU)


Subject(s)
Humans , Hip Fractures/etiology , Hip Joint/anatomy & histology , Hip Joint/diagnostic imaging
17.
Int. j. morphol ; 38(6): 1549-1554, Dec. 2020. graf
Article in English | LILACS | ID: biblio-1134476

ABSTRACT

SUMMARY: Hip joint chronic pain can severely compromise patients' life quality. Peripheral nerve blocks play an important role as diagnostic and therapeutic procedures. The aim of this work is to study the anatomy of the nerve to quadratus femoris (NQF) in view of the possibility of its percutaneous selective block. Forty-three gluteal cadaveric regions fixed in formaldehyde solution were dissected. The quadratus femoris, the obturator internus and superior and inferior gemellus were freed from their lateral insertion, exposing thus the posterior aspect of the hip joint. The NQF was identified, and the horizontal distance to the posterior edge of the greater trochanter at its upper, middle and lower thirds was registered. The number of the articular branches of the NQF was identified. Likewise, the horizontal distance to the posterior edge of the greater trochanter and the longitudinal distance to the line through the distal end of the posterior edge of the greater trochanter were measured. The distance between the NQF and the greater trochanter posterior edge at upper, middle and lower thirds was 46 mm, 41 mm and 35 mm, respectively. In most cases (85 %) the NQF presented one or two articular branches. The longitudinal distances between the line through the distal end of the posterior edge of the greater trochanter and the origin of the first, second and third articular branches of the NQF were 14.7 mm (-19.4 - 40), 16.4 mm (-9.3-42) and 27 mm (0-46), respectively. The distances to the posterior edge of the greater trochanter were 43.1 mm (16.3-66), 37.7 mm (6.5-53) and 39.8 mm (26-52), for the first, second and third articular branches, respectively. In conclusion, the articular branches of the nerve to quadratus femoris have a constant and predictable distribution. Our findings allow for generating a coordinate system for the selective block of the NQF by way of percutaneous techniques.


RESUMEN: El dolor crónico de la articulación coxal puede comprometer severamente la calidad de vida de los pacientes. Los bloqueos nerviosos periféricos juegan un papel importante como procedimientos diagnósticos y terapéuticos. El objetivo de este trabajo es estudiar la anatomía del nervio del músculo cuadrado femoral (NCF) en vista de la posibilidad de su bloqueo selectivo percutáneo. Se utilizaron 22 cadáveres fijados en solución de formaldehído. Fueron disecadas en total 43 regiones glúteas. Los músculos cuadrado femoral, obturador interno y los gemelos superior e inferior fueron liberados de su inserción lateral, exponiendo así la cara posterior de la articulación coxal. Se identificó el NCF y se registró la distancia horizontal al margen posterior del trocánter mayor en sus tercios superior, medio e inferior. Se identificó el número de ramas articulares del NQF. Asimismo, se midió la distancia horizontal al margen posterior del trocánter mayor y la distancia longitudinal a la línea que pasa por el extremo distal del margen posterior del trocánter mayor. La distancia entre el NCF y el margen posterior del trocánter mayor en los tercios superior, medio e inferior fue de 46 mm, 41 mm y 35 mm, respectivamente. En la mayoría de los casos (85 %) el NCF presentó una o dos ramas articulares. Las distancias longitudinales entre la línea que pasa por el extremo distal del margen posterior del trocánter mayor y el origen de la primera, segunda y tercera ramas articulares del NQF fueron 14,7 mm (-19,4 - 40), 16,4 mm (-9,3-42) y 27 mm (0-46), respectivamente. Las distancias al margen posterior del trocánter mayor fueron 43,1 mm (16,3-66), 37,7 mm (6,5-53) y 39,8 mm (26-52), para la primera, segunda y tercera ramas articulares, respectivamente. En conclusión, las ramas articulares del nervio al cuadrado femoral tienen una distribución constante y predecible. Nuestros hallazgos permiten generar un sistema de coordenadas para el bloqueo selectivo del NCF por medio de técnicas percutáneas.


Subject(s)
Humans , Adult , Peripheral Nerves/anatomy & histology , Muscle, Skeletal/innervation , Hip Joint/innervation , Nerve Block/methods , Cadaver
18.
Rev. bras. ortop ; 55(5): 523-531, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1144206

ABSTRACT

Abstract The clinical diagnosis of femoral acetabular impingement (FAI) continues to evolve as the understanding of normal and pathological hips progresses. Femoral acetabular impingement is currently defined as a syndrome in which the diagnosis consists of the combination of a previously-obtained comprehensive clinical history, followed by a consistent and standardized physical examination with specific orthopedic maneuvers. Additionally, radiographic and tomographic examinations are used for the morphological evaluation of the hip, and to ascertain the existence of sequelae of childhood hip diseases and the presence of osteoarthritis. The understanding of the femoral and acetabular morphologies and versions associated with images of labral and osteochondral lesions obtained through magnetic resonance imaging (MRI) contributes to the confirmation of this syndrome in symptomatic patients, and helps in the exclusion of differential diagnoses such as iliopsoas tendon snaps, subspine impingement, ischiofemoral impingement, and other hip joint pathologies.


Resumo O diagnóstico clínico do impacto femoroacetabular continua a evoluir conforme o entendimento dos quadris normal e patológico progride. Impacto femoroacetabular é atualmente definido como uma síndrome na qual o diagnóstico se baseia no somatório de uma história clínica abrangente obtida previamente, seguida de um exame físico coerente e padronizado com manobras ortopédicas específicas. Além disso, exames radiográficos e tomográficos são usados para a avaliação morfológica do quadril, e para verificar a existência de sequelas de doenças do quadril da infância e a presença de osteoartrose. O entendimento da morfologia e versão femoral e acetabular associado às imagens de lesões labrais e osteocondrais obtidas com a ressonância magnética contribuem para a confirmação da síndrome nos pacientes sintomáticos, além de auxiliar na exclusão de diagnósticos diferenciais, como ressalto do tendão do músculo iliopsoas, impacto subespinhal, impacto isquiofemoral, e outras patologias da articulação do quadril.


Subject(s)
Humans , Physical Examination , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Clinical Diagnosis , Diagnosis, Differential , Femoracetabular Impingement , Hip/diagnostic imaging , Hip Joint
19.
Rev. Asoc. Argent. Ortop. Traumatol ; 85(3): 214-221, ago. 2020.
Article in Spanish | LILACS, BINACIS | ID: biblio-1340622

ABSTRACT

Introducción: Considerando la gran cantidad de artroplastias totales de cadera que se realizan hoy en pacientes jóvenes, es esencial comprender ampliamente la supervivencia de dichos implantes. La estabilidad del componente femoral y su resistencia al hundimiento son factores críticos para lograr una correcta osteointegración y el subsiguiente éxito clínico en la artroplastia total de cadera no cementada. Materiales y Métodos: Se llevó a cabo un estudio observacional, descriptivo, retrospectivo. Se analizó a todos los pacientes sometidos a un reemplazo total de cadera primario, por nuestro equipo, entre diciembre de 2017 y mayo de 2018. Se seleccionó a quienes se les habían colocado tallos de fijación metafisaria de segunda generación. Se compararon los valores obtenidos con nuestra base de datos de pacientes a los que se les colocaron tallos de primera generación. Resultados: Al evaluar las 82 artroplastias totales de cadera del grupo 1, contemplando el primer año de seguimiento posoperatorio, hallamos 2 (2,44%) complicaciones registradas durante la cirugía (una fractura de calcar y una falsa vía generada mientras se trabajaba el canal femoral). Un paciente (2%) de los 49 evaluados en el grupo 2 requirió una revisión del tallo femoral, por aflojamiento aséptico, a los 5 meses de la cirugía primaria. Conclusiones: Según nuestra experiencia, este tipo de implantes es conveniente para alcanzar resultados clínicos comparables con los obtenidos usando los de la generación anterior, pero disminuyendo el riesgo de complicaciones intraoperatorias durante su colocación. Es un método reproducible con una baja curva de aprendizaje en manos experimentadas. Nivel de Evidencia: IV


Introduction: The high number of total hip arthroplasties (THAs) currently being performed in young patients warrants a thorough understanding of THA survivorship. Femoral component stability and resistance to subsidence are critical factors to achieve correct osseointegration, and the subsequent clinical success, in uncemented THAs. Materials and Methods: We conducted an observational, descriptive, retrospective study on all patients who underwent primary total hip replacement performed by our surgical team between December 2017 and May 2018. We identified the patients who received second-generation metaphyseal fixation stems (Group 2). Group 2 results were then compared with our database of patients who received first-generation stems (Group 1). Results: Group 1: 82 THAs, of which, after a 1-year postoperative follow-up, 2 patients (2.44%) had complications, which were noted during surgery (a calcar fracture and a false route caused while preparing the femoral canal). Group 2: 49 THAs, 1 patient (2%) required femoral stem revision, due to aseptic loosening, 5 months after primary THA. Conclusions: In our experience, second-generation implants achieve clinical outcomes comparable to those obtained with first-generation implants, while also decreasing the risk of intraoperative complications associated with the placement of the implant. This method has shown to be reproducible and to have an easy learning curve for experienced surgeons. Level of Evidence: IV


Subject(s)
Adult , Middle Aged , Aged , Treatment Outcome , Arthroplasty, Replacement, Hip , Hip Joint/surgery
20.
Arq. bras. med. vet. zootec. (Online) ; 72(4): 1241-1247, July-Aug. 2020. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1131504

ABSTRACT

The aim of this study was to test the accuracy of a new automated computer software tool for the assessment of passive hip laxity. The hip laxity was estimated using the dedicated computer software by two blinded evaluators, one previously trained and one without specific training for distraction index measurement, in two independent sessions using 230 hip joints from 115 dogs that underwent screening for passive hip laxity using the distraction view. Previously, all of these radiographs were sent to PennHIP Analysis Center for an official distraction index record. The measurement repeatability of the two sessions was adequate for both evaluators. The reproducibility of the official distraction index measurement, mean distraction index±standard deviation 0.44±0.15, was adequate (P>0.05) for the trained evaluator, 0.44±0.15, and non-adequate (P<0.05), for the non-trained evaluator 0.47±0.17. The distraction index measurement tool proposed can be used with confidence for hip laxity evaluation by trained evaluators, as it provided good repeatability and reproducibility of official reports. The simplicity of the process described leads to a less time-consuming and more affordable procedure.(AU)


O objetivo deste estudo foi testar a viabilidade de uma nova ferramenta de software informático para avaliação da lassitude articular passiva da articulação coxofemoral. A lassitude articular da articulação coxofemoral foi estimada usando-se um programa informático especial, desenvolvido para o efeito, por dois avaliadores, um com treino prévio e outro não treinado, na medição do índice de distração, em duas sessões independentes, utilizando-se 230 articulações coxofemorais de 115 cães, as quais efetuaram o rastreio de displasia coxofemoral realizando a projeção de distração da articulação coxofemoral. Previamente, todas as radiografias foram enviadas para o PennHIP Analysis Center, para se obter uma medida oficial do índice de distração. A repetibilidade das medições das duas sessões foi adequada para ambos os avaliadores. A reprodutibilidade do índice de distração oficial, média±desvio-padrão 0,44±0,15, foi adequada (P>0,05) para o avaliador treinado, 0,44±0,15, e não adequada (P>0,05) para o avaliador não treinado, 0,47±0,17. A ferramenta de medição do índice de distração proposta pode ser usada com segurança na medição do índice de distração por avaliadores treinados, uma vez que mostra uma adequada repetibilidade e reprodutibilidade das medições oficiais do índice de distração. A simplicidade do processo apresentado torna-o menos demorado e mais econômico.(AU)


Subject(s)
Animals , Dogs , Software , Osteoarthritis, Hip/veterinary , Hip Dysplasia, Canine/diagnosis , Hip Joint/anatomy & histology , Joints/anatomy & histology
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