Yes / Cortico-steroid Injections (CSI) are commonly used to treat patients with Greater Trochanteric Pain Syndrome (GTPS) but it is unclear which patients will experience improvements in pain Objectives: To identify factors that influence improvements in pain for patients with GTPS treated with CSI Design: Systematic review Methods: A search was undertaken of AMED, CINAHL, Cochrane Library, EMBASE, Medline and PEDro databases. Studies were eligible for inclusion of they investigated factors that influenced changes in pain experienced by patients who received a CSI. Studies needed to include relevant summary statistics and tests of clinical significance. Risk Of Bias in Non-randomised Trials Of Interventions (ROBINS-I) and Risk of Bias 2 (ROB2) tools were used to assess bias. Results: The search identified 466 studies, 8 were included in the final review with a total of 643 participants. There was no association between demographic variables such as age, sex, symptom duration or obesity and pain outcomes post-CSI. Having a co-existing musculoskeletal (MSK) condition such as knee osteoarthritis or sacroiliac/lumbar spine pain was associated with less pain reduction post-CSI. Injections into the Trochanteric Bursa were associated with longer lasting pain reduction than Gluteus Medius Bursa or extra-bursal injections. Image guidance of CSI maintained lower pain scores at six months but did not increase the duration of the therapeutic effect past six months. The presence of specific ultrasound scan features was not associated with differences in pain scores. Conclusions: Patients with co-existing MSK conditions may not respond to CSI as well as those without. Injections into the Greater Trochanteric Bursa may have longer lasting benefit. Further research is needed on the use of USS imaging findings and image guidance. / This work was completed as part of a pre-doctoral fellowship funded by the National Institute of Health Research [NIHR301938, 2021].

Submitted as the dissertation component in partial fulfilment of the requirements for the degree of a Masters in Technology in Chiropractic in the department of Chiropractic and Somatology, Durban University of Technology, Durban, South Africa, 2017. / Background: Hip pain is a common problem. Motion palpation is a manual technique applied by the hands in various degrees of joint motion that specifically evaluates range of motion in relation to specific anatomical landmarks, joint play and end feel. Motion palpation remains one of the most used diagnostic techniques and yet it remains unclear whether or not it is a reliable, sensitive and specific tool; especially in the hip joint. Objectives: This study assessed intra- and inter-examiner reliability and clinical responsiveness of motion palpation when it is used as a diagnostic tool in patients with non-specific unilateral anterior hip pain and unilateral asymptomatic hip joints. Methods: Ten participants, between the ages of 18 and 60, were included in this study (three ballet dancers, three golfers and four participants from the general population). The participants were assessed randomly by three blinded examiners. All of the participants then received one adjustment delivered by the researcher (half on the symptomatic side and half on the asymptomatic). The participants were then re-assessed. Data was recorded on a data collection sheet and analysed using SPSS version 23. Intra-examiner reliability and clinical responsiveness were analysed using McNemar’s test and the Chi-Square Test of Independence. Inter-examiner reliability was analysed using Fleiss’ Kappa. Results: Intra-examiner reliability showed to be markedly better on the left-hand side for all three examiners. Kappa scores for inter-examiner reliability varied from none to perfect. The average pairwise agreement scores ranged from 33.3% to 100% at the first assessment, and from 46.6% to 100% in the second assessment. A mean and standard deviation were calculated for the pairwise agreements which represented the sensitivity and specificity respectively. Both showed improvement between the first and second assessments which is positive for inter-examiner reliability. Clinical responsiveness was shown to be absent for examiners A and B but was present for examiner C on the left. Conclusion: This study found that, contrary to the expectations of many clinicians, motion palpation has limited to poor levels of intra-examiner reliability, inter-examiner reliability and clinical responsiveness. This is however limited by the small sample size and methodological limitations in this study. Therefore, the role of palpation as a diagnostic tool used in the diagnosis hip dysfunction may be limited. / M

Tumorous total endoprosthesis of hip joint is used for reconstruction of the limb affected by bone tumor and to regain its functnion. Longterm load conditions must be considered by the reconstruction and the joint mobility must be enabled. Suitability of the endoprosthesis depends on its construction considering shape, material and with this related mechanical properties. This thesis deals with creation of computational model and stress-strain analysis of tumorous total endoprosthesis of hip joint. There are two different types of endoprosthesis modeled in this thesis, each with three different length of resected bone replacement. Based on stress-strain analysis an assessment of possible limit states is made.

Thesis (MMed (Surgical Sciences. Orthopaedic Surgery))--University of Stellenbosch, 2010. / No abstract available

Thesis (MScPhysio)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction-The golf swing is a complex, sequenced movement of body segments. This movement is smooth and well timed and is referred to as the kinematic golf sequence. This kinematic sequence illustrates the rotational speed, which occurs between the upper and lower body segments. Hip rotation plays an integral part to a sound kinematic sequence by providing a pivotal point between the upper and lower body segments, ensuring a synchronised golf swing. Hip rotation kinematics during a golf swing has received relatively little attention compared to other body segments’ movements. However, clinicians need to have a clear understanding of the rotational contribution that each hip make during golf swing in order to enhance the athlete’s performance and reduce the risk of injury. The aim of this descriptive research project was to obtain and investigate the total passive and total dynamic rotation range of movement in both the lead and trail hips of healthy, young adult, male golfers. Methodology-Seven, low handicapped, male golfers between the ages of 18 and 40 years were randomly selected in the Western Cape region from areas surrounding Stellenbosch University’s Tygerberg campus. A questionnaire gathered participant demographics that determined participatory eligibility. A preliminary reliability study established a baseline measurement for passive total articular hip rotation. Seatadjusted total passive hip rotation ranges of motion (ROM) measurements were collected with a hand-held inclinometer. Dynamic total hip rotation kinematic data was captured during a golf swing with an 8-camera video analysis system (VICON). Data analyses were performed with Statistica version 10. Hand-held inclinometer intra-rater reliability was determined with a two-way interclass correlation, standard error of measurement and a 95% confidence interval level. A Spearman correlation coefficient determined correlation between the total passive and total dynamic rotation range of movement in both the lead and trail hips. Results-Passive intra-rater reliability was reported as 0.81 (95% CI: 0.46-0.96). The total average passive articular range between the lead (62.1° ±6.4°) and trail hip (61.4° ±3.8°) did not report any significant difference (p=0.8). The total average dynamic golf swing articular range between the lead (29° ± 6.5°) and trail hip (35.° ±7.8°), was reported as significantly (p=0.04) asymmetric. The findings also demonstrated a positive correlation between the passive and dynamic total articular range in a lead hip, whereas a negative correlation was reported in a trail hip. During the golf swing the lead hip utilised 46.4%(± 8) of the total passive available hip rotation, whereas the trail hip utilised 58.8% (±13.2). Discussion and Conclusions-The findings of this study show that, the passive rotation ROM in a hip (LH=62°; TH=61°) of a golf player does not exceed the available range it has during a golf swing. The golfer’s hip utilises 46% of the available passive range of movement in the lead hip and 59% in the trail hip. In the clinical field careful consideration should be given to the motivation behind mobilizing, treating or stretching the hips of a golf player. These findings can be incorporated in future research on the relationship between hip-rotation ROM and reduction in the incidence of injuries amongst golfers. / AFRIKAANSE OPSOMMING: Inleiding-Die gholfswaai is n komplekse, opeenvolgende beweging van verskeie liggaamsegmente. Hierdie gladde opeenvolgende bewegings word die kinematiese gholfpatron genoem. Hierdie kinematiese opeenvolgende bewegings bied ’n illustrastrasie van die rotasiespoed waarteen die beweging tussen die boonste en onderste liggaamsegmente plaasvind. Heuprotasie speel ’n deurslaggewende rol in hierdie glad verlopende kinematiese proses. Dit dien as ’n spilpunt tussend die boonste en onderste kwadrant, wat op sy beurt weer ’n gesinkroniseerde gholfswaai verseker. Die heuprotasie kinamtieka tydens n gholfswaai het relatief minder aandag ontvang in vergelyking met ander liggaamsegmente. Klinici moet instaat gestel word om ’n duidelike begrip aangaande die bydrae wat heuprotasie tydens ’n golfswaai lewer, te ontwikkel. Die atleet se prestasie kan sodoende verbeter word, en die risiko tot beserings kan ook sodoende voorkom word. Die doel van hierdie beskrywende navorsingsprojek was om te bepaal wat die totale passiewe en die totale dinamies rotasie omvang van die leidende en volgende heupe van gesonde jong mans wat gholf speel, te ondersoek. Metodologie-Sewe gholf-geskoolde manlike gholf spelers met ’n lae voorgee en tussen die ouderdom van 18 en 40 jaar is ewekansig gekies. Hierdie kandidate is gekies uit die omliggende gebiede van die Stellenbosch Tygerberg kampus in die Wes-Kaap waar hulle relatief naby woonagtig was. ’n Vraelys is aangewend om demografiese eienskappe van elke deelnemer in te samel. Hierdie inligting wat deur die vraelys bekom is, is gebruik om te bepaal of die deelnemers in aanmerking is vir die studie. ’n Voorlopige, intra-meter betroubaarheidstudie is gedoen vir passiewe, totale artikulêre heuprotasiemetings wat met ’n hand hanteerbare hoek meter geneem is. ’n Algemene fisiese ondersoek is in die biomeganiese labaratorium afgehandel om te bepaal of die deelnemers geskik is vir die toetse. Sit-aangepaste passiewe totale hip rotasie beweging metings was ingesamel met 'n hand hanteerbare hoek meter. Intra-meter betroubaarheid is bepaal met ’n twee-rigting interklas korrelasie, standaard foutmeting en ’n 95% vertroue interval vlak. Dinamiese totale heup kinematiese rotasiedata is afgeneem met ’n hoë-spoed 3-D videografiestelsel (VICON) tydens 'n gholfswaai. Data-ontleding is bereken met ’n Statistica weergawe 10. Die gemiddelde en Spearman korrelasie koëffisiënt is gebruik as aanwysers van verspreiding. Resultate-Passiewe inter-meter betroubaarheid word geraporteer as 0.81 (95% KI: 0.46-0.96). Die resultate dui op ’n onbeduidende totale passiewe artikulêre reeks verskille tussen die leidende (voorste) (62.1 ± 6.4 °) en volgende (agterste) heupe (61.4 ° ± 3.8 °). ’n Beduidende totale dinamiese artikulêre reeks van die leidende (29 ° ± 6.5 °) en volgende heupe (35.9 ° ± 7.8 °) is tydens die gholfswaai bereik. Verdere resultate toon ’n positiewe korrelasie tussen die passiewe en dinamiese totale artikulêre reeks in die leidende heup, terwyl ’n negatiewe korrelasie gerapporteer word vir die volgende (agterste) heup. Tydens ’n gholfswaai gebruik die leidende heup 46.4% (± 8%) van die totale passiewe beskikbaar heuprotasie, terwyl die opvolgende (agterste) heup 58.8% (± 13.2%) aanwend. Bespreking en gevolgtrekking-Die bevindinge van hierdie studie toon dat tydens ’n gholfswaai, ’n gesonde gholfspeler nie die beskikbare passiewe beweging wat in sy heup bestaan oorskry nie. Slegs 46.4% van die beskikbare passiewe beweging in sy leidende heup word gebruik, en 58.8% van sy agterste heup. Die klinisie moet deeglike oorweging gegee word aan die motivering agter die mobilisering, strekke en die behandeling van die heupe van ’n gholfspeler. Hierdie bevindings kan in toekomstige navorsing geimplimenteer word om die verhouding wat tussen die omvange vand heuprotasie bestaan te ondersoek. Die voorkoming van moontlike toekomstige beserings in gholfspelers kan ook verhoed word.

In this thesis Graphit-iC™, an amorphous carbon coating developed by Teer Coatings Ltd. was modified and deposited onto CoCr and WHMWPE substrates in order to improve the wear properties. It was identified that depositing a hard coating onto soft substrate would cause high stresses and lead to coating delamination. Consequently the polyethylene substrates were ion implanted with nitrogen to reduce the hardness differential at the substrate-coating boundary. The coating was characterised using a pin on disc method in order to determine wear and friction. Hardness and fatigue was characterised using nano-indentation and the coating adhesion was measured using scratch testing. Application of the coatings resulted in a significant reduction in wear. Wear factors as low as 3.65x10¯18m³/Nm were achieved for coated CoCr substrates compared to 3.53x10¯15m³/Nm reported in the literature for uncoated CoCr. The coating resulted in friction coefficients between 0.12 and 0.19 with hardness ranging from 6.65 and 15.63GPa. Similarly coating UHMWPE resulted in a reduction in the wear factor to less than 9.6x10¯17m³/Nm. It was concluded that the deposition of amorphous carbon coatings can improve wear of hip joint prostheses, although consideration must be made for the adhesion of the coating to the substrate so that it does not contribute to an early failure of the device. Improved adhesion can be achieved by reducing the hardness differential between the coating and adhesion, either through softening the coating or by using interlayers.

Einleitung 2015 belegte die Implantation einer Endoprothese am Hüftgelenk mit 219.325 Operationen Platz 8 der 50 häufigsten Operationen der vollstationären Patienten in Krankenhäusern (DRG-Statistik 2015). Bei diesen Eingriffen kommt eine Vielzahl von verschiedenen Prothesenmodellen zum Einsatz (Kirschner 2005). Aktuell geht der Trend in Richtung zementfreie Verankerung, Verkleinerung der Implantate und den Erhalt von möglichst viel Knochensubstanz (Jerosch 2013). So werden in den letzten Jahren immer häufiger Kurzschaftendoprothesen implantiert (Jerosch 2013). Sie stellen ein knochensparendes System dar und erlauben gleichzeitig verschiedene Gleitpaarungen (Jerosch 2013). Allerdings liegen für die meisten Kurzschaftendoprothesentypen noch keine Langzeittestergebnisse vor (Jerosch 2011), so dass das Langzeitverhalten dieser Prothesen nicht vorhergesagt werden kann. Speziell bei Kurzschaftendoprothesen ist der Einfluss der verkürzten Schaftlänge auf das Einwachsverhalten und die Lebensdauer des Implantats noch nicht ausreichend geklärt. Am Lehrstuhl für Konstruktionslehre und CAD der Universität Bayreuth finden deshalb Untersuchungen zur computergestützten Analyse von Kurzschaftendoprothesen statt. Ziel hierbei ist es, durch eine Variation der Schaftlänge eine Prothesenform mit optimalen Spannungsverläufen und einer verbesserten Krafteinleitung in den Knochen zu entwickeln.

Introduction: Question of femoroacetabular impingement is very actual. This young concept brings mechanism which leads to early degenerative changes of the hip joint of young and active individuals (athletes). Objectives: To review influence of sport activity on condition of the hip joint of young athletes (players of table tennis) and to determine incidence of femoroacetabular impingement and its clinical significance. Methods: We performed ultrasound and clinical examination and questionnaire with 22 individuals from 2 training groups. Groups vary in age, height, weight, volume of sport activity and how long they do sports. We found out incidence of cam-type impingement and evaluated pain of anterior impingement test, ranges of motions of the hip joint and deep squat. Results: Cam impingement was found in 27 hip joints, 16 in older group, 11 in younger one. In older group there were 12 from 16 impingements painful during anterior impingement test, 4 from 11 in younger one. In older group there were 4 symptomatic individuals, none in younger one. Older group has lower ranges of motion of flexion and internal rotation. 4 individuals did not perform deep squat, all of them with bilateral cam-type impingement. Conclusion: Femoracetabular impingement is frequent among young athletes. It causes...

Práce posuzuje možnosti využití chůzových testů u pacientů s koxartrózou. Na skupině třiceti pacientů se třetím stupněm koxartrózy kyčelního kloubu bylo provedeno měření pěti různých testů: dotazník Harris Hip Score, Timed Up And Go Test (TUG), Ten Meter Walk Test - desetimetrový test chůze (10MWT), Two Minute Walk Test - dvouminutový test chůze (2MWT) a Six Minute Walk Test - šestiminutový test chůze (6MWT). Následně byly porovnány výsledky jednotlivých testů a zjištěny jejich specifické výpovědní vlastnosti. Cílem studie bylo zjistit jejich vzájemné souvislosti, limity v použití, případně navrhnout jejich úpravu a doporučit cílové skupiny pacientů pro jednotlivé druhy testů. Během měření a při zpracování studie byly zjištěny statisticky významné skutečnosti, pomocí kterých by bylo možné zpřesnit hodnocení kvality terapie a zvýšit efektivitu vyšetřování pacientů s koxartrózou. Byla prokázána shodná výpovědní hodnota testu 2MWT ve srovnání s delšími testy (6MWT) a také výhody provedení testu TUG, jako zdroje doplňujících informací k vyšetření pomocí dotazníku Harris a běžných chůzových testů.

O desenvolvimento da articulação do quadril tem sido de intenso interesse devido à escassa informação acerca dos aspectos morfológicos e ultraestruturais em fetos humanos de diferentes faixas etárias. Pretende-se avaliar os aspectos morfofuncionais e ultraestruturais do desenvolvimento da cartilagem articular da epífise da cabeça do fêmur. Foram utilizados 20 fetos humanos de idades compreendidas entre 16 a 31 semanas de vida intra uterina (VIU), fixados em solução de formol a 10% e conservados em glicerina. Os fetos foram divididos em 4 grupos (n=5): grupo 1 (G1): 16-19 semanas VIU; grupo 2 (G2): 20-23 semanas VIU; grupo 3 (G3): 24-27 semanas VIU e grupo 4 (G4): 28-31 semanas VIU. Os espécimes foram divididos em uma metade anterior e outra, posterior através de um corte frontal em sua parte média. Os antímeros direitos foram processados através da microscopia de luz para análise quantitativa a fim de determinar a área, a densidade dos condrócitos e de matriz extracelular (MEC), e o volume e para análise qualitativa a fim de determinar a distribuição e organização das fibras colágenas na MEC através da coloração da Safranina-O e do Picro-sirius. Os antímeros esquerdos foram submetidos à microscopia eletrônica de varredura. Foram encontradas diferenças significantes entre os grupos com o aumento da área e do volume de condrócitos com a avanço das idades de forma gradativa. Quanto maior a faixa etária, menor o número de condrócitos, e maior a densidade percentual de matriz extracelular. Através da microscopia eletrônica de varredura (MEV), na superfície da epífise, a organização e orientação das fibras de colágeno mudaram nos diferentes grupos, de uma orientação irregular no grupo de fetos mais jovens, para uma organização pantográfica no grupo de fetos mais desenvolvidos. Conhecer a organização e o desenvolvimento normal cartilagíneo da cabeça do fêmur contribui com conhecimentos morfológicos para entender melhor a maturação do colágeno nos locais de reparo dos tecidos e embasar aspectos relacionados a doenças e malformações da articulação. / The development of the hip joint has been of intense interest due to the scarce information about the morphological and ultrastructural aspects in human fetuses of different age groups. It is intended to evaluate the morphofunctional and ultrastructural aspects of the development of the articular cartilage of the epiphysis of the femoral head. Twenty human fetuses aged between 16 and 31 weeks of intrauterine life (IUL), fixed in 10% formalin solution and preserved in glycerin, were used. Fetuses were divided into 4 groups (n = 5): group 1 (G1): 16-19 weeks VIU; group 2 (G2): 20-23 weeks VIU; group 3 (G3): 24-27 weeks VIU and group 4 (G4): 28-31 weeks VIU. The specimens were divided into an anterior half and a posterior one through a frontal cut in the middle part. The right antimers were processed by light microscopy for quantitative analysis to determine the area, chondrocyte density and extracellular matrix (ECM), and volume and for qualitative analysis in order to determine the distribution and organization of collagen fibers in MEC through the staining of Safranin-O and Picrosirius. The left antimers were submitted to scanning electron microscopy. Significant differences were found between groups with increasing area and volume of chondrocytes with advancing age gradually. The higher the age group, the lower the number of chondrocytes, and the higher the percentage density of extracellular matrix. Through scanning electron microscopy (SEM), on the surface of the epiphysis, the organization and orientation of the collagen fibers changed in the different groups, from an irregular orientation in the group of younger fetuses, to a pantographic organization in the group of more developed fetuses. Knowing the normal organization and development of the cartilaginous head of the femur contributes with morphological knowledge to better understand the maturation of collagen in the tissue repair sites and to support aspects related to diseases and malformations of the joint.