Our study established a higher prevalence of radiographic markers of FAI in an asymptomatic population.

Abstract-Hip osteoarthritis (OA) is a degenerative disease, and total hip arthroplasty (THA) is one of the surgical procedures of choice to improve the OA patient's quality of life. Without a rehabilitation program, THA patients will develop functional limitations. A randomized double-blind trial was performed between July 2009 and October 2011 to compare over a short follow-up time two groups of patients who underwent THA for OA. The THA protocol (THAP) group received verbal instructions and physiotherapy exercise demonstrations, and the THA physiotherapy care protocol (THAPCP) group received the same verbal instructions and demonstrations associated with daily exercise practice guided by a physiotherapist. The outcomes that were assessed preoperatively and 15 d postoperatively in 106 patients were muscle strength force, goniometry, Medical Outcomes Study 36-Item Short Form Health Survey, and Merle d'Aubigné and Postel score. Higher muscle strength force scores and degrees in range of motion were found in the THAPCP group. Greater improvements were also observed for the THAPCP group than the THAP group in the Merle d'Aubigné and Postel score. At the end of the follow-up period, the intervention in the THAPCP group improved functional capacity, quality of life, mobility, muscle strength, goniometry, and pain. It appears to be a safe tool for accelerating recovery in THA patients.Clinical Trial Registration: ClinicalTrials.gov; NCT01491048, "Evaluation of functional rehabilitation in patients undergoing physiotherapy after total hip arthroplasty (arthrosis)"; https://clinicaltrials.gov/ct2/show/NCT01491048

ABSTRACT ABSTRACTObjective Objective Objective Objective Objective: to determine the prevalence of radiographic signs of femoroacetabular impingement (FAI) in asymptomatic adults and correlate them with data from physical examinations. Methods Methods Methods Methods Methods: We conducted a cross-sectional study with 82 asymptomatic volunteers, 164 hips, between 40 and 60 years of age, selected by convenience. They were submitted to anamnesis and clinical examination of the hip, anteroposterior (AP) pelvis radiographs with three incidences, Dunn 45° and Lequesne false profile of each hip, to measure the variables. We measured the alpha angle, anterior offset of the femoral neck, cervical diaphyseal angle, CE angle of Wiberg, acetabular index, Sharp angle, and the crossing, ischial spine and posterior wall signs. Results Results ResultsResults Results: our sample consisted of 66% women, mean age of 50.4 years. The average alpha angle was 45.10°, SD=8.6. One quarter of the hips showed alpha angle greater than or equal to 50°; among men the prevalence was 34%, and among women, 11%. We found indicative radiographic signs of femoroacetabular impingement in 42.6% of hips, whether femoral or acetabular, and the increased alpha angle was related to the decrease in hip internal rotation (p<0.001). Conclusion: Conclusion: Conclusion: Conclusion: Conclusion: the radiographic findings of femoroacetabular impingement in asymptomatic patients were frequent in the studied sample. The increase in alpha angle was associated with decreased internal rotation.

The reconstruction of an acetabular bone defect is one of the most important aspects of revision total hip arthroplasty surgery. It can be done by the use of grafts. Therefore, many kinds of grafts may be used and lyophilized xenograft is an alternative example. The purpose of the study was to evaluate the histological findings of lyophilized bovine xenografts used in previous total hip arthroplasty revision surgery. A case series was carried out from July 2000 to April 2013 with the approval of the Hospital Ethics Committee. Fourteen subjects were analyzed. Of these, 64.3 % were female. The average age of the patients was 52.36 ± 18.55. Neoformed bone was present in 85.7 % of subjects, and constituted 61.79 % of the total bone matrix area. The diagnosis of xenograft absorption was present in 12 subjects. A strong inverse correlation between the percentage of neoformed bone and the percentage of xenograft in the total bone matrix by analysis of biopsies was found by the Pearson test (p = 0.001). No inflammatory response was found in the clinical status of the patients or in the histological analysis. Lyophilized bovine xenograft shown to be safe until the present moment, with acceptable results. Most of the cases presented new bone formation as expected (considered values greater than 30 %) and for this reason the xenograft has proven to be an osteoconductive compatible scaffold/trellis for the bone ingrowth. Therefore, it can be considered an alternative to other bone grafts in the treatment of bone loss.

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Objective: To evaluate the physicochemical characteristics of lyophilized bovine grafts manufactured on a semi-industrial scale (Orthogen; Baumer S/A*) in accordance with a protocol previously developed by the authors. Methods: The lyophilized bovine bone grafts were characterized by means of scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), X-ray diffractometry (XRD), thermogravimetric (TG) analysis, differential exploratory scanning calorimetry (DSC) and Fourier-transform infrared (FT-IR) spectroscopy. Results: Ca was the main component (60%) found in the samples, followed by P (28%) and O (5%). The mean (sd) pore size was 316 µm (146.7), ranging from 91.2 to 497.8 µm, andRev Bras Ortop. 2011;46(4):444-51

This paper evaluates the mechanical behavior of an uncemented hip stem using finite element analysis.The analysis is focused on the stem-bone interaction which is assessed by simulation of distinct conditions encountered daily on orthopedic practice of hip implants. Logical uncemented femoral stem was used in this work. Three distinct conditions have been modeled: a) exposed neck with fully embedded fins, b) partially exposed anti-rotational fins and c) fully exposed fins, representing real femoral hip conditions. Anthropometric variations and different angulations for the stem neck were investigated for typical body weight of populations submitted to implants. The ratio of mobilized stress to yield stress is shown to be lower than 55% indicating a safety factor against stem failure. Although small displacements are observed in all conditions, the displacement increases with the increase of both the length of exposed fins and the magnitude of applied forces. Even for the extreme condition of fully exposed fins, the prostheses will support the working loads, and the risk of bone fracture still has a safety factor. Stresses and displacements change considerably with neck angulations suggesting that anthropometric variations should be considered in the future to optimize prostheses performance. Numerical analysis of the used uncemented femoral stem demonstrated that small stresses and strains are generated under working load conditions indicating that a proper factor of safety is obtained for the static conditions tested in the present study.Keywords Numerical analysis, Hip surgery, Uncemented stem, Prosthesis. Análise numérica do comportamento biomecânico da haste femoral não-cimentada Logical