Journal of Back and Musculoskeletal Rehabilitation - Volume 4, issue 3

Article Type: Other

DOI: 10.3233/BMR-1994-4301

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. iv-iv, 1994

Authors: Rucker, Karen S.

Article Type: Editorial

DOI: 10.3233/BMR-1994-4302

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. vi-vi, 1994

Authors: Garden, Fae H.

Article Type: Introduction

DOI: 10.3233/BMR-1994-4303

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. vii-vii, 1994

Authors: Johnson, Ernest W.

Article Type: Editorial

DOI: 10.3233/BMR-1994-4304

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. viii-viii, 1994

Authors: Anderson, Leigh C. | Blake, Donna Jo

Article Type: Research Article

Abstract: The human hip is the largest ball and socket joint in the body. It differs in design from the more common hinge joint in order to meet the requirements of ambulation. The hip is an inherently stable joint because of its bony structure and its extensive ligamentous and muscular support. Regardless of this stability, the hip joint maintains a wide functional range of movement. This dichotomy of function has resulted in a complex organization of joint structure. A thorough understanding of the biomechanic forces exerted across the joint surfaces is essential to the understanding of both normal and pathologic function. …The authors of this article will explore the complex structural anatomy of this joint system in light of the biomechanic principles that effect movement and weight bearing through the joint. Show more

Keywords: Hip joint, biomechanics, anatomy, function, vector forces

DOI: 10.3233/BMR-1994-4305

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. 145-153, 1994

Authors: Feinberg, Joseph H.

Article Type: Research Article

Abstract: This review discusses the many etiologies of hip pain and how to clinically evaluate. Both primary hip disorders and conditions that refer pain to the hip are included in the differential diagnosis. The key components to a history are reviewed with clinically relevant examples. A comprehensive physical exam is described that includes disease and injury-specific tests. Imaging studies and diagnostic tests available are outlined. Conditions of bursitis, snapping hip syndromes, myofascial pain, fibromyalgia, arthropathies, fractures, neurogenic pain, metabolic diseases, and neoplastic disorders will be discussed.

Keywords: Hip, pain, physical examination, diagnosis, differential, medical history taking

DOI: 10.3233/BMR-1994-4306

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. 154-173, 1994

Authors: Schramm, Donna Marie

Article Type: Research Article

Abstract: Osteoporosis is a common entity, especially among elderly Caucasian women. Osteoporosis leads to hip fracture in many persons, putting them at risk for death and marked handicap. Hip fracture shows a steady increase in incidence after age 60 years, and most of the victims are over age 75 years. Screening studies predict hip fracture up to 8 years before fracture. Estrogen therapy, to be effective, should be initiated between the ages of 50 and 60 years, 25 to 15 years before the most likely age of fracture. Guidelines describing for whom the physician targets estrogen therapy, which is not without …risks, are sketchy or nonexistent. The patient should also be educated as a young adult about risk factor modification for osteoporosis, including increasing exercise, ceasing smoking, and minimizing coffee and alcohol use. Show more

Keywords: Hip fracture, osteoporosis, risk factors osteoporosis, prevention osteoporosis

DOI: 10.3233/BMR-1994-4307

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. 174-184, 1994

Authors: Garden, Fae H.

Article Type: Research Article

Abstract: Rehabilitation professionals play an important role in the comprehensive postoperative management of the patient who has undergone a total hip replacement. Understanding the general surgical considerations that eventually impact the rehabilitation process is essential. Coordination of physicians, physical and occupational therapists, social services, and family members results in better quality of care. The technology and design of hip prostheses and fixation methods impact the functional outcome of total hip arthroplasty. Professionals involved in total hip arthroplasty rehabilitation should also understand the potential complications following total hip arthroplasty that oftentimes cause delays or revisions in the rehabilitation program. When these are …combined with appropriate preoperative patient selection and education, as well as postoperative physical and occupational therapy programs, most patients are able to achieve a satisfactory functional outcome, including independence in basic activities of daily living and independent ambulation with an assistive device. Show more

Keywords: Rehabilitation, total hip replacement, physical therapy

DOI: 10.3233/BMR-1994-4308

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. 185-192, 1994

Authors: Kevorkian, C. George

Article Type: Research Article

Abstract: Venous thromboembolism is the most common and potentially lethal problem following elective or emergency hip surgery. Appropriate DVT prophylaxis is absolutely essential, as the incidence of both calf and proximal vein thrombosis is significant. Two to three percent of postoperative hip patients die secondary to pulmonary embolism. Prophylactic measures include a variety of pharmacological and non pharmacological tools. Early mobilization, leg exercises, and gradient compression stockings constitute a minimum protocol. Low-dose Coumadin or low molecular weight heparin should be employed as a pharmacological prophylaxis. If deep venous thrombosis is suspected, clinical judgment alone should not be a basis …for treatment decisions. Venography or, if necessary, other modem diagnostic agents must be employed. If appropriate studies are positive, aggressive treatment with heparin followed by Coumadin is suggested. Show more

Keywords: Hip surgery, venous thromboembolism

DOI: 10.3233/BMR-1994-4309

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. 193-206, 1994

Authors: Kirshblum, Steven C. | Campagnolo, Denise I.

Article Type: Research Article

Abstract: Heterotopic ossification (HO) is a common finding after total hip arthroplasty (THA), and may cause diminished hip range of motion and an antalgic gait. Although the etiology remains unclear, two theories currently prevail. In this article, the incidence, etiology, risk factors, and classifications of HO are discussed. Effective prophylactic treatments including radiation and anti-inflammatory medications are detailed. Once HO is present, the value of these treatments are doubtful and surgical excision may be required after bony maturity. With increasing THA projected as the population ages, the need for safe, effective, and inexpensive prophylaxis may be required.

Keywords: Heterotopic ossification, total hip arthroplasty

DOI: 10.3233/BMR-1994-4310

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. 207-217, 1994

Authors: Nelson, Maureen R.

Article Type: Research Article

Abstract: The pediatric hip changes through development, leading to a challenging evaluation of pain. Common problems noted in children include congenital dislocation of the hip, Legg-Calve-Perthes disease, slipped capital femoral epiphysis, and transient synovitis. Hip disorders are also seen secondary to other childhood diseases, such as spina bifida. Long-term complications of all of these hip disorders can lead to joint deformity and osteoarthritis in adulthood.

Keywords: Hip, dislocation, children, slipped capital femoral epiphysis, Legg-Calve-Perthes disease

DOI: 10.3233/BMR-1994-4311

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. 218-229, 1994

Authors: Leonard, Ellen I.

Article Type: Research Article

Abstract: The care of the hip in children with cerebral palsy is an ongoing challenge. Interventions need to be physiologically based and well timed. Early management will prevent future complications in both the ambulatory and nonambulatory child with cerebral palsy. Evaluation management and treatment of the hips in cerebral palsy will be discussed in this article.

Keywords: Cerebral palsy, spasticity, hip dislocation

DOI: 10.3233/BMR-1994-4312

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. 230-235, 1994

Authors: Wilder, Robert P. | Cole, Andrew J. | Sobel, Janet | O'Connor, Francis G.

Article Type: Research Article

Abstract: The majority of athletic injuries of the hip and pelvis are caused by overuse. Most of these injuries will respond to adequate rehabilitative management, including the correction of intrinsic and extrinsic risk factors and controlling abusive force loads that may have contributed to injury. In addition to injury-specific rehabilitation, imbalances and abnormalities at each level of the kinetic chain also must be corrected to ensure optimal healing.

Keywords: Overuse, sports, hip, pelvis

DOI: 10.3233/BMR-1994-4313

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. 236-247, 1994

Authors: Scott, Dan D. | Anderson, Leigh C.

Article Type: Research Article

Abstract: Piriformis syndrome is a controversial cause of hip and low back pain whose etiology stems from anatomic irregularities of the piriformis muscle and surrounding structures of the posterior hip region. Although this syndrome has been described by many clinicians, the association of piriformis muscle dysfunction and pain in the hip region remains conjectural. The diagnosis is one of exclusion of other more common pain generators in the hip, pelvis, or low back. The authors of this article will review the anatomy of the region as it relates to piriformis muscle dysfunction and delineate the various clinical, radiological, and interventional …procedures described in the literature to diagnose and treat this elusive syndrome. Show more

Keywords: Piriformis syndrome, sciatica, myofascial pain, low back pain

DOI: 10.3233/BMR-1994-4314

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 4, no. 3, pp. 248-254, 1994