According to these user features, the device-centered features are delimited in terms of two principal groups: mechanical design and actuation and control. Within these features, the user features are described depending on their needs and requirements to perform a specific task. Firstly, the user-centered features are divided into targeted goals focused on the applications and anatomic concepts. These devices had a design process that followed two principal features that are centered on the user and the device itself. The development of the lower-limb exoskeleton has been increased over the years, presenting a wide variety of devices that enhance or assist the user. They usually attain normal limb length and range of movement. On functional assessment, the HHS was 100% in 27 (90%) patients, 96% in 2 (7%) patients, and 83% in 1 (3%) patient with an average of 99.2%, while 29 (97%) patients had excellent and only 1 (3%) patient had a good outcome on modified HHS.Ĭementless total hip arthroplasty, performed in patients <60 years of age and avascular necrosis of the hip with no other associated hip pathologies, has excellent functional outcomes with no pain, limping, physical deformity, difficulty in walking, difficulty in climbing stairs, difficulty using public transport, difficulty in sitting, or difficulty in wearing shoes and socks. A total of 30 patients of age 50o inclined in 7 (23%) patients, while femoral component was found neutral in 28 (93%), valgus in 2 (7%), and varus in zero (0%) patients on radiography at follow-up. This prospective study was conducted at a major metropolitan hospital in Karachi, Pakistan over a period of six months. The purpose of this study is to access the functional outcomes of cementless total hip arthroplasty in patients with avascular necrosis of the hip. Total hip arthroplasty is the treatment of choice for third and fourth stage avascular necrosis that can be cemented or uncemented. Its management can be conservative or invasive.

It mostly affects the femoral head (hip joint).

It can be caused by fractures, dislocations, chronic steroid use, chronic alcohol use, coagulopathy, congenital source, and many other factors. Reduction in pain and disability utilizing opioid and non-opioid therapies, regional anesthesia, patient-tailored anesthetic approach, and delirium prevention strategies seems to ensure best outcomes.Īvascular necrosis occurs due to impaired blood supply to the bone. Perioperative multidisciplinary and multimodal approaches require medical, surgical, and anesthesiology teams employing adequate preoperative optimization. Common issues associated with morbidity and mortality include patients’ physiological decrease in function, medical comorbidities, and cognitive impairment, which all can confound and complicate pain assessment and treatment. The acute pain management in these situations is often challenging. The present investigation was undertaken to review epidemiology, socio-economic and medical implications, relevant anatomy, and anesthetic and pain modalities of hip fracture.Ī literature search of PubMed, Ovid Medline, and Cochrane databases was conducted in December 2018 to identify relevant published clinical trials, review articles, and meta-analyses studies related to anesthetic and pain modalities of hip fracture. The large individual morphologic variability across all levels of dysplastic hips suggests the femoral prosthesis cannot be chosen on the basis of the severity of the subluxation alone.Hip fracture is common in the elderly population, painful and costly.

The true acetabulum had a reduced anteroposterior diameter. The proximal femur had more anteversion with individual variations ranging from 1 degrees to 80 degrees. With high grade subluxations the femoral neck shaft angle decreased but with low grades, especially in Class II, the neck shaft angle increased. Compared with primary osteoarthritis, the intramedullary femoral canal had reduced mediolateral and anteroposterior dimensions. According to the classification of Crowe et al, 78 of the dislocated hips were graded Class I, 26 as Class II, 20 as Class III or IV, and 169 dysplastic hips had no subluxation. A cohort of 310 primary osteoarthritic hips was used as a control group. We studied three-dimensional anatomic parameters in 247 dysplastic hips from 218 adult patients using radiographs and computed tomography, and analyzed the consequences for total hip arthroplasty. Total hip arthroplasty in dysplastic hips is challenging because of the modified anatomy of the proximal femur and acetabulum.

Complete anatomy of hip joint