Many subjects may be performing anterior trunk flexion with limited physiologic hip flexion, due to a poor bodily perception. This study assessed, among 21 subjects (10 men), which body part is perceived as being responsible for performing anterior trunk flexion; and verified whether, after one single physical therapy intervention (with visual, verbal and tactile stimuli), a raise in global flexibility would take place due to hip flexion increase. Both the distance fingertip-to-floor and the hip angular variation were measured before and after intervention; measures were analysed by means of photograph tracings. When questioned before intervention, 71% of the subjects pointed to the iliac crest region as being the major responsible for performing trunk flexion, showing that most were unaware of hip preponderance in this movement. Following intervention, a significant decrease was noticed in the fingertip-to-floor distance (21.8 cm before and 18.5 cm after), as well as significant increase in hip flexion (p=0.0036). As expected, global flexibility increased after intervention due to increase in hip flexion.

A crescente necessidade de artroplastia da anca tem resultado num aumento dos tempos de espera, podendo exacerbar o declínio funcional das Pessoas com osteoartrite e dificultar a recuperação pós-operatória. Esta recuperação está relacionada com os cuidados de Enfermagem de Reabilitação ao nível da mobilidade, ensino e preparação para o regresso ao domicílio. O sucesso da intervenção cirúrgica depende da intervenção do Enfermeiro Especialista em Enfermagem de Reabilitação, a qual deve ser precoce, planeada e individualizada, em concordância com as necessidades e os objetivos da Pessoa. O objetivo geral deste Projeto foi elaborar o Programa de Reabilitação e Capacitação para a transição segura para o domicílio da Pessoa submetida a artroplastia da anca. Foram desenvolvidas as seguintes atividades: conversas com a equipa de Enfermagem; análise SWOT do plano de cuidados do serviço; revisão da literatura sobre artroplastia da anca e transição segura para o domicílio; conceção, apresentação e implementação do guia de questões sobre as características habitacionais, bem como o Programa de Reabilitação. A avaliação das características habitacionais oferece contributos importantes na adaptação do Programa de Reabilitação às necessidades da Pessoa/Família. Embora este programa tenha sido implementado faltam evidências quanto à sua inclusão nos registos de Enfermagem de Reabilitação: 100% dos processos têm identificados os focos de atenção definidos com a avaliação do nível de dependência para cada autocuidado e do potencial de reconstrução de autonomia para o autocuidado; mas 10% dos processos têm a avaliação da capacidade para o uso de estratégias adaptativas para cada autocuidado. O Programa de Reabilitação desenvolvido, conjuntamente com os cuidados de Enfermagem de Reabilitação, proporciona: melhor controlo da dor; diminuição de complicações; ganhos em amplitude de movimento; recuperação mais rápida da força muscular, capacidade de marcha e funcionalidade; maior capacidade para o autocuidado aquando da alta; menor risco de queda; maior qualidade de vida.

Protrusio acetabuli is a disease characterized by a deformity of the medial wall of the acetabulum with a progressive migration of the femoral head into the pelvic cavity, resulting in some mechanical disorders, pain and limited limb hip movement. It was first described by Otto in 1824 as an intrapelvic protusion of the femoral head. It is considered multifactorial, and it is suggested that there is a heredity background to this disease. It is classified as primary (75,3%) or secundary (24,7%) according to aetiology; mild, moderate and severe radiologically. This review aims to present some treatment techniques using arthroplasties which are several and little explored. As in the literature, the choice was bone graft since there is no migration of the cemented acetabulum and no necessity of a titanium cup of great diameter.

Introduction: Patellofemoral pain syndrome (PFPS) is characterized by anterior knee pain, which may limit the performance of functional activities. The influence of hip joint motion on the development of this syndrome has already been documented in the literature. In this regard, studies have investigated the effectiveness of hip muscle strengthening in patients with PFPS. Objectives: The aims of this systematic review were (1) to summarize the literature related to the effects of hip muscle strengthening on pain intensity, muscle strength, and function in individuals with PFPS and (2) to evaluate the methodological quality of the selected studies. Method: A search for randomized controlled clinical trials was conducted using the following databases: Google Scholar, MEDLINE, PEDro, LILACS, and SciELO. The selected studies had to distinguish the effects of hip muscle strengthening in a group of patients with PFPS, as compared to non-intervention or other kinds of intervention, and had to investigate the following outcomes: pain, muscle strength, and function. The methodological quality of the selected studies was analyzed by means of the PEDro scale. Results: Seven studies were selected. These studies demonstrated that hip muscle strengthening was effective in reducing pain. However, the studies disagreed regarding the treatments' ability to improve muscle strength. Improvement in functional capabilities after hip muscle strengthening was found in five studies. Conclusion: Hip muscle strengthening is effective in reducing the intensity of pain and improving functional capabilities in patients with PFPS, despite the lack of evidence for its ability to increase muscle strength.

OBJECTIVES: To compare gait and functional performance parameters in elderly subjects who had or had not total hip arthroplasty (THA). METHODS: Our sample comprised 23 elderly subjects (72±6.5 years of age) with a mean of 2.6±1.3 years following THA, named the arthroplasty group (AG) and 23 asymptomatic elderly subjects (70.1±5.9 years of age), named the control group (CG). Case and control subjects were paired by gender, age, body mass index and level of physical activity. The GAITRite® system was used to analyze various gait parameters in four situations: usual speed (US), fast speed (FS), slow speed (SS) and dual task (DT); the Dynamic Gait Index (DGI) and Timed Up and Go test (TUG) methods were used to evaluate functional capacity. The statistical analyses were carried out using the Shapiro-Wilk test, Student's-t-tests for independent samples, chi-square tests, ANOVA for repeated measurements and paired Student's-t-tests. RESULTS: The AG had the worst results for gait speed (AG=1.18±0.13 and CG=1.39±0.09; p=0.012), symmetry index (SI) of step length (AG=3.60±1.01 and CG=1.12±0.59; p=0.000), SI of step time (AG=-2.65±0.92 and CG=0.99±0.74; p=0.000), SI of stance phase (AG=-2.55 and CG=-1.04±0.50; p=0.005), SI of single support phase (AG=-2.17±0.78 and CG=1.21±0.51; p=0.003), DGI (AG=20.04±1.91 and CG=21.69±1.45; p=0.001) and TUG (AG=14.67±1.94 and CG=10.08±1.49; p=0.001). CONCLUSION: Elderly subjects with a history of THA had changes in gait parameters and lower performance in TUG test even 2.6±1,3 years after surgery, which suggests functional impairment.

<p><b>INTRODUCTION:</b> The population around the world is aging. With this, there will be an increased incidence of fractures due to osteoporosis of the hip and this will be a serious global health problem. A World Health Organization (WHO) estimate suggests that the incidence of hip osteoporotic fractures worldwide will triple by 2050.<br> <b>OBJECTIVE:</b> To present, through a literature review, the main results of the femoral reinforcement, a technique described by scientific articles, with the potential to increase the proximal femoral load for the occurrence of fractures, whether using polymethylmethacrylate (PMMA), phosphate cement calcium (CPC), (j elastomers and metal implants.<br> <b>METHODS:</b> Through electronic search in databases PubMed, Latin American and Caribbean Center of Health Information Information (Bireme), Coordination for the Improvement of Higher Education Personnel (Capes), Scientific Electronic Library Online (SciELO), Google Scholar And Cochrane, using the terms cementoplasty and femororplasty, the studies were selected according to a specific inclusion criterion, describing the main findings of the biomechanical results, type of study and material used to perform the femoral reinforcement.<br> <b>RESULTS:</b> Of the 15 articles analyzed, 14 were experimental analyzes and one was a clinical trial, seven studies used PMMA, two used CPC, four elastomers and two metal implants, 13 of them showed favorable Newton load (N) results for the fracture hip.<br> <b>CONCLUSION:</b> Most of the studies on femoral reinforcement is experimental, and mostly used the PMMA, presenting an increase in the load in N for fracture occurrence.</p>

Abstract Objective This study aims to compare the in vitro wear rate of crosslinked, high molecular weight polyethylene coupled to 36-mm diameter ceramic heads and 32-mm diameter metal heads. Methods Ceramic-on-polyethylene (36 mm) and metal-on-polyethylene (32 mm) tribological pairs were submitted to biomechanical tests in a simulator to determine the wear rate after 15 × 106 cycles. Results A statistically significant difference (p= 0.0005) was detected when comparing the wear rate of assemblies with metallic heads (average wear: 14.12 mg/MC) and ceramic heads (average wear: 7.46 mg/MC). Conclusion The present study demonstrated the lower wear rate in prosthetic assemblies using 36-mm crosslinked ceramic-on-polyethylene tribological pairs compared to 32-mm crosslinked metal-on-polyethylene assemblies. This finding demonstrates the effectiveness of ceramic-on-polyethylene tribological pairs, even with large diameter heads.

Abstract Objective To evaluate the incidence of prosthetic instability in a consecutive series of 42 cases of total hip arthroplasty using dual mobility cup. Methods A retrospective study of 38 patients undergoing primary or revision total hip arthroplasty (THA) using the acetabular dual-mobility cup (DMC) implant between January 2012 and January 2018. The rates of complications and instability after surgery were evaluated. Results In total, 42 arthroplasties were performed in 38 patients, with a minimum follow-up of 16 months. The mean age of the sample was 60 years. In 38 cases, we used a cementless DMC, and, in the other 4 cases, a cemented DMC. There were no cases of early or late instability. Conclusion The series herein presented proves the good result of the DMC in cases of primary arthroplasty, complex and complicated cases of failed osteosynthesis of proximal femoral fractures, and revision for THA instability. The absence of episodes of prosthetic instability and complications in complex cases of primary and revision THA increases the confidence in this concept.