Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: 2012 International Hip Society Proceedings 21 articles

Articles

Persistent Structural Disease Is the Most Common Cause of Repeat Hip Preservation Surgery

John C. Clohisy MD, Jeffrey J. Nepple MD, Christopher M. Larson MD, Ira Zaltz MD, Michael Millis MD

Hip preservation surgery has become more commonplace, yet when it fails, it is unclear why it does so. Understanding failed procedures should lead to improved surgical results.

Which Patients Are at Risk for Kidney Dysfunction After Hip Fracture Surgery?

George A. Macheras MD, PhD, Konstantinos Kateros MD, PhD, Stefanos D. Koutsostathis MD, PhD, Stamatios A. Papadakis MD, PhD, Eleftherios Tsiridis MD, PhD, FRCS

Kidney dysfunction (KD) after hip fracture surgery is a major complication. However, the incidence and risk factors of KD in this population are unclear.

What is the Long-term Survival of Impaction Allografting of the Femur?

Kevin L. Garvin MD, Beau S. Konigsberg MD, Natalie D. Ommen MPT, Elizabeth R. Lyden MS

Revision hip surgery of the femur for patients with substantial bone loss is challenging. We previously reported 41 patients (44 hips) treated with femoral impaction grafting followed for a minimum of 2 years. The survivorship, using femoral reoperation for symptomatic aseptic loosening as the end point, was 97% at 8 years. However, data on longer term survival are crucial to adequately compare this surgical technique with other types of revision hip arthroplasty procedures.

Is the Bone-bonding Ability of a Cementless Total Hip Prosthesis Enhanced by Alkaline and Heat Treatments?

Kazutaka So MD, PhD, Ayumi Kaneuji MD, PhD, Tadami Matsumoto MD, PhD, Shuichi Matsuda MD, PhD, Haruhiko Akiyama MD, PhD

Cementless total hip arthroplasty (THA) implants using alkaline and heat treatments were developed to enhance bone bonding. Although bone-bonding ability of the alkali- and heat-treated titanium surface has been demonstrated in animal studies, it remains unknown whether it enhances or provides durable bone bonding in humans.

The Natural History of Inflammatory Pseudotumors in Asymptomatic Patients After Metal-on-metal Hip Arthroplasty

Sulaiman A. Almousa MBBS, Nelson V. Greidanus MD, MPH, Bassam A. Masri MD, Clive P. Duncan MD, MSc, Donald S. Garbuz MD, MHSc

Although pseudotumors have been reported in 32% of asymptomatic metal-on-metal hips, the natural history of asymptomatic pseudotumors is unknown.

What Are the Causes for Failures of Primary Hip Arthroplasties in France?

Christian Delaunay MD, Moussa Hamadouche MD, PhD, Julien Girard MD, Alain Duhamel PhD

There are no large database cohorts describing the causes for failure of primary THAs in France. Because implants and causes for revision vary between national registers, it is important to obtain data from all countries.

Low Rate of Dislocation of Dual-mobility Cups in Primary Total Hip Arthroplasty

Antoine Combes MD, Henri Migaud MD, Julien Girard MD, PhD, Alain Duhamel PhD, Michel Henri Fessy MD, PhD

Dual-mobility (DM) cups were introduced to minimize the risk of THA dislocation. The overall rate of dislocation of DM cups (including both large and small articulations) is controversial and ranges from 0% to 5% in previous studies.

No Difference in Gait Recovery After THA With Different Head Diameters: A Prospective Randomized Study

Luigi Zagra MD, Federica Anasetti MSEng, Luca Bianchi MD, Vittorio Licari MD, Roberto Giacometti Ceroni MD

Larger femoral heads are commonly presumed to improve joint stability and hip biomechanics; some studies have suggested they may hasten recovery of a normal gait. To our knowledge, no gait analysis studies have compared different size head diameters in THA.

Case Reports: Anteroinferior Acetabular Rim Damage Due to Femoroacetabular Impingement

Lisa M. Tibor MD, Reinhold Ganz MD, Michael Leunig MD

The most common location of labral tears and chondral damage in the hip is the anterosuperior region of the acetabulum, which is associated with pain in flexion and rotation. We describe a case series of patients with labral tears, ganglion formation, and chondromalacia isolated to the anteroinferior acetabulum. Clinically, patients had pain in extension and internal rotation.

Two or More Impingement and/or Instability Deformities Are Often Present in Patients With Hip Pain

Lisa M. Tibor MD, Gunnar Liebert MD, Reto Sutter MD, Franco M. Impellizzeri PhD, Michael Leunig MD

Damage to the hip can occur due to impingement or instability caused by anatomic factors such as femoral and acetabular version, neck-shaft angle, alpha angle, and lateral center-edge angle (CEA). The associations between these anatomic factors and how often they occur in a painful hip are unclear but if unaddressed might explain failed hip preservation surgery.

Do Young, Active Patients Perceive Advantages After Surface Replacement Compared to Cementless Total Hip Arthroplasty?

Robert L. Barrack MD, Erin L. Ruh MS, Michael E. Berend MD, Craig J. Della Valle MD, C. Anderson Engh MD, Javad Parvizi MD, FRCS, John C. Clohisy MD, Ryan M. Nunley MD

Potential advantages suggested but not confirmed for surface replacement arthroplasty (SRA) over THA include lower frequency of limp, less thigh pain, less limb length discrepancy, and higher activity.

Valgus Hip With High Antetorsion Causes Pain Through Posterior Extraarticular FAI

Klaus A. Siebenrock MD, Simon Damian Steppacher MD, Pascal Cyrill Haefeli MD, Joseph Michael Schwab MD, Moritz Tannast MD

Valgus hips with increased antetorsion present with lack of external rotation and posterior hip pain that is aggravated with hip extension and external rotation. This may be the result of posterior femoroacetabular impingement (FAI).

Oxford Hip Scores at 6 Months and 5 Years Are Associated With Total Hip Revision Within the Subsequent 2 Years

Peter Devane MD, Geoffrey Horne MD, Daniel J. Gehling MD

The Oxford hip score (OHS) is commonly reported in research studies as a reflection of pain and function but it is unclear whether it predicts subsequent prosthesis failure.

Femoral Remodeling Around Charnley Total Hip Arthroplasty Is Unpredictable

Matthew J. Teusink MD, Katharine A. Callaghan BA, Noelle F. Klocke MS, Devon D. Goetz MD, John J. Callaghan MD

There are two unusual remodeling patterns of the proximal femur around well-fixed Charnley total hip arthroplasties: cortical thinning leading to endosteal widening around the femoral component and hypertrophy of the distal femoral cortex. Previous studies have shown remodeling patterns are affected by stem design and occur early postoperatively. It is unclear if these changes are related to patient demographics or if they progress throughout the lifetime of the implant.

Method of Fixation Does Not Influence the Overall Risk of Rerevision in First-time Cup Revisions

Maziar Mohaddes MD, Göran Garellick MD, PhD, Johan Kärrholm MD, PhD

During the last two decades, uncemented fixation has been increasingly preferred worldwide during cup revision surgery. In Sweden, the number of uncemented cup revisions has been increasing during the last decade. However, it is unclear whether the risk of rerevision differs between cemented and uncemented cups.

Are Antibiotics Necessary in Hip Arthroplasty With Asymptomatic Bacteriuria? Seeding Risk With/Without Treatment

José Cordero-Ampuero MD, PhD, Enrique González-Fernández MD, David Martínez-Vélez MD, Jaime Esteban MD, PhD

In patients with asymptomatic bacteriuria undergoing hip arthroplasty, the risk of prosthetic joint infection (PJI) and appropriateness of specific antibiotics are unclear.

Acetabular Liner With Focal Constraint to Prevent Dislocation After THA

Jacob T. Munro MBChB, Mihai H. Vioreanu MD, MCh, Bassam A. Masri MD, Clive P. Duncan MD, MSc

Dislocation continues to commonly cause failure after primary and revision total hip arthroplasty (THA). Fully constrained liners intended to prevent dislocation are nonetheless associated with a substantial incidence of failure by redislocation, mechanical failure, aseptic loosening, or a combination. Constrained liners with cutouts of the elevated rims can theoretically increase range of movement and therefore decrease the risk dislocation, but it is unclear if they do so in practice and whether they are associated with early wear or loosening.

Ceramic-on-ceramic Bearing Decreases the Cumulative Long-term Risk of Dislocation

Philippe Hernigou MD, Yasuhiro Homma MD, Olivier Pidet MD, Isaac Guissou MD, Jacques Hernigou MD

It is unclear whether late THA dislocations are related to mechanical impingement or to a biological mechanism that decreases the stability provided by the capsule (eg, inflammation secondary to osteolysis). It is also unknown if alumina-on-alumina bearing couples decrease the risk of late dislocation as a result of the absence of wear and osteolysis.

Readmission Rates in the State of Florida: A Reflection of Quality?

Carlos J. Lavernia MD, Jesus M. Villa MD, David A. Iacobelli MD

High readmission rates are viewed by the Centers for Medicare & Medicaid Services as a quality of care determinant but it is unclear whether readmission rates per se reflect quality and the drivers of readmissions after hip arthroplasty remain unclear.

Increase of Cortical Bone After a Cementless Long Stem in Periprosthetic Fractures

Eduardo García-Rey MD, PhD, EBOT, Eduardo García-Cimbrelo MD, PhD, Ana Cruz-Pardos MD, PhD, Rosário Madero MS

Healing and functional recovery have been reported using an extensively porous-coated stem in Vancouver B2 and B3 periprosthetic fractures; however, loss of cortical bone has been observed when using these stems in revision surgery for aseptic loosening. However, it is unclear whether this bone loss influences subsequent loosening.