Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 716 articles

Articles

Do Surgeon Expectations Predict Clinically Important Improvements in WOMAC Scores After THA and TKA?

Hassan M. K. Ghomrawi PhD, MPH, Carol A. Mancuso MD, Allison Dunning MS, Alejandro Gonzalez Della Valle MD, Michael Alexiades MD, Charles Cornell MD, Thomas Sculco MD, Matthias Bostrom MD, David Mayman MD, Robert G. Marx MD, Geoffrey Westrich MD, Michael O’Dell MD, Alvin I. Mushlin MD

Failure of THA or TKA to meet a patient’s expectations may result in patient disappointment and litigation. However, there is little evidence to suggest that surgeons can consistently anticipate which patients will benefit from those interventions.

Does Removal of Subchondral Cortical Bone Provide Sufficient Resection Depth for Treatment of Cam Femoroacetabular Impingement?

Penny R. Atkins BS, Stephen K. Aoki MD, Ross T. Whitaker PhD, Jeffrey A. Weiss PhD, Christopher L. Peters MD, Andrew E. Anderson PhD

Residual impingement resulting from insufficient resection of bone during the index femoroplasty is the most-common reason for revision surgery in patients with cam-type femoroacetabular impingement (FAI). Development of surgical resection guidelines therefore could reduce the number of patients with persistent pain and reduced ROM after femoroplasty.

Epiphyseal Arterial Network and Inferior Retinacular Artery Seem Critical to Femoral Head Perfusion in Adults With Femoral Neck Fractures

Dewei Zhao MD, PhD, Xing Qiu PhD, Benjie Wang MD, Zihua Wang MD, Wei Wang PhD, Jun Ouyang PhD, Rona M. Silva PhD, Xiaotian Shi PhD, Kai Kang PhD, Dachuan Xu PhD, Chuang Li MD, Shizhen Zhong PhD, Yu Zhang PhD, Kent E. Pinkerton PhD

A better understanding of the blood supply of the femoral head is essential to guide therapeutic strategies for patients with femoral neck fractures. However, because of the limitations of conventional techniques, the precise distribution and characteristics of intraosseous arteries of the femoral head are not well displayed.

Prediction of Polyethylene Wear Rates from Gait Biomechanics and Implant Positioning in Total Hip Replacement

Marzieh M. Ardestani PhD, Pedro P. Amenábar Edwards MD, Markus A. Wimmer PhD

Patient-specific gait and surgical variables are known to play an important role in wear of total hip replacements (THR). However a rigorous model, capable of predicting wear rate based on a comprehensive set of subject-specific gait and component-positioning variables, has to our knowledge, not been reported.

Exchangeable Femoral Neck (Dual-Modular) THA Prostheses Have Poorer Survivorship Than Other Designs: A Nationwide Cohort of 324,108 Patients

Sandrine Colas MSc, MPH, Assia Allalou MSc, Antoine Poichotte MD, Philippe Piriou MD, PhD, Rosemary Dray-Spira MD, PhD, Mahmoud Zureik MD, PhD

Exchangeable neck stems, defined as those with a dual taper (that is, a modular junction between the femoral head and the femoral neck and an additional junction between the neck and the stem body), were introduced in THA to improve restoration of joint biomechanics (restoring anteversion, offset, and limb length) and reduce the risk of dislocation. However exchangeable necks have been reported to result in adverse effects such as stem fractures and acute local tissue reaction. Whether they result in a net improvement to or impairment of reconstructive survivorship remains controversial.

High Survivorship and Little Osteoarthritis at 10-year Followup in SCFE Patients Treated With a Modified Dunn Procedure

Kai Ziebarth MD, Milan Milosevic MD, Till D. Lerch MD, Simon D. Steppacher MD, Theddy Slongo MD, Klaus A. Siebenrock MD

The modified Dunn procedure has the potential to restore the anatomy in hips with slipped capital femoral epiphyses (SCFE) while protecting the blood supply to the femoral head and minimizing secondary impingement deformities. However, there is controversy about the risks associated with the procedure and mid- to long-term data on clinical outcomes, reoperations, and complications are sparse.

Does N-terminal Pro-brain Type Natriuretic Peptide Predict Cardiac Complications After Hip Fracture Surgery?

Hiroki Ushirozako MD, Tsuyoshi Ohishi MD, PhD, Tomotada Fujita MD, Daisuke Suzuki MD, PhD, Kazufumi Yamamoto MD, PhD, Tomohiro Banno MD, Hiroyuki Takase MD, PhD, Yukihiro Matsuyama MD, PhD

Elderly patients with hip fracture are at risk for cardiac complications. N-terminal pro-brain type natriuretic peptide (NT-proBNP) has been shown to predict cardiac complications in surgical patients; however, to our knowledge, only two studies have evaluated the utility of this test in patients with hip fracture. We believe it is important to assess a more accurate cutoff value of NT-proBNP with exclusion of patients with renal failure.

High Risk of Readmission in Octogenarians Undergoing Primary Hip Arthroplasty

Arthur L. Malkani MD, Brian Dilworth MD, Kevin Ong PhD, Doruk Baykal PhD, Edmund Lau MS, Theresa N. Mackin BA, Gwo-Chin Lee MD

As life expectancy increases, more elderly patients with end-stage hip arthritis are electing to undergo primary THA. Octogenarians undergoing THA have more comorbidities than younger patients, but this is not reflected in risk adjustment models for bundled care programs. The burden of care associated with THA in octogenarians has not been well characterized, and doing so may help these value-based programs make adjustments so that this vulnerable patient population does not risk losing access under accountable care models.

Periacetabular Osteotomy Provides Higher Survivorship Than Rim Trimming for Acetabular Retroversion

Corinne A. Zurmühle MD, Helen Anwander MD, Christoph E. Albers MD, Markus S. Hanke MD, Simon D. Steppacher MD, Klaus A. Siebenrock MD, Moritz Tannast MD

Acetabular retroversion can cause impaction-type femoroacetabular impingement leading to hip pain and osteoarthritis. It can be treated by anteverting periacetabular osteotomy (PAO) or acetabular rim trimming with refixation of the labrum. There is increasing evidence that acetabular retroversion is a rotational abnormality of the entire hemipelvis and not a focal overgrowth of the anterior acetabular wall, which favors an anteverting PAO. However, it is unknown if this larger procedure would be beneficial in terms of survivorship and Merle d’Aubigné scores in a midterm followup compared with rim trimming.

One-third of Hips After Periacetabular Osteotomy Survive 30 Years With Good Clinical Results, No Progression of Arthritis, or Conversion to THA

Till Dominic Lerch MD, Simon Damian Steppacher MD, Emanuel Francis Liechti MD, Moritz Tannast MD, Klaus Arno Siebenrock MD

Since its first description in 1984, periacetabular osteotomy (PAO) has become an accepted treatment for hip dysplasia. The 30-year survivorship with this procedure has not been reported. Because these patients are often very young at the time of surgery, long-term followup and identification of factors associated with poor outcome could help to improve patient selection.