Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

Complete Circumferential Osseous Extension in the Acetabular Rim Occurs Regardless of Acetabular Coverage

Keisuke Watarai MD, Fumihiko Kimura MD, Yuho Kadono MD, PhD, Yoon Taek Kim MD, PhD, Mamoru Niitsu MD, PhD, Hiromi Oda MD, PhD, Hirohiko Azuma MD, PhD

Complete circumferential osseous extension in the acetabular rim has been reported to occur in the deep hip with pincer impingement. However, this phenomenon occasionally is observed in dysplastic hips without pincer impingement, and the degree to which this finding might or might not be associated with hip pain, and how often it occurs bilaterally among patients, are not well characterized.

Increase in Total Joint Arthroplasty Projected from 2014 to 2046 in Australia: A Conservative Local Model With International Implications

Maria C. S. Inacio PhD, Stephen E. Graves MBBS, DPhil, Nicole L. Pratt PhD, Elizabeth E. Roughead PhD, Szilard Nemes PhD

The incidence of joint arthroplasty is increasing worldwide. International estimates of future demand for joint arthroplasty have used models that propose either an exponential future increase, despite obvious system constraints, or static increases, which do not account for past trends. Country-specific projection estimates that address limitations of past projections are necessary. In Australia, a high-income country with the 7th highest incidence of TKA and 15th highest incidence of THA of the Organization for Economic Cooperation and Development (OECD) countries, the volume of TKAs and THAs increased 198% between 1994 and 2014.

Free Vascularized Fibular Grafting Improves Vascularity Compared With Core Decompression in Femoral Head Osteonecrosis: A Randomized Clinical Trial

Lu Cao MD, Changan Guo MD, Jifei Chen MD, Zenggan Chen MD, Zuoqin Yan MD

Management of osteonecrosis of the femoral head remains challenging. Core decompression and free vascularized fibular grafting are commonly used surgical procedures for treatment of osteonecrosis of the femoral head. Few studies, however, have compared these two procedures in a randomized controlled study, in terms of improved vascularity of the femoral head, progression of disease, or hip scores.

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.