Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

Does Chronic Corticosteroid Use Increase Risks of Readmission, Thromboembolism, and Revision After THA?

Matthew R. Boylan ScB, Dean C. Perfetti BA, Randa K. Elmallah MD, Viktor E. Krebs MD, Carl B. Paulino MD, Michael A. Mont MD

Systemic corticosteroids are commonly used to treat autoimmune and inflammatory diseases, but they can be associated with various musculoskeletal problems and disorders. There currently is a limited amount of data describing the postoperative complications of THA associated specifically with chronic corticosteroid use.

How Does Bony Surgery Affect Results of Anterior Open Reduction in Walking-age Children With Developmental Hip Dysplasia?

Alpesh Kothari MRCS, MSc, George Grammatopoulos FRCS (Tr & Orth), DPhil, Sally Hopewell DPhil, Tim Theologis MSc, PhD

Anterior open reduction is commonly used to treat hip subluxation or dislocation in developmental dysplasia of the hip (DDH) in walking-age children. Pelvic and/or femoral osteotomy may be used in addition, but it is unclear how this affects avascular necrosis (AVN) risk and radiological and clinical results.

Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis

Eduardo N. Novais MD, Mary K. Hill BA, Patrick M. Carry BA, Patricia C. Heyn MS, PhD

Osteonecrosis of the femoral head is a major complication that negatively impacts the clinical and radiographic long-term outcome after treatment of developmental hip dysplasia (DDH). There are conflicting results in the literature whether age at the time of closed or open reduction and a specific surgical approach are associated with osteonecrosis. Better understanding of the impact of age at reduction and surgical approach is important to reduce the risk of osteonecrosis in patients with DDH.

Custom Acetabular Cages Offer Stable Fixation and Improved Hip Scores for Revision THA With Severe Bone Defects

Huiwu Li MD, Xinhua Qu MD, Yuanqing Mao MD, Kerong Dai MD, Zhenan Zhu MD

Revision THA is particularly challenging in hips with severe acetabular bone loss. When the extent or geometry of the acetabular bone loss precludes more-straightforward techniques such as jumbo hemispheric cementless shells, reconstruction with morselized allograft protected by a custom cage may offer an alternative, but, to our knowledge, few series have reported on results with this approach.

What Is the Learning Curve for the Anterior Approach for Total Hip Arthroplasty?

Richard Noel Steiger MBBS, FRACS, Michelle Lorimer BSc(Math & Comp Sci) (Hons), Michael Solomon MBChB, FRACS

There are many factors that may affect the learning curve for total hip arthroplasty (THA) and surgical approach is one of these. There has been renewed interest in the direct anterior approach for THA with variable outcomes reported, but few studies have documented a surgeon’s individual learning curve when using this approach.

Does a Titanium-coated Polyethylene Press-fit Cup Give Reliable Midterm Results?

Nikki Hooper MBChB, Harry Sargeant MBChB, Chris Frampton PhD, Gary Hooper MD, FRACS

Uncemented acetabular components have demonstrated low revision rates and high patient satisfaction but with concerns regarding increased costs compared with monoblock cups. Some newer lower-cost uncemented monoblock options have become available in the last decade, but limited data are available on their performance.

Ceramic-on-ceramic THA Implants in Patients Younger Than 20 Years

Didier Hannouche MD, PhD, Flore Devriese MD, Jérôme Delambre MD, Frédéric Zadegan MD, Idriss Tourabaly MD, Laurent Sedel MD, Sylvie Chevret MD, PhD, Rémy Nizard MD, PhD

Poor survival of THA implants in very young patients has been attributed to use of cemented implants, wear of conventional polyethylene, and the presence of morphologic deformities in the proximal femur or in the acetabulum. Few studies have reported the long-term results of ceramic-on-ceramic implants in THAs in patients younger than 20 years.

Does Periacetabular Osteotomy Have Depth-related Effects on the Articular Cartilage of the Hip?

Andreas M. Hingsammer MD, Patricia E. Miller MS, Michael B. Millis MD, Young-Jo Kim MD, PhD

Osteoarthritis may result from abnormal mechanics leading to biochemically mediated degradation of cartilage. In a dysplastic hip, the periacetabular osteotomy (PAO) is designed to normalize the mechanics and our initial analysis suggests that it may also alter the cartilage biochemical composition. Articular cartilage structure and biology vary with the depth from the articular surface including the concentration of glycosaminoglycans (GAG), which are the charge macromolecules that are rapidly turned over and are lost in early osteoarthritis. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) enables noninvasive measurement of cartilage GAG content. The dGEMRIC index represents an indirect measure of GAG concentration with lower values indicating less GAG content. GAG content can normally vary with mechanical loading; however, progressive loss of GAG is associated with osteoarthritis. By looking at the changes in amounts of GAG in response to a PAO at different depths of cartilage, we may gain further insights into the types of biologic events that are occurring in the joint after a PAO.

High Risk of Failure With Bimodular Femoral Components in THA

Aidin Eslam Pour MD, Robert Borden BS, Takayuki Murayama MD, Mary Groll-Brown BS, J. David Blaha MD

The bimodular femoral neck implant (modularity in the neck section and prosthetic head) offers several implant advantages to the surgeon performing THAs, however, there have been reports of failure of bimodular femoral implants involving neck fractures or adverse tissue reaction to metal debris. We aimed to assess the results of the bimodular implants used in the THAs we performed.

Adverse Reactions to Metal on Metal Are Not Exclusive to Large Heads in Total Hip Arthroplasty

Adolph V. Lombardi MD, Keith R. Berend MD, Joanne B. Adams BFA, Keri L. Satterwhite

There is some suggestion that smaller diameter heads in metal-on-metal total hip arthroplasty (MoM THA) may be less prone to the adverse reactions to metal debris (ARMD) seen with large-diameter heads.