Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles


Planar dGEMRIC Maps May Aid Imaging Assessment of Cartilage Damage in Femoroacetabular Impingement

Evgeny Bulat MA, Sarah D. Bixby MD, Carl Siversson PhD, Leslie A. Kalish ScD, Simon K. Warfield PhD, Young-Jo Kim MD, PhD

Three-dimensional (3-D) delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) helps quantify biochemical changes in articular cartilage that correlate with early-stage osteoarthritis. However, dGEMRIC analysis is performed slice by slice, limiting the potential of 3-D data to give an overall impression of cartilage biochemistry. We previously developed a computational algorithm to produce unfolded, or “planar,” dGEMRIC maps of acetabular cartilage, but have neither assessed their application nor determined whether MRI-based grading of cartilage damage or dGEMRIC measurements predict intraoperative findings in hips with symptomatic femoroacetabular impingement (FAI).

Short-term Risk of Revision THA in the Medicare Population Has Not Improved With Time

Kevin J. Bozic MD, MBA, Kevin Ong PhD, Steven Kurtz PhD, Edmund Lau MS, Thomas P. Vail MD, Harry Rubash MD, Daniel Berry MD

Advances in surgical technique, implant design, and clinical care pathways have resulted in higher expectations for improved clinical outcomes after primary THA; however, despite these advances, it is unclear whether the risk of revision THA actually has decreased with time. Understanding trends in short- and mid-term risks of revision will be helpful in directing clinical, research, and policy efforts to improve THA outcomes.

Total Hip Arthroplasty After Acetabular Fracture Is Associated With Lower Survivorship and More Complications

Zachary Morison MSc, Dirk Jan F. Moojen MD, PhD, Aaron Nauth MD, Jeremy Hall MD, Michael D. McKee MD, James P. Waddell MD, Emil H. Schemitsch MD

Despite modern fracture management techniques allowing for near anatomic reduction of acetabular fractures, there continues to be a risk of posttraumatic arthritis and need for total hip arthroplasty (THA). Few well-controlled studies have compared THA after acetabular fractures with THAs performed for other indications in terms of survivorship or complications, and none, to our knowledge, present 10-year survivorship data in this setting.

Risk Calculators Predict Failures of Knee and Hip Arthroplasties: Findings from a Large Health Maintenance Organization

Elizabeth W. Paxton MA, Maria C. S. Inacio PhD, Monti Khatod MD, Eric Yue MD, Tadashi Funahashi MD, Thomas Barber MD

Considering the cost and risk associated with revision Total knee arthroplasty (TKAs) and Total hip arthroplasty (THAs), steps to prevent these operations will help patients and reduce healthcare costs. Revision risk calculators for patients may reduce revision surgery by supporting clinical decision-making at the point of care.

Oxidized Zirconium Head on Crosslinked Polyethylene Liner in Total Hip Arthroplasty: A 7- to 12-year In Vivo Comparative Wear Study

George K. Karidakis MD, Theofilos Karachalios MD, DSc

Osteolysis resulting from wear debris production from the bearing surfaces is a major factor limiting long-term survival of hip implants. Oxidized zirconium head on crosslinked polyethylene (XLPE) is a modern bearing coupling. However, midterm in vivo wear data of this coupling are not known.

Acetabuloplasties at Open Reduction Prevent Acetabular Dysplasia in Intentionally Delayed Developmental Dysplasia of the Hip: A Case-control Study

M. Belen Carsi MD, PhD, BSc, FRCS, Nicholas M. P. Clarke ChM, DM, FRCS

Avascular necrosis (AVN) and residual acetabular dysplasia are the two main complications of developmental dysplasia of the hip (DDH) treatment. Although early reduction of the hip may decrease the incidence of residual dysplasia, it may increase the incidence of AVN and vice versa. However, we do not know if changes in surgical technique may lead to a modification in these outcomes.

Dedicated Perioperative Hip Fracture Comanagement Programs are Cost-effective in High-volume Centers: An Economic Analysis

Eric Swart MD, Eshan Vasudeva BS, Eric C. Makhni MD, MBA, William Macaulay MD, Kevin J. Bozic MD, MBA

Osteoporotic hip fractures are common injuries typically occurring in patients who are older and medically frail. Studies have suggested that creation of a multidisciplinary team including orthopaedic surgeons, internal medicine physicians, social workers, and specialized physical therapists, to comanage these patients can decrease complication rates, improve time to surgery, and reduce hospital length of stay; however, they have yet to achieve widespread implementation, partly owing to concerns regarding resource requirements necessary for a comanagement program.

THA Revisions Using Impaction Allografting With Mesh Is Durable for Medial but Not Lateral Acetabular Defects

Eduardo García-Rey MD, PhD, EBOT, Rosario Madero Math Stat, Eduardo García-Cimbrelo MD, PhD

Most acetabular revisions are managed with cementless hemispherical or elliptical metal implants relying on bone ingrowth. Nonetheless, loss of acetabular bone stock and inability to achieve secure component fixation represent challenges in the setting of revision total hip arthroplasty. Impaction bone grafting (IBG) using allograft represents one option for treatment of this problem. However, cup migration and bone graft resorption are limitations when IBG is used for large segmental defects, and the precise role of IBG as well as the use of mesh (and the kinds of defects for which mesh does not work well) in this setting remains unknown.

Can a Conical Implant Successfully Address Complex Anatomy in Primary THA? Radiographs and Hip Scores at Early Followup

Quoqiang Zhang MD, Stuart B. Goodman MD, PhD, William J. Maloney MD, James I. Huddleston MD

Total hip arthroplasty (THA) in patients with small or abnormal proximal femoral anatomy is challenging as a result of complex anatomic deformities in the hip. It is unclear which stem is the most appropriate for these patients. One possible implant design that may help meet this need is the modified Wagner Cone prosthesis, whose design consists of monoblock cone with splines; however, to our knowledge, no clinical results have been published using this implant.

Women Demonstrate More Pain and Worse Function Before THA but Comparable Results 12 Months After Surgery

Anne F. Mannion PhD, Franco M. Impellizzeri PhD, Florian D. Naal MD, Michael Leunig MD, PhD

Many studies report differences in patient-reported outcome measures (PROMs) for men and women undergoing total hip arthroplasty (THA). Few studies have evaluated whether these are explained by corresponding differences in important preoperative factors.