Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 716 articles

Articles

Which Fixation Device is Preferred for Surgical Treatment of Intertrochanteric Hip Fractures in the United States? A Survey of Orthopaedic Surgeons

Emily Niu MD, Arthur Yang MS, Alex H. S. Harris PhD, Julius Bishop MD

The best treatment for intertrochanteric hip fractures is controversial. The use of cephalomedullary nails has increased, whereas use of sliding hip screws has decreased despite the lack of evidence that cephalomedullary nails are more effective. As current orthopaedic trainees receive less exposure to sliding hip screws, this may continue to perpetuate the preferential use of cephalomedullary nails, with important implications for resident education, evidence-based best practices, and healthcare cost.

Otto Aufranc Award: Large Heads Do Not Increase Damage at the Head-neck Taper of Metal-on-polyethylene Total Hip Arthroplasties

Georgios K. Triantafyllopoulos MD, Marcella E. Elpers BS, Jayme C. Burket PhD, Christina I. Esposito PhD, Douglas E. Padgett MD, Timothy M. Wright PhD

Fretting and corrosion at head-neck junctions of total hip arthroplasties (THAs) have been associated with adverse local tissue reactions in patients with both metal-on-polyethylene (MoP) and metal-on-metal (MoM) prostheses. Femoral head size contributes to the severity of fretting and corrosion in large-diameter MoM THAs, but its impact on such damage in MoP THAs remains unknown.

Do Patients With a Failed Metal-on-metal Hip Implant With a Pseudotumor Present Differences in Their Peripheral Blood Lymphocyte Subpopulations?

Isabelle Catelas PhD, Eric A. Lehoux PhD, Ian Hurda MSc, Stephen J. Baskey BASc, Luca Gala MD, Ryan Foster MD, Paul R. Kim MD, Paul E. Beaulé MD

Early adverse tissue reactions around metal-on-metal (MoM) hip replacements, especially pseudotumors, are a major concern. Because the causes and pathomechanisms of these pseudotumors remain largely unknown, clinical monitoring of patients with MoM bearings is challenging.

Cemented Bipolar Hemiarthroplasty Provides Definitive Treatment for Femoral Neck Fractures at 20 Years and Beyond

Philipp Roth MD, Matthew P. Abdel MD, W. Scott Harmsen MS, Daniel J. Berry MD

Displaced femoral neck fractures frequently are treated with bipolar hemiarthroplasties. Despite the frequency with which bipolar hemiarthroplasty is used to treat these fractures, there are few long-term data.

Does Cup-cage Reconstruction With Oversized Cups Provide Initial Stability in THA for Osteoporotic Acetabular Fractures?

Lucian B. Solomon MD, PhD, Patrick Studer MD, John M. Abrahams MBBS, Stuart A. Callary BAppSc, Caroline R. Moran BBTech, Roumen B. Stamenkov MD, MS, Donald W. Howie MBBS, PhD

The incidence of acetabular fractures in osteoporotic patients is increasing. Immediate total hip arthroplasty (THA) has potential advantages, but achieving acetabular component stability is challenging and, at early followup, reported revision rates for loosening are high.

Can Radiographs Predict the Use of Modular Stems in Developmental Dysplasia of the Hip?

Christopher L. Peters MD, Jesse Chrastil MD, Gregory J. Stoddard MPH, MBA, Jill A. Erickson PA-C, Mike B. Anderson MSc, Christopher E. Pelt MD

Abnormal anatomy frequently results in the use of a modular stem in patients undergoing primary total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH). However, because these stems are not always available in the operating room, it would be helpful if standard radiographic views could be analyzed in such a way that patients whose femoral anatomy might call for stem modularity could be anticipated before surgery. To our knowledge, no such parameters have been defined.

Early Lessons From a Worldwide, Multicenter, Followup Study of the Recalled Articular Surface Replacement Hip System

Rami Madanat MD, PhD, Daniel K. Hussey BA, Gabrielle S. Donahue BA, Hollis G. Potter MD, Robert Wallace MD, Charles Bragdon PhD, Orhun Muratoglu PhD, Henrik Malchau MD, PhD

Adverse local tissue reactions (ALTRs) around hip arthroplasties are an important reason for failure of metal-on-metal (MoM) hip implants. Little is known about capsular dehiscence patterns as ALTRs decompress from the hip into the surrounding tissue planes; these patterns may also influence the onset and severity of patient symptoms.

Catastrophic Femoral Neck Failure after THA with the Accolade® I Stem in Three Patients

Jonathon Spanyer MD, Jennifer Hines DO, Christopher Maxwell Beaumont BS, Jonathan Yerasimides MD

We report a series of three femoral stem failures, each occurring at the head-neck junction, with all patients experiencing limited and painful ambulation, leading to subsequent revision arthroplasty. All patients were male with high-offset femoral stems and increased head lengths, and each had undergone primary THA at a minimum of 7 years before presentation (average, 94 months). There were no associated deep infections or cases of aseptic loosening in the cohort.

What Safe Zone? The Vast Majority of Dislocated THAs Are Within the Lewinnek Safe Zone for Acetabular Component Position

Matthew P. Abdel MD, Philipp Roth MD, Matthew T. Jennings BS, Arlen D. Hanssen MD, Mark W. Pagnano MD

Numerous factors influence total hip arthroplasty (THA) stability including surgical approach and soft tissue tension, patient compliance, and component position. One long-held tenet regarding component position is that cup inclination and anteversion of 40° ± 10° and 15° ± 10°, respectively, represent a “safe zone” as defined by Lewinnek that minimizes dislocation after primary THA; however, it is clear that components positioned in this zone can and do dislocate.

Do Alumina Matrix Composite Bearings Decrease Hip Noises and Bearing Fractures at a Minimum of 5 Years After THA?

Seung-Hoon Baek MD, PhD, Won Keun Kim MD, Jun Young Kim MD, Shin-Yoon Kim MD, PhD

Ceramic-on-ceramic bearing couples are theoretically attractive in total hip arthroplasty (THA) because of low wear, but concerns regarding ceramic fracture and squeaking have arisen. Improved material properties of newer alumina matrix composite (AMC) materials, known as Delta ceramics, may reduce these risks. In addition, the use of thinner liners and larger femoral heads may be helpful clinically to lower the rate of dislocation. However, limited short-term clinical results are available and intermediate-term effects are unclear.