Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 724 articles

Articles

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.

Is Embolization an Effective Treatment for Recurrent Hemorrhage After Hip or Knee Arthroplasty?

Peter I. Kalmar MD, Andreas Leithner MD, Reinhard Ehall MD, Rupert Horst Portugaller MD

Spontaneous recurrent hemorrhage after arthroplasty of the hip or knee is a rare condition. In patients who do not have coagulopathy, the likeliest etiology for hemarthrosis is hypertrophic vascular synovium. Treatments include arthroscopic or open synovectomy, or angiography with embolization; however, because the condition is rare, seldom reported, and debilitating, small case series characterizing the efficacy of any approach are important to allow a collective experience with this condition to emerge.

Is There a Benefit to Modularity in ‘Simpler’ Femoral Revisions?

James I. Huddleston MD, Matthew W. Tetreault MD, Michael Yu MD, Hany Bedair MD, Viktor J. Hansen MD, Ho-Rim Choi MD, Stuart B. Goodman MD, PhD, Scott M. Sporer MD, Craig J. Della Valle MD

Modular revision femoral components allow the surgeon to make more precise intraoperative adjustments in anteversion and sizing, which may afford lower dislocation rates and improved osseointegration, but may not offer distinct advantages when compared with less expensive monoblock revision stems.

Backside Wear Is Not Dependent on the Acetabular Socket Design in Crosslinked Polyethylene Liners

Kamal Bali MBBS, MS, DNB, Richard W. McCalden MD, MPhil, FRCSC, Douglas D. R. Naudie MD, FRCSC, Steven J. MacDonald MD, FRCSC, Matthew G. Teeter PhD

Although it is understood that backside damage occurs in polyethylene acetabular liners, the effect of highly crosslinked polyethylene, which has completely replaced conventional polyethylene, has yet to be examined.

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.