Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 716 articles

Articles

No Difference in Reoperations at 2 Years Between Ceramic-on-metal and Metal-on-metal THA: A Randomized Trial

C. Anderson Engh MD, Supatra Sritulanondha MPH, Abigail Korczak RN, Terrence David Whalen BS, DC, Douglas D. R. Naudie MD, Richard W. McCalden MD, Steven J. MacDonald MD

Hard-on-hard bearings for total hip arthroplasty continue to warrant analysis even though crosslinked polyethylene is performing very well. Ceramic-on-metal (CoM) has low in vitro wear and did well in an early clinical trial. We report on a prospective, randomized, multicenter investigational device trial comparing CoM with metal-on-metal (MoM).

Low Wear Rates Seen in THAs With Highly Crosslinked Polyethylene at 9 to 14 Years in Patients Younger Than Age 50 Years

Kevin L. Garvin MD, Tyler C. White BS, Anand Dusad MBBS, Curtis W. Hartman MD, John Martell MD

Patients 50 years or younger are at high risk for wear-related complications of their total hip arthroplasty (THA) because of their generally higher levels of activity. Highly crosslinked polyethylene (HXLPE) is believed to be more durable for this population than conventional polyethylene because of its improved wear; however, limited information is available on the wear of HXLPE in this population, particularly the wear of HXLPE when it articulates with alternative bearings like Oxinium (Smith & Nephew, Memphis, TN, USA).

High Rates of Interest in Sex in Patients With Hip Arthritis

Carlos J. Lavernia MD, Jesus M. Villa MD

Being sexually active has been associated with a high quality of life. Unfortunately, the topic of sexual limitations in patients undergoing total hip arthroplasty (THA) has not been well studied.

Do Oxidized Zirconium Femoral Heads Reduce Polyethylene Wear in Cemented THAs? A Blinded Randomized Clinical Trial

Amine Zaoui MD, Samer El Hage MD, Jean Langlois MD, Caroline Scemama MD, Jean Pierre Courpied MD, Moussa Hamadouche MD, PhD

Charnley low-friction torque total hip arthroplasty (THA) remains the gold standard in THA. The main cause for failure is wear of the socket. Highly crosslinked polyethylene (HXLPE) has been associated with reduced wear rates. Also, oxidized zirconium has shown in vitro reduced wear rates. However, to our knowledge, there are no data comparing oxidized zirconium femoral heads with metal heads against HXLPE or ultrahigh-molecular-weight polyethylene (UHMWPE) when 22.25-mm bearings were used, which was the same size that performed so well in Charnley-type THAs.

Are There Long-term Benefits to Cementing the Metaphyseal Stem in Hip Resurfacing?

Harlan C. Amstutz MD, Michel J. Duff MA, Sandeep K. Bhaurla MPH

Cementing the metaphyseal stem during hip resurfacing surgery improves the initial fixation of the femoral component. However, there may be long-term detrimental effects such as stress shielding or an increased risk of thermal necrosis associated with this technique.

Polyethylene Liner Dissociation Is a Complication of the DePuy Pinnacle Cup: A Report of 23 Cases

Andrew Yun MD, Emmanuel N. Koli MD, John Moreland MD, Richard Iorio MD, John F. Tilzey MD, J. Wesley Mesko MD, Gwo-Chin Lee MD, Mark Froimson MD

Polyethylene liner dissociation is a rare but catastrophic event in total hip arthroplasty (THA), and certain implant designs are known to be at greater risk. Although the DePuy Pinnacle (Warsaw, IN, USA) modular acetabular construct has an excellent record of fixation and wear, an unexpectedly high number of liner dissociations has been noted.

Are Ceramic-on-ceramic Bearings in Total Hip Arthroplasty Associated With Reduced Revision Risk for Late Dislocation?

Rocco P. Pitto MD, PhD, Mikaela Garland MBChB, Laurent Sedel MD

Dislocation is a major complication after primary total hip arthroplasty (THA), but little is known about the potential relationships between bearing materials and risk of dislocation. Dislocation within the first year after surgery is typically related to either surgical error or patient inattention to precautions, but the reasons for dislocation after the first year are often unclear, and whether ceramic bearings are associated with an increased or decreased likelihood of late dislocation is controversial.

Does Perfusion MRI After Closed Reduction of Developmental Dysplasia of the Hip Reduce the Incidence of Avascular Necrosis?

Alex L. Gornitzky BS, Andrew G. Georgiadis MD, Mark A. Seeley MD, B. David Horn MD, Wudbhav N. Sankar MD

Gadolinium-enhanced perfusion MRI (pMRI) after closed reduction/spica casting for developmental dysplasia of the hip (DDH) has been suggested as a potential means to identify and avoid avascular necrosis (AVN). To date, however, no study has evaluated the effectiveness of pMRI in clinical practice or compared it with other approaches (such as postreduction CT scan) to show a difference in the proportion of AVN.

What Is the Early/Mid-term Survivorship and Functional Outcome After Bernese Periacetabular Osteotomy in a Pediatric Surgeon Practice?

George Grammatopoulos FRCS (Tr & Orth), DPhil, Jeremy Wales MBBS, Alpesh Kothari MSc, MRCS, Harinderjit S. Gill BEng, DPhil, Andrew Wainwright FRCS (Orth), MSc, Tim Theologis MSc, PhD, FRCS

The Bernese periacetabular osteotomy (PAO) is a recognized joint-preserving procedure. Achieving joint stability without creating impingement is important, but the orientation target that best balances these sometimes competing goals has not yet been clearly defined. Moreover, the learning curve of this challenging procedure has not been described.

Adipose-derived Mesenchymal Stem Cells Are Phenotypically Superior for Regeneration in the Setting of Osteonecrosis of the Femoral Head

Cody C. Wyles BS, Matthew T. Houdek MD, Ruben J. Crespo-Diaz PhD, German A. Norambuena MD, Paul G. Stalboerger MS, Andre Terzic MD, PhD, Atta Behfar MD, PhD, Rafael J. Sierra MD

Bone marrow-derived mesenchymal stem cells (bmMSCs) have been used as a cellular therapeutic option for treatment of osteonecrosis of the femoral head. However, use of bmMSCs as a treatment adjuvant for orthopaedic disorders in general has achieved limited success. Adipose-derived MSCs (aMSCs) may be a more-efficient regenerative cell source given their greater quantity and protection from physiologic stress.