Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 721 articles

Articles

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.

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.