Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 723 articles

Articles

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.

An Increased Iliocapsularis-to-rectus-femoris Ratio Is Suggestive for Instability in Borderline Hips

Pascal Cyrill Haefeli MD, Simon Damian Steppacher MD, Doris Babst MD, Klaus Arno Siebenrock MD, Moritz Tannast MD

The iliocapsularis muscle is an anterior hip structure that appears to function as a stabilizer in normal hips. Previous studies have shown that the iliocapsularis is hypertrophied in developmental dysplasia of the hip (DDH). An easy MR-based measurement of the ratio of the size of the iliocapsularis to that of adjacent anatomical structures such as the rectus femoris muscle might be helpful in everyday clinical use.

Dissociation and Intrapelvic Entrapment of a Dual-mobility Polyethylene Component

Keith A. Fehring MD, Daniel J. Berry MD

Dual-mobility bearings have gained popularity in recent years as a proposed method of reducing the risk of dislocation after primary and revision hip arthroplasties. Intraprosthetic dislocation, defined as dissociation of the smaller femoral head from the larger outer polyethylene head, is a known complication of these designs. Intraprosthetic dislocation typically requires reoperation and revision as closed reduction of intraprosthetic dislocations of these components is not effective. The small femoral head typically remains inside the large diameter acetabular component during intraprosthetic dislocation, thus the diagnosis may be missed if femoral head eccentricity is not identified on radiographs. Intraprosthetic dislocation leads to a free polyethylene bearing which typically stays in the joint space, however in theory, migration of the bearing is possible.

Posterior Soft Tissue Repair After Primary THA is Durable at Mid-term Followup: A Prospective MRI Study

Alexander S. McLawhorn MD, MBA, Hollis G. Potter MD, Michael B. Cross MD, Friedrich Boettner MD, Weiyang Lim MBBS, FRCR, MMED, Yuo-yu Lee MS, Paul M. Pellicci MD

The enhanced posterior soft tissue repair has reduced the frequency of dislocation after primary THA performed through the posterolateral approach. However, the long-term integrity of the repair is unknown and could influence surgeon choice regarding surgical technique and THA approach.