Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

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.

The 2015 Frank Stinchfield Award: Radiographic Abnormalities Common in Senior Athletes With Well-functioning Hips but Not Associated With Osteoarthritis

Lucas A. Anderson MD, Mike B. Anderson MSc, Ashley Kapron PhD, Stephen K. Aoki MD, Jill A. Erickson PA-C, Jesse Chrastil MD, Ramon Grijalva MD, Christopher Peters MD

It is not known whether morphological abnormalities of the hip are compatible with lifelong hip function and avoidance of osteoarthritis (OA). Our purpose was to investigate the prevalence of radiographic findings consistent with femoroacetabular impingement (FAI) and dysplasia (DDH) in senior athletes with well-functioning hips.

Ceramic-on-ceramic THA Associated With Fewer Dislocations and Less Muscle Degeneration by Preserving Muscle Progenitors

Philippe Hernigou MD, Xavier Roussignol MD, Jerome Delambre MD, Alexandre Poignard MD, Charles-Henri Flouzat-Lachaniette MD

Dislocation is a common complication after total hip arthroplasty (THA). Although the etiology of dislocation is multifactorial, longer-term changes in muscle such as atrophy may influence the risk of prosthetic dislocation. Biological differences in wear products generated by different bearing surfaces may influence differences in the appearance of periarticular muscle after THA; however, such bearing-associated differences to our knowledge have not been studied in vivo, and few studies have evaluated bearing-associated differences in dislocation risk.

Primary Ceramic-on-ceramic Total Hip Arthroplasty Using a 32-mm Ceramic Head With a Titanium-alloy Sleeve

Seung-Jae Lim MD, Seung-Pil Jang MD, Dong-Wook Kim MD, Young-Wan Moon MD, Youn-Soo Park MD

Modern ceramic-on-ceramic bearings have become attractive alternatives to conventional polyethylene in total hip arthroplasty (THA) as a result of their low wear and minimal particle production. However, 28-mm heads in ceramic-on-ceramic bearing couples have been associated with ceramic fracture. To address these issues, 32-mm and larger ceramic heads with a titanium-alloy sleeve have been introduced, although limited data are available on their durability and clinical outcomes.

Does Native Combined Anteversion Influence Pain Onset in Patients With Dysplastic Hips?

Yusuke Kohno MD, Yasuharu Nakashima MD, PhD, Mio Akiyama MD, PhD, Masanori Fujii MD, PhD, Yukihide Iwamoto MD, PhD

Combined anteversion is the sum of femoral and acetabular anteversion and represents their morphological relationship in the axial plane. Few studies have investigated the native combined anteversion in patients with symptomatic dysplastic hips.