Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles


What Host Factors Affect Aseptic Loosening After THA and TKA?

Jeffrey J. Cherian DO, Julio J. Jauregui MD, Samik Banerjee MD, Todd Pierce MD, Michael A. Mont MD

Aseptic loosening is the most common cause for revisions after lower-extremity total joint arthroplasties, however studies differ regarding the degree to which host factors influence loosening.

What Is the Rerevision Rate After Revising a Hip Resurfacing Arthroplasty? Analysis From the AOANJRR

James Min-Leong Wong MBBS, FRCS, Yen-Liang Liu M App Stats, Stephen Graves MBBS, Richard Steiger MBBS, FRACS, FA OrthoA

More than 15,000 primary hip resurfacing arthroplasties have been recorded by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) with 884 primary procedures requiring revision for reasons other than infection, a cumulative percent revision rate at 12 years of 11%. However, few studies have reported the survivorship of these revision procedures.

Time-driven Activity-based Costing More Accurately Reflects Costs in Arthroplasty Surgery

Sina Akhavan BA, Lorrayne Ward MBA, MPP, Kevin J. Bozic MD, MBA

Cost estimates derived from traditional hospital cost accounting systems have inherent limitations that restrict their usefulness for measuring process and quality improvement. Newer approaches such as time-driven activity-based costing (TDABC) may offer more precise estimates of true cost, but to our knowledge, the differences between this TDABC and more traditional approaches have not been explored systematically in arthroplasty surgery.

Promising Mid-term Results With a Cup-cage Construct for Large Acetabular Defects and Pelvic Discontinuity

Tomas Amenabar MD, Wael A. Rahman MD, Bandar M. Hetaimish MD, Paul R. Kuzyk MD, Oleg A. Safir MD, Allan E. Gross MD

Restoring normal anatomy and achieving stable fixation of the acetabular component can be especially challenging when the surgeon must deal with severe acetabular defects and/or pelvic discontinuity. The cup-cage (CC) construct, where an ilioischial cage is cemented within a biologically fixed porous metal cup, has emerged as an excellent option to treat such challenges.

Standard Comorbidity Measures Do Not Predict Patient-reported Outcomes 1 Year After Total Hip Arthroplasty

Meridith E. Greene BA, Ola Rolfson MD, PhD, Max Gordon MD, PhD, Göran Garellick MD, PhD, Szilard Nemes PhD

Comorbidities influence surgical outcomes and therefore need to be included in risk adjustment when predicting patient-reported outcomes. However, there is no consensus on how best to use the available data about comorbidities in registry-based predictive models.

Twenty Percent of Patients May Remain Colonized With Methicillin-resistant Staphylococcus aureus Despite a Decolonization Protocol in Patients Undergoing Elective Total Joint Arthroplasty

Michael D. Baratz MD, Ruth Hallmark BSN, Susan M. Odum PhD, Bryan D. Springer MD

is the most commonly isolated organism in periprosthetic joint infection (PJI). Resistant strains such as methicillin-resistant(MRSA) are on the rise, and many programs have instituted decolonization protocols. There are limited data on the success ofnasal decolonization programs and their impact on PJI.

Revision of Metal-on-metal Hip Prostheses Results in Marked Reduction of Blood Cobalt and Chromium Ion Concentrations

Olli Lainiala BM, Aleksi Reito MD, Petra Elo MD, PhD, Jorma Pajamäki MD, PhD, Timo Puolakka MD, PhD, Antti Eskelinen MD, PhD

High revision rates attributable to adverse reactions to metal debris have been reported for total hip arthroplasties (THAs) with metal-on-metal implants and hip resurfacings. The effect of revision on blood metal ion levels is described only in small series, the clinical results of revisions have been contradictory, and concerns regarding component loosening have been presented.

Are There Sex-dependent Differences in Acetabular Dysplasia Characteristics?

Stephen T. Duncan MD, Ljiljana Bogunovic MD, Geneva Baca BA, Perry L. Schoenecker MD, John C. Clohisy MD

Many patients who undergo periacetabular osteotomy (PAO) for symptomatic acetabular dysplasia experience decreased pain and improved function, yet some experience inadequate clinical improvement. The etiologies of treatment failure have not been completely defined, and sex-dependent disease characteristics that may be associated with less pain relief are not understood.

What Is the Utility of Biomarkers for Assessing the Pathophysiology of Hip Osteoarthritis? A Systematic Review

Jeffrey J. Nepple MD, Kayla M. Thomason BS, Tonya W. An BS, Marcie Harris-Hayes DPT, John C. Clohisy MD

Innovations in biologics offer great promise in the treatment of patients with orthopaedic conditions and in advancing our ability to monitor underlying disease pathophysiology. Our understanding of the pathophysiology of hip osteoarthritis (OA) has improved significantly in the last decade. Femoroacetabular impingement (FAI) and hip dysplasia are increasingly recognized and treated as forms of prearthritic hip disease, yet the inability of radiographic and MR imaging to identify patients before the onset of irreversible articular cartilage injury limits their use for early diagnosis and treatment of patients with these conditions. Molecular biomarkers, as objectively measureable indicators of the pathophysiology of hip OA, have the potential to improve diagnosis, disease staging, and prognosis of hip OA and prearthritic hip disease. Although research into molecular biomarkers of hip OA has been conducted, investigations in prearthritic hip disease have only recently begun.

Does Surgical Hip Dislocation and Periacetabular Osteotomy Improve Pain in Patients With Perthes-like Deformities and Acetabular Dysplasia?

John C. Clohisy MD, Jeffrey J. Nepple MD, James R. Ross MD, Gail Pashos BS, Perry L. Schoenecker MD

Patients with symptomatic residual Perthes-like deformities may present with a combination of structural abnormalities including a large aspheric femoral head, short and wide femoral neck, high greater trochanter, and acetabular dysplasia. Sometimes, the hip is further compromised by concurrent symptomatic femoroacetabular impingement (FAI) (proximal femoral deformities) and structural instability (acetabular dysplasia).