Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles


Retrieval Analysis of Sequentially Annealed Highly Crosslinked Polyethylene Used in Total Hip Arthroplasty

Steven M. Kurtz PhD, Daniel W. MacDonald MS, Michael A. Mont MD, Javad Parvizi MD, Arthur L. Malkani MD, William Hozack MD

First-generation annealed and second-generation sequentially annealed, highly crosslinked polyethylenes (HXLPEs) have documented reduced clinical wear rates in their first decade of clinical use compared with conventional gamma inert-sterilized polyethylene. However, for both types of annealed HXLPE formulations, little is known about their reasons for revision, their in vivo oxidative stability, and their resistance to mechanical degradation.

Does Previous Pelvic Osteotomy Compromise the Results of Periacetabular Osteotomy Surgery?

Jeffrey B. Stambough MD, John C. Clohisy MD, Geneva R. Baca BA, Ira Zaltz MD, Robert Trousdale MD, Michael Millis MD, Daniel Sucato MD, MS, Young-Jo Kim MD, PhD, Ernest Sink MD, Perry L. Schoenecker MD, Rafael Sierra MD, David Podeszwa MD, Paul Beaulé MD

As the Bernese periacetabular osteotomy (PAO) has grown in popularity, specific indications and the results in patients treated for those indications need to be evaluated. Currently, although many patients undergo PAO after having had prior pelvic osteotomy, there is limited information regarding the efficacy of the PAO in these patients.

Short-term Complications Have More Effect on Cost-effectiveness of THA than Implant Longevity

David W. Shearer MD, MPH, Jiwon Youm MD, MS, Kevin J. Bozic MD, MBA

Outcomes research in THA has focused largely on long-term implant survivorship as a primary outcome and emphasized the development of new implant technologies. In contrast, strategies to improve short-term outcomes, such as the frequencies of periprosthetic joint infections and unplanned readmissions, have received less attention.

Sex Differences in Cartilage Topography and Orientation of the Developing Acetabulum: Implications for Hip Preservation Surgery

Jonathan B. Peterson MD, Josh Doan MEng, James D. Bomar MPH, Dennis R. Wenger MD, Andrew T. Pennock MD, Vidyadhar V. Upasani MD

Increased attention is being placed on hip preservation surgery in the early adolescent. An understanding of three-dimensional (3-D) acetabular development as children approach maturity is essential. Changes in acetabular orientation and cartilage topography have not previously been quantified as the adolescent acetabulum completes development.

Metal-on-conventional Polyethylene Total Hip Arthroplasty Bearing Surfaces Have a Higher Risk of Revision Than Metal-on-highly Crosslinked Polyethylene: Results From a US Registry

Elizabeth W. Paxton MA, Maria C. S. Inacio PhD, Robert S. Namba MD, Rebecca Love MPH, RN, Steven M. Kurtz PhD

Although studies have reported lower radiological wear in highly crosslinked polyethylene (HXLPE) versus conventional polyethylene in total hip arthroplasty (THA), there is limited clinical evidence on the risk of revision of these polyethylene THA bearing surfaces.

Functional Acetabular Orientation Varies Between Supine and Standing Radiographs: Implications for Treatment of Femoroacetabular Impingement

James R. Ross MD, Eric P. Tannenbaum MD, Jeffrey J. Nepple MD, Bryan T. Kelly MD, Christopher M. Larson MD, Asheesh Bedi MD

Often, anteroposterior (AP) pelvic radiographs are performed with the patient positioned supine. However, this may not represent the functional position of the pelvis and the acetabulum, and so when assessing patients for conditions like femoroacetabular impingement (FAI), it is possible that standing radiographs better incorporate the dynamic influences of periarticular musculature and sagittal balance. However, this thesis remains largely untested.

How Are Dysplastic Hips Different? A Three-dimensional CT Study

Harold Bosse MD, John H. Wedge MD, Paul Babyn MD

Surgical correction of acetabular dysplasia can postpone or prevent joint degeneration. The specific abnormalities that make up the dysplastic hip are controversial.

Topical Tranexamic Acid Does Not Affect Electrophysiologic or Neurovascular Sciatic Nerve Markers in an Animal Model

Ran Schwarzkopf MD, MSc, Phuc Dang MD, Michele Luu, Tahseen Mozaffar MD, Ranjan Gupta MD

Tranexamic acid is a safe and effective antifibrinolytic agent used systemically and topically to reduce blood loss and transfusion rate in patients having TKA or THA. As the hip does not have a defined capsule, topical application of tranexamic acid may entirely envelop the sciatic nerve during THA. Accidental application of tranexamic acid onto the spinal cord in spinal anesthesia has been shown to produce seizures; therefore, we sought to investigate if topical application of tranexamic acid on the sciatic nerve has a deleterious effect.

The EQ-5D-5L Improves on the EQ-5D-3L for Health-related Quality-of-life Assessment in Patients Undergoing Total Hip Arthroplasty

Meridith E. Greene BA, Kevin A. Rader PhD, Göran Garellick MD, PhD, Henrik Malchau MD, PhD, Andrew A. Freiberg MD, Ola Rolfson MD, PhD

The EQ-5D is a generic health survey that can be used to compare improvement across different interventions, measure changes in health-related quality of life over time, or to explore cost-effectiveness among treatments, hospitals, or providers. The original EQ-5D survey has three response options for each of five health dimensions; however, with so few response options, ceiling and floor effects are problematic in some populations. A new version, called the EQ-5D-5L, was developed, which gives respondents five answer options (the “5L” refers to five response levels, which is in contrast to the original survey’s three levels). However, the validity of this version has not, to our knowledge, been evaluated in patients undergoing total hip arthroplasty (THA).

Periacetabular Osteotomy Restores the Typically Excessive Range of Motion in Dysplastic Hips With a Spherical Head

Simon D. Steppacher MD, Corinne A. Zurmühle MD, Marc Puls PhD, Klaus A. Siebenrock MD, Michael B. Millis MD, Young-Jo Kim MD, PhD, Moritz Tannast MD

Residual acetabular dysplasia is seen in combination with femoral pathomorphologies including an aspherical femoral head and valgus neck-shaft angle with high antetorsion. It is unclear how these femoral pathomorphologies affect range of motion (ROM) and impingement zones after periacetabular osteotomy.