Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles


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.

Does Radiographic Coxa Profunda Indicate Increased Acetabular Coverage or Depth in Hip Dysplasia?

Masanori Fujii MD, PhD, Tetsuro Nakamura MD, Toshihiko Hara MD, Yasuharu Nakashima MD, PhD, Yukihide Iwamoto MD, PhD

Although radiographic coxa profunda has been considered an indicator of acetabular overcoverage, recent studies suggest that radiographic coxa profunda is a nonspecific finding seen even in hip dysplasia. The morphologic features of coxa profunda in hip dysplasia and the frequency with which the two overlap are not well defined.

Do Claims-based Comorbidities Adequately Capture Case Mix for Surgical Site Infections?

Hilal Maradit Kremers MD, Laura W. Lewallen MD, Brian D. Lahr MS, Tad M. Mabry MD, James M. Steckelberg MD, Daniel J. Berry MD, Arlen D. Hanssen MD, Elie F. Berbari MD, Douglas R. Osmon MD

There is increasing interest in using administrative claims data for surveillance of surgical site infections in THAs and TKAs, but the performance of claims-based models for case-mix adjustment has not been well studied. Performance of claims-based models can be improved with the addition of clinical risk factors for surgical site infections.

Comparative Epidemiology of Revision Arthroplasty: Failed THA Poses Greater Clinical and Economic Burdens Than Failed TKA

Kevin J. Bozic MD, MBA, Atul F. Kamath MD, Kevin Ong PhD, Edmund Lau MS, Steve Kurtz PhD, Vanessa Chan MPH, Thomas P. Vail MD, Harry Rubash MD, Daniel J. Berry MD

Revision THA and TKA are growing and important clinical and economic challenges. Healthcare systems tend to combine revision joint replacement procedures into a single service line, and differences between revision THA and revision TKA remain incompletely characterized. These differences carry implications for guiding care and resource allocation. We therefore evaluated epidemiologic trends associated with revision THAs and TKAs.

Increased Risk of Periprosthetic Femur Fractures Associated With a Unique Cementless Stem Design

Chad D. Watts MD, Matthew P. Abdel MD, David G. Lewallen MD, Daniel J. Berry MD, Arlen D. Hanssen MD

Postoperative periprosthetic femur fractures are an increasing concern after primary total hip arthroplasty (THA). Identifying and understanding predisposing factors are important to mitigating future risk. Femoral stem design may be one such factor.