Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 716 articles

Articles

Are Readmissions After THA Preventable?

Douglas S. Weinberg MD, Matthew J. Kraay MD, Steven J. Fitzgerald MD, Vasu Sidagam MD, Glenn D. Wera MD

Readmissions after total joint arthroplasty have become a key quality measure in elective surgery in the United States. The Affordable Care Act includes the Hospital Readmission Reduction Program, which calls for reduced payments to hospitals with excessive readmissions. This policy uses a method to determine excess readmission ratios and calculate readmission payment adjustments to hospitals, however, it is unclear whether readmission rates are an effective quality metric. The reasons or conditions associated with readmission after elective THA have been well established but the extent to which readmissions can be prevented after THA remains unclear.

Three Patterns of Acetabular Deficiency Are Common in Young Adult Patients With Acetabular Dysplasia

Jeffrey J. Nepple MD, Joel Wells MD, MPH, James R. Ross MD, Asheesh Bedi MD, Perry L. Schoenecker MD, John C. Clohisy MD

Detailed recognition of the three-dimensional (3-D) deformity in acetabular dysplasia is important to help guide correction at the time of reorientation during periacetabular osteotomy (PAO). Common plain radiographic parameters of acetabular dysplasia are limited in their ability to characterize acetabular deficiency precisely. The 3-D characterization of such deficiencies with low-dose CT may allow for more precise characterization.

Periprosthetic Occult Fractures of the Acetabulum Occur Frequently During Primary THA

Kazuhiro Hasegawa MD, Tamon Kabata MD, PhD, Yoshitomo Kajino MD, PhD, Daisuke Inoue MD, Hiroyuki Tsuchiya MD, PhD

Periprosthetic fractures of the acetabulum occurring during primary THA are rare. Periprosthetic occult fractures are defined as those not identified by the surgeon during the procedure which might be missed on a routine postoperative radiograph. However, it is unclear how frequently these fractures occur and whether their presence affects functional recovery.

The Femoro-Epiphyseal Acetabular Roof (FEAR) Index: A New Measurement Associated With Instability in Borderline Hip Dysplasia?

Michael Wyatt FRACS, Jan Weidner MD, Dominik Pfluger PhD, Martin Beck PD, MD

The definition of osseous instability in radiographic borderline dysplastic hips is difficult. A reliable radiographic tool that aids decision-making—specifically, a tool that might be associated with instability—therefore would be very helpful for this group of patients.

Both 3-T dGEMRIC and Acetabular-Femoral T2 Difference May Detect Cartilage Damage at the Chondrolabral Junction

Tobias Hesper MD, Evgeny Bulat MA, Sarah Bixby MD, Alireza Akhondi-Asl PhD, Onur Afacan PhD, Patricia Miller MS, Garrett Bowen BS, Simon Warfield PhD, Young-Jo Kim MD, PhD

In addition to case reports of gadolinium-related toxicities, there are increasing theoretical concerns about the use of gadolinium for MR imaging. As a result, there is increasing interest in noncontrast imaging techniques for biochemical cartilage assessment. Among them, T2 mapping holds promise because of its simplicity, but its biophysical interpretation has been controversial.

Femoral Morphology in the Dysplastic Hip: Three-dimensional Characterizations With CT

Joel Wells MD, MPH, Jeffrey J. Nepple MD, Karla Crook BS, James R. Ross MD, Asheesh Bedi MD, Perry Schoenecker MD, John C. Clohisy MD

Hip dysplasia represents a spectrum of complex deformities on both sides of the joint. Although many studies have described the acetabular side of the deformity, to our knowledge, little is known about the three-dimensional (3-D) head and neck offset differences of the femora of dysplastic hips. A thorough knowledge of proximal femoral anatomy is important to prevent potential impingement and improve results after acetabular reorientation.

What Are the Risk Factors for Revision Surgery After Hip Arthroscopy for Femoroacetabular Impingement at 7-year Followup?

Pascal Cyrill Haefeli MD, Christoph Emanuel Albers MD, Simon Damian Steppacher MD, Moritz Tannast MD, Lorenz Büchler MD

In recent years, surgical treatment of symptomatic femoroacetabular impingement (FAI) has been increasingly performed using arthroscopy. Bony pathomorphologies and damage to the labrum as well as cartilage defects can be addressed with comparable results to open surgery with overall less surgery-related complications. Despite the increasing importance of hip arthroscopy, however, reports on midterm clinical and radiographic outcomes and comparison to open surgical hip dislocation are scarce.

Labral Reattachment in Femoroacetabular Impingement Surgery Results in Increased 10-year Survivorship Compared With Resection

Helen Anwander MD, Klaus A. Siebenrock MD, Moritz Tannast MD, Simon D. Steppacher MD

Since the importance of an intact labrum for normal hip function has been shown, labral reattachment has become the standard method for open or arthroscopic treatment of hips with femoroacetabular impingement (FAI). However, no long-term clinical results exist evaluating the effect of labral reattachment. A 2-year followup comparing open surgical treatment of FAI with labral resection versus reattachment was previously performed at our clinic. The goal of this study was to report a concise followup of these patients at a minimum of 10 years.

Reconstruction of the Shallow Acetabulum With a Combination of Autologous Bulk and Impaction Bone Grafting Fixed by Cement

Masaaki Maruyama MD, PhD, Shinji Wakabayashi MD, PhD, Hiroshi Ota MD, PhD, Keiji Tensho MD, PhD

Acetabular bone deficiency, especially proximal and lateral deficiency, is a difficult technical problem during primary total hip arthroplasty (THA) in developmental dysplasia of the hip (DDH). We report a new reconstruction method using a medial-reduced cemented socket and additional bulk bone in conjunction with impaction morselized bone grafting (additional bulk bone grafting method).

How Does the dGEMRIC Index Change After Surgical Treatment for FAI? A Prospective Controlled Study: Preliminary Results

Florian Schmaranzer MD, Pascal C. Haefeli MD, Markus S. Hanke MD, Emanuel F. Liechti MD, MSc, Stefan F. Werlen MD, Klaus A. Siebenrock MD, Moritz Tannast MD

Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) allows an objective, noninvasive, and longitudinal quantification of biochemical cartilage properties. Although dGEMRIC has been used to monitor the course of cartilage degeneration after periacetabular osteotomy (PAO) for correction of hip dysplasia, such longitudinal data are currently lacking for femoroacetabular impingement (FAI).