Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles


Head Reduction Osteotomy With Additional Containment Surgery Improves Sphericity and Containment and Reduces Pain in Legg-Calvé-Perthes Disease

Klaus A. Siebenrock MD, Helen Anwander MD, Corinne A. Zurmühle MD, Moritz Tannast MD, Theddy Slongo MD, Simon D. Steppacher MD

Severe femoral head deformities in the frontal plane such as hips with Legg-Calvé-Perthes disease (LCPD) are not contained by the acetabulum and result in hinged abduction and impingement. These rare deformities cannot be addressed by resection, which would endanger head vascularity. Femoral head reduction osteotomy allows for reshaping of the femoral head with the goal of improving head sphericity, containment, and hip function.

Does the Nature of Chondrolabral Injury Affect the Results of Open Surgery for Femoroacetabular Impingement?

Christopher L. Peters MD, Lucas A. Anderson MD, Claudio Diaz-Ledezma MD, Mike B. Anderson MS, ATC, Javad Parvizi MD

The degree to which patient characteristics, clinical outcomes, and the nature, severity, and corresponding treatment of chondrolabral injury in femoroacetabular impingement (FAI) is associated with failure after surgery is incompletely understood.

What Are the Radiographic Reference Values for Acetabular Under- and Overcoverage?

Moritz Tannast MD, Markus S. Hanke MD, Guoyan Zheng PhD, Simon D. Steppacher MD, Klaus A. Siebenrock MD

Both acetabular undercoverage (hip dysplasia) and overcoverage (pincer-type femoroacetabular impingement) can result in hip osteoarthritis. In contrast to undercoverage, there is a lack of information on radiographic reference values for excessive acetabular coverage.

Can Combining Femoral and Acetabular Morphology Parameters Improve the Characterization of Femoroacetabular Impingement?

Heinse W. Bouma MD, Tom Hogervorst MD, PhD, Emmanuel Audenaert MD, PhD, Peter Krekel PhD, Paulien M. Kampen PhD

Femoroacetabular impingement (FAI) presupposes a dynamic interaction of the proximal femur and acetabulum producing clinical symptoms and chondrolabral damage. Currently, FAI classification is based on alpha angle and center-edge angle measurements in a single plane. However, acetabular and femoral version and neck-shaft angle also influence FAI. Furthermore, each of these parameters has a reciprocal interaction with the others; for example, a shallow acetabulum delays impingement of the femoral head with the acetabular rim.

Relative Femoral Neck Lengthening Improves Pain and Hip Function in Proximal Femoral Deformities With a High-riding Trochanter

Christoph E. Albers MD, Simon D. Steppacher MD, Joseph M. Schwab MD, Moritz Tannast MD, Klaus A. Siebenrock MD

Complex proximal femoral deformities, including an elevated greater trochanter, short femoral neck, and aspherical head-neck junction, often result in pain and impaired hip function resulting from intra-/extraarticular impingement. Relative femoral neck lengthening may address these deformities, but mid-term results of this approach have not been widely reported.

What Clinimetric Evidence Exists for Using Hip-specific Patient-reported Outcome Measures in Pediatric Hip Impingement?

Agnes G. d’Entremont PhD, Anthony P. Cooper FRCS, Ashok Johari FAMS, Kishore Mulpuri MS(Ortho)

Patient-reported outcomes (PROs) are an increasingly popular research tool used to evaluate the outcomes of surgical intervention. If applied appropriately, they can be useful both for disease monitoring and as a method of assessing the efficacy of treatment. Many disorders can lead to impingement in children and adolescents, but it is not clear if any PROs have been validated to evaluate outcomes in these populations.

Similar Clinical Outcomes for THAs With and Without Prior Periacetabular Osteotomy

Derek F. Amanatullah MD, PhD, Louis Stryker MD, Perry Schoenecker MD, Michael J. Taunton MD, John C. Clohisy MD, Robert T. Trousdale MD, Rafael J. Sierra MD

Some patients opt to undergo conversion to a THA for continued pain or progression of hip arthritis after periacetabular osteotomy. Whether patients are at greater risk for postoperative complications, revision THA, poor clinical outcomes, or compromised radiographic results after periacetabular osteotomy is debatable.

Eighty Percent of Patients With Surgical Hip Dislocation for Femoroacetabular Impingement Have a Good Clinical Result Without Osteoarthritis Progression at 10 Years

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

We previously reported the 5-year followup of hips with femoroacetabular impingement (FAI) that underwent surgical hip dislocation with trimming of the head-neck junction and/or acetabulum including reattachment of the labrum. The goal of this study was to report a concise followup of these patients at a minimum 10 years.

No Regeneration of the Human Acetabular Labrum After Excision to Bone

Hermes H. Miozzari MD, Marco Celia MD, John M. Clark MD, PhD, Stefan Werlen MD, Florian D. Naal MD, Hubert P. Nötzli MD

Treatment options for a symptomatic, torn, irreparable, or completely ossified acetabular labrum are limited to either excision and/or reconstruction with grafts. In a previous animal model, regeneration of the acetabular labrum after excision to the bony rim has been shown. In humans, less is known about the potential of regeneration of the labrum. Recent studies seem to confirm labral regrowth, but it is still unclear if wide excision might be a surgical option in cases where repair is not possible.

How Do Acetabular Version and Femoral Head Coverage Change With Skeletal Maturity?

Andreas M. Hingsammer MD, Sarah Bixby MD, David Zurakowski PhD, Yi-Meng Yen MD, PhD, Young-Jo Kim MD, PhD

Normal changes in acetabular version over the course of skeletal development have not been well characterized. Knowledge of normal version development is important because acetabular retroversion has been implicated in several pathologic hip processes.