Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

What Are the Demographic and Radiographic Characteristics of Patients With Symptomatic Extraarticular Femoroacetabular Impingement?

Benjamin F. Ricciardi MD, Peter D. Fabricant MD, MPH, Kara G. Fields MS, Lazaros Poultsides MD, MS, PhD, Ira Zaltz MD, Ernest L. Sink MD

Extraarticular femoroacetabular impingement (FAI) can result in symptomatic hip pain, but preoperative demographic, radiographic, and physical examination findings have not been well characterized.

Can Femoral Rotation Be Localized and Quantified Using Standard CT Measures?

Andrew G. Georgiadis MD, Daniel S. Siegal MD, Courtney E. Scher DO, Ira Zaltz MD

The terms “femoral anteversion” and “femoral torsion” have often been used interchangeably in the orthopaedic literature, yet they represent distinct anatomical entities. Anteversion refers to anterior tilt of the femoral neck, whereas torsion describes rotation of the femoral shaft. Together, these and other transverse plane differences describe what may be considered rotational deformities of the femur. Assessment of femoral rotation is now routinely measured by multiple axial CT methods. The most widely used radiographic technique (in which only two CT-derived axes are made, one through the femoral neck and one at the distal femoral condyles) may not accurately quantify proximal femoral anatomy nor allow identification of the anatomic locus of rotation.

Do Sex and BMI Predict or Does Stem Design Prevent Muscle Damage in Anterior Supine Minimally Invasive THA?

Benjamin M. Frye MD, Keith R. Berend MD, Adolph V. Lombardi MD, Michael J. Morris MD, Joanne B. Adams BFA

Cadaveric and clinical studies have suggested that, despite being touted as muscle-sparing, the direct anterior approach is still associated with muscle damage, particularly to the tensor fascia lata (TFL). Patient body mass index (BMI) and/or sex may also influence this parameter.

What Factors Predict Improvements in Outcomes Scores and Reoperations After the Bernese Periacetabular Osteotomy?

Paul E. Beaulé MD, Chris Dowding MD, Gillian Parker BSc, Jae-Jin Ryu PhD

The Bernese periacetabular osteotomy (PAO) has entered its fourth decade and is frequently used for corrective osteotomy in patients with acetabular dysplasia. Although our capacity to preserve the joint after corrective osteotomy is excellent, gaining a better understanding on how well patients function after this surgery is important as well.

Large-diameter Metal-on-metal Total Hip Arthroplasty: Dislocation Infrequent but Survivorship Poor

Adolph V. Lombardi MD, Keith R. Berend MD, Michael J. Morris MD, Joanne B. Adams BFA, Michael A. Sneller BS

Use of large-diameter metal-on-metal (MoM) articulations in THA increased, at least in part, because of the possibility of achieving improved joint stability and excellent wear characteristics in vitro. However, there have been subsequent concerning reports with adverse reactions to metal debris (ARMD), pseudotumors, and systemic complications related to metal ions.

Are Custom Triflange Acetabular Components Effective for Reconstruction of Catastrophic Bone Loss?

Carl C. Berasi MD, Keith R. Berend MD, Joanne B. Adams BFA, Erin L. Ruh MS, Adolph V. Lombardi MD

Although the introduction of ultraporous metals in the forms of acetabular components and augments has increased the orthopaedic surgeon’s ability to reconstruct severely compromised acetabuli, there remain some that cannot be managed readily using cups, augments, or cages. In such situations, allograft-prosthetic composites or custom acetabular components may be called for. However, few studies have reported on the results of these components.

Modern Trunnions Are More Flexible: A Mechanical Analysis of THA Taper Designs

David A. Porter MD, Robert M. Urban PhD, Joshua J. Jacobs MD, Jeremy L. Gilbert PhD, José A. Rodriguez MD, H. John Cooper MD

There is renewed concern surrounding the potential for corrosion at the modular head-neck junction to cause early failure in contemporary THAs. Although taper corrosion involves a complex interplay of many factors, a previous study suggested that a decrease in flexural rigidity of the femoral trunnion may be associated with an increased likelihood of corrosion at retrieval.

Revision Surgery Occurs Frequently After Percutaneous Fixation of Stable Femoral Neck Fractures in Elderly Patients

Michael S. Kain MD, Andrew J. Marcantonio DO, Richard Iorio MD

Femoral neck fractures are a major public health problem. Multiple-screw fixation is the most commonly used surgical technique for the treatment of stable femoral neck fractures.

Are Younger Patients Undergoing THA Appropriately Characterized as Active?

James A. Keeney MD, Ryan M. Nunley MD, Geneva R. Baca BA, John C. Clohisy MD

Surgeons perform THA to address a variety of conditions in younger patients, including osteoarthritis (OA), osteonecrosis, inflammatory arthritis, and congenital deformities. Younger patients aged 50 years or younger have been characterized as active in the literature, but a direct relationship between age and activity level has not been well substantiated. Younger patients with OA may engage in higher activity levels; however, associated medical conditions in patients with other surgical indications may not support a generalization that age is a surrogate for activity level. We recently evaluated these issues in younger patients undergoing total knee arthroplasty (TKA) and noted that the majority would not be considered active. Given this observation, we considered whether younger patients undergoing THA are characterized by high activity levels, which is relevant to understanding the long-term risk of wear-related failures.

Diabetes Confers Little to No Increased Risk of Postoperative Complications After Hip Fracture Surgery in Geriatric Patients

Nicholas S. Golinvaux BA, Daniel D. Bohl MPH, Bryce A. Basques BS, Michael R. Baumgaertner MD, Jonathan N. Grauer MD

Diabetes and hip fractures in geriatric patients are common, and many elderly patients have a history of diabetes. However, the influence of diabetes on surgical complications may vary based on which particular type of diabetes a patient has. To our knowledge, no prior study has stratified patients with diabetes to compare patients with noninsulin-dependent and insulin-dependent diabetes regarding rates of postoperative adverse events, length of hospitalization, and readmission rate after surgical stabilization of hip fractures in geriatric patients.