Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles

Articles

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.

Does Fluoroscopy Improve Acetabular Component Placement in Total Hip Arthroplasty?

Brandon S. Beamer MD, Jordan H. Morgan BS, Christopher Barr BS, Michael J. Weaver MD, Mark S. Vrahas MD

The success of THA largely depends on correct placement of the individual components. Traditionally, these have been placed freehand using anatomic landmarks, but studies have shown poor accuracy with this method.

Hip Arthroscopy in the Setting of Hip Osteoarthritis: Systematic Review of Outcomes and Progression to Hip Arthroplasty

Joanne L. Kemp PT, PhD, David MacDonald PT, PhD, Natalie J. Collins PT, PhD, Anna L. Hatton PT, PhD, Kay M. Crossley PT, PhD

Hip arthroscopy is now commonly used to treat hip pain and pathology, including osteoarthritis (OA). Despite this, little is known about the effect of hip arthroscopy on outcomes of pain and function and progression to total hip arthroplasty (THA) in hip OA.

Which Radiographic Hip Parameters Do Not Have to Be Corrected for Pelvic Rotation and Tilt?

Moritz Tannast MD, Stefan Fritsch MD, Guoyan Zheng PhD, Klaus A. Siebenrock MD, Simon D. Steppacher MD

Acetabular anatomy on AP pelvic radiographs depends on pelvic orientation during radiograph acquisition. However, not all parameters may change to a clinically relevant degree with differences in pelvic orientation. This issue may influence the diagnosis of acetabular pathologies and planning of corrective acetabular surgery (reorientation or rim trimming). However, to this point, it has not been well characterized.

Subject-specific Patterns of Femur-labrum Contact are Complex and Vary in Asymptomatic Hips and Hips With Femoroacetabular Impingement

Ashley L. Kapron PhD, Stephen K. Aoki MD, Christopher L. Peters MD, Andrew E. Anderson PhD

Femoroacetabular impingement (FAI) may constrain hip articulation and cause chondrolabral damage, but to our knowledge, in vivo articulation and femur-labrum contact patterns have not been quantified.