Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles

Articles

Does the Risk Assessment and Prediction Tool Predict Discharge Disposition After Joint Replacement?

Viktor J. Hansen MD, Kirill Gromov MD, PhD, Lauren M. Lebrun MHA, Harry E. Rubash MD, Henrik Malchau MD, PhD, Andrew A. Freiberg MD

Payers of health services and policymakers place a major focus on cost containment in health care. Studies have shown that early planning of discharge is essential in reducing length of stay and achieving financial benefit; tools that can help predict discharge disposition would therefore be of use. The Risk Assessment and Prediction Tool (RAPT) is a preoperative survey constructed to predict discharge disposition after total joint arthroplasty (TJA). The RAPT was developed and tested on a population of Australian patients undergoing joint replacement, but its validity in other populations is unknown. A low RAPT score is reported to indicate a high risk of needing any form of inpatient rehabilitation after TJA, including short-term nursing facilities.

Biochemical MRI Predicts Hip Osteoarthritis in an Experimental Ovine Femoroacetabular Impingement Model

Klaus A. Siebenrock MD, Karl-Philipp Kienle MD, Simon D. Steppacher MD, Moritz Tannast MD, Tallal C. Mamisch MD, Brigitte Rechenberg MD

Cam-type femoroacetabular impingement (FAI) resulting from an abnormal nonspherical femoral head shape leads to chondrolabral damage and is considered a cause of early osteoarthritis. A previously developed experimental ovine FAI model induces a cam-type impingement that results in localized chondrolabral damage, replicating the patterns found in the human hip. Biochemical MRI modalities such as T2 and T2* may allow for evaluation of the cartilage biochemistry long before cartilage loss occurs and, for that reason, may be a worthwhile avenue of inquiry.

Preservation of the Rectus Femoris Origin During Periacetabular Osteotomy Does Not Compromise Acetabular Reorientation

Christopher L. Peters MD, Jill A. Erickson PA-C, Mike B. Anderson MS, ATC, Lucas A. Anderson MD

The early recovery period after periacetabular osteotomy (PAO) can be limited by pain and activity restrictions. Modifications of the Bernese PAO, including sparing the rectus tendon and discontinuing routine arthrotomy, may accelerate early postoperative recovery compared with the standard approach.

The National Hospital Discharge Survey and Nationwide Inpatient Sample: The Databases Used Affect Results in THA Research

Stijn Bekkers BSc, Arjan G. J. Bot MD, PhD, Dennis Makarawung BSc, Valentin Neuhaus MD, David Ring MD, PhD

The National Hospital Discharge Survey (NHDS) and the Nationwide Inpatient Sample (NIS) collect sample data and publish annual estimates of inpatient care in the United States, and both are commonly used in orthopaedic research. However, there are important differences between the databases, and because of these differences, asking these two databases the same question may result in different answers. The degree to which this is true for arthroplasty-related research has, to our knowledge, not been characterized.

Is the T1ρ MRI Profile of Hyaline Cartilage in the Normal Hip Uniform?

Kawan S. Rakhra MD, Arturo Cárdenas-Blanco PhD, Gerd Melkus PhD, Mark E. Schweitzer MD, Ian G. Cameron PhD, Paul E. Beaulé MD

T1ρ MRI is an imaging technique sensitive to proteoglycan (PG) content of hyaline cartilage. However, normative T1ρ values have not been established for the weightbearing cartilage of the hip, and it is not known whether it is uniform or whether there is topographic variation. Knowledge of the T1ρ profile of hyaline cartilage in the normal hip is important for establishing a baseline against which comparisons can be made to experimental and clinical arthritic subjects.

Direct Anterior versus Miniposterior THA With the Same Advanced Perioperative Protocols: Surprising Early Clinical Results

Kirsten L. Poehling-Monaghan MD, Atul F. Kamath MD, Michael J. Taunton MD, Mark W. Pagnano MD

Although some surgeons strongly advocate for one approach over the other, there are few data directly comparing the direct anterior approach with a miniposterior approach for total hip arthroplasty (THA).

What Are the Predictors and Prevalence of Pseudotumor and Elevated Metal Ions After Large-diameter Metal-on-metal THA?

Nick Bayley MD, Habeeb Khan MBBS, Paul Grosso MD, Thomas Hupel MD, David Stevens MD, Matthew Snider MD, Emil Schemitsch MD, Paul Kuzyk MD, MSc

Soft tissue masses, or “pseudotumors,” around metal-on-metal total hip arthroplasty (MoM THA) have been reported frequently; however, their prevalence remains unknown. Several risk factors, including elevated metal ion levels, have been associated with the presence of pseudotumor, although this remains controversial.

Surgery for Hip Fracture Yields Societal Benefits That Exceed the Direct Medical Costs

Qian Gu PhD, Lane Koenig PhD, Richard C. Mather MD, John Tongue MD

A hip fracture is a debilitating condition that consumes significant resources in the United States. Surgical treatment of hip fractures can achieve better survival and functional outcomes than nonoperative treatment, but less is known about its economic benefits.

Preoperative Erythropoietin Alpha Reduces Postoperative Transfusions in THA and TKA but May Not Be Cost-effective

Hany Bedair MD, Judy Yang MD, Maureen K. Dwyer PhD, ATC, Joseph C. McCarthy MD

Preoperative erythropoietin alpha (EPO) has been shown to be effective at reducing postoperative blood transfusions in total hip arthroplasty (THA) and total knee arthroplasty (TKA); however, treatment with EPO is associated with additional costs, and it is not known whether these costs can be justified when weighed against the transfusion reductions achieved in patients who receive the drug.

The 2014 Frank Stinchfield Award: The ‘Landing Zone’ for Wear and Stability in Total Hip Arthroplasty Is Smaller Than We Thought: A Computational Analysis

Jacob M. Elkins MD, PhD, John J. Callaghan MD, Thomas D. Brown PhD

Positioning of total hip bearings involves tradeoffs, because cup orientations most favorable in terms of stability are not necessarily ideal in terms of reduction of contact stress and wear potential. Previous studies and models have not addressed these potentially competing considerations for optimal total hip arthroplasty (THA) function.