Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

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.

How Have New Bearing Surfaces Altered the Local Biological Reactions to Byproducts of Wear and Modularity?

Thomas W. Bauer MD, PhD, Patricia A. Campbell PhD, Gretchen Hallerberg MS, MSLS, AHIP

The biologic reactions to byproducts of wear or corrosion can involve innate and adaptive processes and are dependent on many factors, including the composition, size, surface properties, shape, and concentration of debris.

How Have Alternative Bearings and Modularity Affected Revision Rates in Total Hip Arthroplasty?

William M. Mihalko MD, PhD, Markus A. Wimmer PhD, Carol A. Pacione BS, Michel P. Laurent PhD, Robert F. Murphy MD, Carson Rider BS

Total hip arthroplasty (THA) continues to be one of the most successful surgical procedures in the medical field. However, over the last two decades, the use of modularity and alternative bearings in THA has become routine. Given the known problems associated with hard-on-hard bearing couples, including taper failures with more modular stem designs, local and systemic effects from metal-on-metal bearings, and fractures with ceramic-on-ceramic bearings, it is not known whether in aggregate the survivorship of these implants is better or worse than the metal-on-polyethylene bearings that they sought to replace.

Modular Tapered Implants for Severe Femoral Bone Loss in THA: Reliable Osseointegration but Frequent Complications

Nicholas M. Brown MD, Matthew Tetreault MD, Cara A. Cipriano MD, Craig J. Della Valle MD, Wayne Paprosky MD, Scott Sporer MD

Modular tapered stems have been suggested as the optimal implants for patients with severe femoral bone loss (Paprosky Type IIIB and IV) undergoing revision total hip arthroplasty (THA); however, there are few data describing survivorship and hip scores associated with this treatment.

Patient-Specific Anatomical and Functional Parameters Provide New Insights into the Pathomechanism of Cam FAI

K. C. Geoffrey Ng MASc, Mario Lamontagne PhD, Andrew P. Adamczyk MSc, Kawan S. Rahkra MD, Paul E. Beaulé MD

Femoroacetabular impingement (FAI) represents a constellation of anatomical and clinical features, but definitive diagnosis is often difficult. The high prevalence of cam deformity of the femoral head in the asymptomatic population as well as clinical factors leading to the onset of symptoms raises questions as to what other factors increase the risk of cartilage damage and hip pain.

Revisions of Monoblock Metal-on-metal THAs Have High Early Complication Rates

Louis S. Stryker MD, Susan M. Odum PhD, Thomas K. Fehring MD, Bryan D. Springer MD

A relatively high percentage of monoblock metal-on-metal total hip arthroplasties (THAs) undergo early revision. Revision of these THAs poses challenges unique to this implant type. The early complications after these revisions remain unreported as do the clinical and demographic factors associated with these complications.

Benefit of Cup Medialization in Total Hip Arthroplasty is Associated With Femoral Anatomy

Alexandre Terrier PhD, Francesc Levrero Florencio MSc, Hannes A. Rüdiger MD

Medialization of the cup with a respective increase in femoral offset has been proposed in THA to increase abductor moment arms. Insofar as there are potential disadvantages to cup medialization, it is important to ascertain whether the purported biomechanical benefits of cup medialization are large enough to warrant the downsides; to date, studies regarding this question have disagreed.