Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles


What Are the Current Clinical Issues in Wear and Tribocorrosion?

Daniel J. Berry MD, Matthew P. Abdel MD, John J. Callaghan MD

Wear and corrosion in joint arthroplasty are important causes of failure. From the standpoint of current clinical importance, there are four main categories of wear and tribocorrosion: polyethylene wear, ceramic-on-ceramic (CoC) bearing wear, metal-on-metal (MoM) bearing wear, and taper tribocorrosion. Recently, problems with wear in the knee have become less prominent as have many issues with hip polyethylene (PE) bearings resulting from the success of crosslinked PE. However, MoM articulations and taper tribocorrosion have been associated with soft tissue inflammatory responses, and as a result, they have become prominent clinical concerns.

Increased Rates of Periprosthetic Joint Infection in Patients With Cirrhosis Undergoing Total Joint Arthroplasty

Shirley L. Jiang MD, William W. Schairer MD, Kevin J. Bozic MD, MBA

Total joint arthroplasty (TJA) is becoming more prevalent, with additional increases in procedure rates expected as the US population ages. Small series have suggested increased risk of periprosthetic joint infections in patients with liver cirrhosis after TJA. However, the rates of periprosthetic joint infections and use of TJA for patients with cirrhosis have not been evaluated on a larger scale.

Hospital Costs of Total Hip Arthroplasty for Developmental Dysplasia of the Hip

Ali Ashraf MD, A. Noelle Larson MD, Hilal Maradit-Kremers MD, MSc, Walter K. Kremers PhD, David G. Lewallen MD

Developmental dysplasia of the hip (DDH) is a leading cause of total hip arthroplasty (THA) in younger patients. It is unknown how the hospital costs of THA in patients with DDH compare with patients with degenerative arthritis.

What Are the Advantages and Disadvantages of Imaging Modalities to Diagnose Wear-related Corrosion Problems?

Denis Nam MD, Robert L. Barrack MD, Hollis G. Potter MD

Adverse tissue reactions are known to occur after total hip arthroplasty using both conventional and metal-on-metal (MoM) bearings and after MoM hip resurfacing arthroplasty (SRA). A variety of imaging tools, including ultrasound (US), CT, and MRI, have been used to diagnose problems associated with wear after MoM hip arthroplasty and corrosion at the head-trunnion junction; however, the relative advantages and disadvantages of each remain a source of controversy.

Loosely Implanted Cementless Stems May Become Rotationally Stable After Loading

Arun Kannan MD, John R. Owen MS, Jennifer S. Wayne PhD, William A. Jiranek MD

Experimental studies have suggested that initial micromotion of cementless components may lead to failure of osteointegration. Roentgen stereophotogrammetric analyses have shown durable implant fixation can be achieved long-term even when initial instability exists, as evidenced by subsidence. However improved implant stability as a result of subsidence, before osteointegration, has not been shown biomechanically.

Nationwide Inpatient Sample and National Surgical Quality Improvement Program Give Different Results in Hip Fracture Studies

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

National databases are being used with increasing frequency to conduct orthopaedic research. However, there are important differences in these databases, which could result in different answers to similar questions; this important potential limitation pertaining to database research in orthopaedic surgery has not been adequately explored.

Hip Resurfacing versus Total Hip Arthroplasty: A Systematic Review Comparing Standardized Outcomes

Deborah A. Marshall PhD, Karen Pykerman MPH, Jason Werle MD, Diane Lorenzetti MLS, Tracy Wasylak CHE, MSc, BN, Tom Noseworthy MD, MSc, MPH, Donald A. Dick MD, Greg O’Connor MD, Aish Sundaram BMSc, Sanne Heintzbergen MSc, Cy Frank MD

Metal-on-metal hip resurfacing was developed for younger, active patients as an alternative to THA, but it remains controversial. Study heterogeneity, inconsistent outcome definitions, and unstandardized outcome measures challenge our ability to compare arthroplasty outcomes studies.

Fewer Postoperative Fevers: An Unexpected Benefit of Multimodal Pain Management?

Joseph A. Karam MD, Benjamin Zmistowski BS, Camilo Restrepo MD, William J. Hozack MD, Javad Parvizi MD

Elevated temperatures after total joint arthroplasty (TJA) are common and can be a source of anxiety both for the patient and the surgical team. Although such fevers rarely are caused by acute infection, many patients are subjected to extensive testing for elevated body temperature after surgery. We recently implemented a multimodal pain management regimen for TJA, which includes acetaminophen, pregabalin, and celecoxib or toradol, and because some of these medications have antipyrexic properties, it was speculated that this protocol might influence the frequency of postoperative pyrexia.

Psychologic Distress Reduces Preoperative Self-assessment Scores in Femoroacetabular Impingement Patients

Michael Q. Potter MD, James D. Wylie MD, Grant S. Sun BS, James T. Beckmann MD, Stephen K. Aoki MD

In several areas of orthopaedics, including spine and upper extremity surgery, patients with greater levels of psychologic distress report worse self-assessments of pain and function than patients who are not distressed. This effect can lead to lower than expected baseline scores on common patient-reported outcome scales, even those not traditionally considered to have a psychologic component.

Is Changing Hospitals for Revision Total Joint Arthroplasty Associated With More Complications?

Christopher J. Dy MD, MPH, Kevin J. Bozic MD, MBA, Douglas E. Padgett MD, Ting Jung Pan MPH, Robert G. Marx MD, Stephen Lyman PhD

Many patients change hospitals for revision total joint arthroplasty (TJA). The implications of changing hospitals must be better understood to inform appropriate utilization strategies.