Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 723 articles

Articles

Modular versus Nonmodular Neck Femoral Implants in Primary Total Hip Arthroplasty: Which is Better?

Paul J. Duwelius MD, Bob Burkhart PA, Clay Carnahan PA, Grant Branam BSc, Laura Matsen Ko MD, YingXing Wu MD, Cecily Froemke MS, Lian Wang MS, Gary Grunkemeier PhD

Restoration of the hip center is considered important for a successful THA and requires achieving the right combination of offset, anteversion, and limb length. Modular femoral neck designs were introduced to make achieving this combination easier. No previous studies have compared these designs in primary THA, and there is increasing concern that modular designs may have a higher complication rate than their nonmodular counterparts.

Symptomatic Pulmonary Embolus After Joint Arthroplasty: Stratification of Risk Factors

Javad Parvizi MD, Ronald Huang MD, Ibrahim J. Raphael MD, William V. Arnold MD, PhD, Richard H. Rothman MD, PhD

Prophylaxis for pulmonary embolism (PE) after total joint arthroplasty (TJA) presents the clinical dilemma of balancing the risk of postoperative thrombotic risk and anticoagulation-related complications such as bleeding, hematoma formation, and infection. Risk stratification of patients undergoing TJA is needed to tailor prophylaxis based on thrombotic and bleeding risk.

Long-term Results and Bone Remodeling After THA With a Short, Metaphyseal-fitting Anatomic Cementless Stem

Young-Hoo Kim MD, Jang-Won Park MD, Jun-Shik Kim MD, Jun-Seok Kang MD

Long-term results of standard total hip arthroplasty (THA) in young patients were not optimal. There are a number of reported disadvantages to longer cementless stems in THA including thigh pain and proximal stress shielding. However, it is unknown whether a short, metaphyseal-fitting anatomic stem without diaphyseal fixation, which represents a possible alternative, will maintain fixation over the longer term.

Efficacy of Revision Surgery for the Dislocating Total Hip Arthroplasty: Report From a Large Community Registry

Tiare Salassa MD, Daniel Hoeffel MD, Susan Mehle BS, Penny Tatman MPH, Terence J. Gioe MD

Historically, achieving stability for the unstable total hip arthroplasty (THA) with revision surgery has been achieved inconsistently. Most of what we know about this topic comes from reports of high-volume surgeons’ results; the degree to which these results are achieved in the community is largely unknown, but insofar as most joint replacements are done by community surgeons, the issue is important.

Total Hip Arthroplasty Performed in Patients with Residual Poliomyelitis: Does it Work?

Byung-Ho Yoon MD, Young-Kyun Lee MD, Jeong Joon Yoo MD, PhD, Hee Joong Kim MD, Kyung-Hoi Koo MD

Patients with residual poliomyelitis can have advanced degenerative arthritis of the hip in the paralytic limb or the nonparalytic contralateral limb. Although THA is a treatment option for some of these patients, there are few studies regarding THA in this patient population.

High Complication Rate in Revision Total Hip Arthroplasty in Juvenile Idiopathic Arthritis

Stuart B. Goodman MD, PhD, Katherine Hwang MS, Susanna Imrie PT, MS

Revision total hip arthroplasty (THA) in patients with juvenile idiopathic arthritis (JIA) is challenging as a result of the patient’s young age, systemic disease, multiple affected joints, small proportions, and bone loss. The intermediate- to long-term results of these surgeries remain unknown.

Obesity Increases Length of Stay and Direct Medical Costs in Total Hip Arthroplasty

Hilal Maradit Kremers MD, MSc, Sue L. Visscher PhD, Walter K. Kremers PhD, James M. Naessens PhD, David G. Lewallen MD

The number of obese patients undergoing THA is increasing. Previous studies have shown that obesity is associated with an increased likelihood of complications after THA, but there is little information regarding the impact of obesity on medical resource use and direct medical costs in THA.

Cemented versus Uncemented Hemiarthroplasty for Displaced Femoral Neck Fractures: 5-year Followup of a Randomized Trial

Ellen Langslet MD, Frede Frihagen MD, PhD, Vidar Opland MD, Jan Erik Madsen MD, PhD, Lars Nordsletten MD, PhD, Wender Figved MD, PhD

Displaced femoral neck fractures usually are treated with hemiarthroplasty. However, the degree to which the design of the implant used (cemented or uncemented) affects the outcome is not known and may be therapeutically important.

High Metal Ion Levels After Use of the ASR™ Device Correlate With Development of Pseudotumors and T Cell Activation

Nils P. Hailer Dr, Med, Mats Bengtsson PhD, Christina Lundberg MD, Jan Milbrink PhD

Pseudotumors and immunologic alterations are reported in patients with elevated metal ion levels after resurfacing arthroplasty of the hip. A direct association of increased cobalt and chromium concentrations with the development of pseudotumors has not been established.

Single- or Two-stage Revision for Infected Total Hip Arthroplasty? A Systematic Review of the Literature

Hugh A. C. Leonard MA, BMBCh, Alexander D. Liddle BSc, MRCS, Órlaith Burke PhD, David W. Murray MD, FRCS(Orth), Hemant Pandit FRCS(Orth), DPhil

The best approach for surgical treatment of an infected THA remains controversial. Two-stage revision is believed to result in lower reinfection rates but may result in significant functional impairment. Some authors now suggest that single-stage revision may provide comparable results in terms of infection eradication while providing superior functional outcomes.