Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 723 articles

Articles

The Femoro-Epiphyseal Acetabular Roof (FEAR) Index: A New Measurement Associated With Instability in Borderline Hip Dysplasia?

Michael Wyatt FRACS, Jan Weidner MD, Dominik Pfluger PhD, Martin Beck PD, MD

The definition of osseous instability in radiographic borderline dysplastic hips is difficult. A reliable radiographic tool that aids decision-making—specifically, a tool that might be associated with instability—therefore would be very helpful for this group of patients.

Both 3-T dGEMRIC and Acetabular-Femoral T2 Difference May Detect Cartilage Damage at the Chondrolabral Junction

Tobias Hesper MD, Evgeny Bulat MA, Sarah Bixby MD, Alireza Akhondi-Asl PhD, Onur Afacan PhD, Patricia Miller MS, Garrett Bowen BS, Simon Warfield PhD, Young-Jo Kim MD, PhD

In addition to case reports of gadolinium-related toxicities, there are increasing theoretical concerns about the use of gadolinium for MR imaging. As a result, there is increasing interest in noncontrast imaging techniques for biochemical cartilage assessment. Among them, T2 mapping holds promise because of its simplicity, but its biophysical interpretation has been controversial.

Femoral Morphology in the Dysplastic Hip: Three-dimensional Characterizations With CT

Joel Wells MD, MPH, Jeffrey J. Nepple MD, Karla Crook BS, James R. Ross MD, Asheesh Bedi MD, Perry Schoenecker MD, John C. Clohisy MD

Hip dysplasia represents a spectrum of complex deformities on both sides of the joint. Although many studies have described the acetabular side of the deformity, to our knowledge, little is known about the three-dimensional (3-D) head and neck offset differences of the femora of dysplastic hips. A thorough knowledge of proximal femoral anatomy is important to prevent potential impingement and improve results after acetabular reorientation.

What Are the Risk Factors for Revision Surgery After Hip Arthroscopy for Femoroacetabular Impingement at 7-year Followup?

Pascal Cyrill Haefeli MD, Christoph Emanuel Albers MD, Simon Damian Steppacher MD, Moritz Tannast MD, Lorenz Büchler MD

In recent years, surgical treatment of symptomatic femoroacetabular impingement (FAI) has been increasingly performed using arthroscopy. Bony pathomorphologies and damage to the labrum as well as cartilage defects can be addressed with comparable results to open surgery with overall less surgery-related complications. Despite the increasing importance of hip arthroscopy, however, reports on midterm clinical and radiographic outcomes and comparison to open surgical hip dislocation are scarce.

Labral Reattachment in Femoroacetabular Impingement Surgery Results in Increased 10-year Survivorship Compared With Resection

Helen Anwander MD, Klaus A. Siebenrock MD, Moritz Tannast MD, Simon D. Steppacher MD

Since the importance of an intact labrum for normal hip function has been shown, labral reattachment has become the standard method for open or arthroscopic treatment of hips with femoroacetabular impingement (FAI). However, no long-term clinical results exist evaluating the effect of labral reattachment. A 2-year followup comparing open surgical treatment of FAI with labral resection versus reattachment was previously performed at our clinic. The goal of this study was to report a concise followup of these patients at a minimum of 10 years.

Reconstruction of the Shallow Acetabulum With a Combination of Autologous Bulk and Impaction Bone Grafting Fixed by Cement

Masaaki Maruyama MD, PhD, Shinji Wakabayashi MD, PhD, Hiroshi Ota MD, PhD, Keiji Tensho MD, PhD

Acetabular bone deficiency, especially proximal and lateral deficiency, is a difficult technical problem during primary total hip arthroplasty (THA) in developmental dysplasia of the hip (DDH). We report a new reconstruction method using a medial-reduced cemented socket and additional bulk bone in conjunction with impaction morselized bone grafting (additional bulk bone grafting method).

How Does the dGEMRIC Index Change After Surgical Treatment for FAI? A Prospective Controlled Study: Preliminary Results

Florian Schmaranzer MD, Pascal C. Haefeli MD, Markus S. Hanke MD, Emanuel F. Liechti MD, MSc, Stefan F. Werlen MD, Klaus A. Siebenrock MD, Moritz Tannast MD

Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) allows an objective, noninvasive, and longitudinal quantification of biochemical cartilage properties. Although dGEMRIC has been used to monitor the course of cartilage degeneration after periacetabular osteotomy (PAO) for correction of hip dysplasia, such longitudinal data are currently lacking for femoroacetabular impingement (FAI).

Iatrogenic Hip Instability Is a Devastating Complication After the Modified Dunn Procedure for Severe Slipped Capital Femoral Epiphysis

Vidyadhar V. Upasani, Oliver Birke, Kevin E. Klingele, Michael B. Millis

The modified Dunn procedure facilitates femoral capital realignment for slipped capital femoral epiphysis (SCFE) through a surgical hip dislocation approach. Iatrogenic postoperative hip instability after this procedure has not been studied previously; however, we were concerned when we observed several instances of this serious complication, and we wished to study it further.

What is the Diagnostic Accuracy of Aspirations Performed on Hips With Antibiotic Cement Spacers?

Jared M. Newman MD, Jaiben George MBBS, Alison K. Klika MS, Stephen F. Hatem MD, Wael K. Barsoum MD, W. Trevor North MD, Carlos A. Higuera MD

Periprosthetic joint infection is a serious complication after THA and commonly is treated with a two-stage revision. Antibiotic-eluting cement spacers are placed for local delivery of antibiotics. Aspirations may be performed before the second-stage reimplantation for identification of persistent infection. However, limited data exist regarding the diagnostic parameters of synovial fluid aspiration with or without saline lavage from a hip with an antibiotic-loaded cement spacer.

Nonmodular Tapered Fluted Titanium Stems Osseointegrate Reliably at Short Term in Revision THAs

Nemandra A. Sandiford MBBS, MSc, FRCS(Tr&Orth), Donald S. Garbuz MD, MHSc, FRCS(C), Bassam A. Masri MD, FRCS(C), Clive P. Duncan MB, MSc, FRCS(C)

The ideal femoral component for revision THA is undecided. Cylindrical nonmodular stems have been associated with stress shielding, whereas junctional fractures have been reported with tapered fluted modular titanium stems. We have used a tapered fluted nonmodular titanium femoral component (Wagner Self-locking [SL] femoral stem) to mitigate this risk. This component has been used extensively in Europe by its designer surgeons, but to our knowledge, it has not been studied in North America. Added to this, the design of the component has changed since early reports.