Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles


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.

Association of Obesity With Inflammation and Pain After Total Hip Arthroplasty

Roja Motaghedi MD, James J. Bae MSc, Stavros G. Memtsoudis MD, PhD, David H. Kim MD, Jonathan C. Beathe MD, Leonardo Paroli MD, PhD, Jacques T. YaDeau MD, PhD, Michael A. Gordon MD, Daniel B. Maalouf MD, MPH, Yi Lin MD, PhD, Yan Ma PhD, Susanna Cunningham-Rundles PhD, Spencer S. Liu MD

The prevalence of obesity is increasing, and obesity often leads to degenerative joint disease requiring total hip arthroplasty (THA). Obesity is a proinflammatory state associated with an increase in chronic, low-grade inflammatory response. As such, it may augment the postoperative inflammatory response, which has been associated with postoperative pain and complications.

Surgical Hip Dislocation for Treatment of Femoroacetabular Impingement: Factors Predicting 5-year Survivorship

Simon D. Steppacher MD, Carmen Huemmer MD, MSC, Joseph M. Schwab MD, Moritz Tannast MD, Klaus A. Siebenrock MD

Patients with femoroacetabular impingement (FAI) often develop pain, impaired function, and progression of osteoarthritis (OA); this is commonly treated using surgical hip dislocation, femoral neck and acetabular rim osteoplasty, and labral reattachment. However, results with these approaches, in particular risk factors for OA progression and conversion to THA, have varied.

Comparison of Robotic-assisted and Conventional Acetabular Cup Placement in THA: A Matched-pair Controlled Study

Benjamin G. Domb MD, Youssef F. El Bitar MD, Adam Y. Sadik BS, Christine E. Stake MA, Itamar B. Botser MD

Improper acetabular component orientation in THA has been associated with increased dislocation rates, component impingement, bearing surface wear, and a greater likelihood of revision. Therefore, any reasonable steps to improve acetabular component orientation should be considered and explored.

Randomized Trial of Hemiarthroplasty versus Internal Fixation for Femoral Neck Fractures: No Differences at 6 Years

Ragnhild Øydna Støen MD, Cathrine M. Lofthus MD, PhD, Lars Nordsletten MD, PhD, Jan Erik Madsen MD, PhD, Frede Frihagen MD, PhD

Hemiarthroplasty has been shown superior to internal fixation for displaced femoral neck fractures (FNF) in the first 2 years. However, there are unanswered questions about the performance of hemiarthroplasty over the longer term compared with internal fixation.

Stability and Trunnion Wear Potential in Large-diameter Metal-on-Metal Total Hips: A Finite Element Analysis

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

Large-diameter femoral heads for metal-on-metal THA hold theoretical advantages of joint stability and low bearing surface wear. However, recent reports have indicated an unacceptably high rate of wear-associated failure with large-diameter bearings, possibly due in part to increased wear at the trunnion interface. Thus, the deleterious consequences of using large heads may outweigh their theoretical advantages.

Elevation of Serum Tumor Necrosis Factor α in Patients with Periprosthetic Osteolysis: A Case-Control Study

R. Krishna Chaganti MD, Edward Purdue PhD, Thomas P. Sculco MD, Lisa A. Mandl MD

Periprosthetic osteolysis is the leading reason for THA revision. The relationship of serum biomarkers with severe radiographic periprosthetic osteolysis has not been defined but may be important to direct future research and clinical therapeutics.

Does the Direct Anterior Approach in THA Offer Faster Rehabilitation and Comparable Safety to the Posterior Approach?

José A. Rodriguez MD, Ajit J. Deshmukh MD, Parthiv A. Rathod MD, Michelle L. Greiz PT, Prashant P. Deshmane MD, Matthew S. Hepinstall MD, Amar S. Ranawat MD

Newer surgical approaches to THA, such as the direct anterior approach, may influence a patient’s time to recovery, but it is important to make sure that these approaches do not compromise reconstructive safety or accuracy.

High Frequency of Adverse Local Tissue Reactions in Asymptomatic Patients With Metal-on-Metal THA

Thomas K. Fehring MD, Susan Odum PhD, Robert Sproul MD, Jessica Weathersbee PA-C

The key to successful management of patients with metal-on-metal (MOM) THAs is to diagnose adverse local tissue reactions (ALTRs) early. ALTRs have been described in asymptomatic patients with resurfacing arthroplasties. Whether this concerning finding applies to modular MOM THAs is unknown.