Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 715 articles

Articles

Treatment of Femoral Head Osteonecrosis in the United States: 16-year Analysis of the Nationwide Inpatient Sample

Aaron J. Johnson MD, Michael A. Mont MD, Audrey K. Tsao MD, Lynne C. Jones PhD

Many surgical interventions are used to treat osteonecrosis of the femoral head. The instance and distribution of these various procedures may give some insight into the practicing community’s understanding of the efficacy of these treatments. We therefore sought to determine trends in the types and numbers of procedures performed for atraumatic osteonecrosis from 1992 through 2008 in the United States.

Persistent Structural Disease Is the Most Common Cause of Repeat Hip Preservation Surgery

John C. Clohisy MD, Jeffrey J. Nepple MD, Christopher M. Larson MD, Ira Zaltz MD, Michael Millis MD

Hip preservation surgery has become more commonplace, yet when it fails, it is unclear why it does so. Understanding failed procedures should lead to improved surgical results.

Correlation of Magnetic Resonance Arthrography with Revision Hip Arthroscopy

Joseph C. McCarthy MD, Philip J. Glassner MD

Arthroscopic approaches for the diagnosis and treatment of hip disorders are well established; however, there are limited data regarding revision hip arthroscopy. There have been several studies evaluating the findings of MR arthrography with primary hip arthroscopy, but to our knowledge, no study has evaluated the diagnostic value of MR arthrography before revision hip arthroscopy.

What Causes Unexplained Pain in Patients With Metal-on metal Hip Devices? A Retrieval, Histologic, and Imaging Analysis

Danyal H. Nawabi MD, FRCS (Orth), Nader A. Nassif MD, Huong T. Do MA, Kirsten Stoner MEng, Marcella Elpers BS, Edwin P. Su MD, Timothy Wright PhD, Hollis G. Potter MD, Douglas E. Padgett MD

Adverse tissue reactions associated with metal-on-metal (MOM) hips are common in resurfacing and total hip arthroplasty (THA) designs. The etiology of these reactions in painful, well-positioned arthroplasties is inconsistently described.

Low Wear of a Second-generation Highly Crosslinked Polyethylene Liner: A 5-year Radiostereometric Analysis Study

Stuart A. Callary BAppSc, John R. Field DVSc, PhD, David G. Campbell BM, BS, FRACS, PhD

A sequentially irradiated and annealed, second-generation highly crosslinked polyethylene (XLPE) liner was introduced clinically in 2005 to reduce in vivo oxidation. This liner design has also been shown to reduce wear in vitro when compared with conventional and first-generation crosslinked liners. To date, there is only one study reporting an in vivo wear rate of this liner at 5 years’ followup. However, that study used measurements made from plain radiographs, which have limited sensitivity, particularly when monitoring very low amounts of wear.

Durable Fixation Achieved With Medialized, High Hip Center Cementless THAs for Crowe II and III Dysplasia

Danyal H. Nawabi MD, Morteza Meftah MD, Denis Nam MD, Amar S. Ranawat MD, Chitranjan S. Ranawat MD

A high hip center total hip arthroplasty (THA) for dysplasia allows more complete socket coverage by native bone at the expense of abnormal hip biomechanics. Despite poor results with cemented components, intermediate-term results with cementless cups at a high hip center have been promising, but there are few reports at long-term followup without bone graft.

Improved Survival of Uncemented versus Cemented Femoral Stems in Patients Aged < 70 Years in a Community Total Joint Registry

John Wechter MD, Thomas K. Comfort MD, Penny Tatman MPH, Susan Mehle BS, Terence J. Gioe MD

Aseptic loosening of the femoral stem remains a significant reason for revision in total hip arthroplasty (THA). Although stem fixation methods have changed over time, there is relatively little evidence supporting cemented or uncemented stems as more durable constructs.

The John Charnley Award: Diagnostic Accuracy of MRI Versus Ultrasound for Detecting Pseudotumors in Asymptomatic Metal-on-Metal THA

Donald S. Garbuz MD, MHSc, Brian A. Hargreaves PhD, Clive P. Duncan MD, MSc, Bassam A. Masri MD, David R. Wilson DPhil, Bruce B. Forster MSc, MD

The prevalence of pseudotumors in patients with large-head metal-on-metal (MOM) THA has been the subject of implant recalls and warnings from various regulatory agencies. To date, there is no consensus on whether ultrasound or MRI is superior for the detection of pseudotumors.

Vitamin D Insufficiency in Patients With THA: Prevalence and Effects on Outcome

Carlos J. Lavernia MD, Jesus M. Villa MD, David A. Iacobelli MD, Mark D. Rossi PhD

The consequences of vitamin D insufficiency in the elderly remain controversial. The prevalence and potential effects of its chronic insufficiency on quality of life and physical function in patients undergoing THA have received little attention.

Do Jumbo Cups Cause Hip Center Elevation in Revision THA? A Computer Simulation

Chima Nwankwo BS, Nick N. Dong MS, Christopher D. Heffernan BS, Michael D. Ries MD

Acetabular revision THA with use of a large (jumbo) cup is an effective treatment for many cavitary and segmental peripheral bone defects. However, the jumbo cup may result in elevation of the hip center and protrusion through the anterior acetabular wall as a result of the oversized geometry of the jumbo cup compared with the physiologic acetabulum.