Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

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.

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.