Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 721 articles

Articles

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.

Partial Two-stage Exchange for Infected Total Hip Arthroplasty: A Preliminary Report

Timothy E. Ekpo DO, Keith R. Berend MD, Michael J. Morris MD, Joanne B. Adams BFA, Adolph V. Lombardi MD

One common approach to the infected total hip arthroplasty (THA) calls for a staged revision, including removal of all components. However, removal of well-fixed femoral components can result in bone loss and compromised fixation; it is not known whether it is effective to leave a well-fixed femoral component in situ, remove only the acetabular component, débride thoroughly, place a spacer, and delay reimplantation.

Are Short Fully Coated Stems Adequate for “Simple” Femoral Revisions?

Matthew W. Tetreault MD, Sanjai K. Shukla MD, Paul H. Yi BA, Scott M. Sporer MD, Craig J. Della Valle MD

Many studies suggest long femoral components should be used in revision THA. However, longer stems are more difficult to insert and reduce femoral bone stock for future revisions.

What Is Normal Femoral Head/Neck Anatomy? An Analysis of Radial CT Reconstructions in Adolescents

Amir A. Jamali MD, Walter Mak MD, Ping Wang BS, Lynn Tai BS, John P. Meehan MD, Ramit Lamba MBBS, MD

Cam morphology in femoroacetabular impingement has been implicated in the development of osteoarthritis. The alpha angle and femoral head/neck offset are widely used to determine femoral head asphericity. To our knowledge, no study has evaluated the alpha angle circumferentially using three-dimensional imaging in a population of healthy individuals of adolescent age.

Surgical Technique: Gluteus Maximus and Tensor Fascia Lata Transfer for Primary Deficiency of the Abductors of the Hip

Leo A. Whiteside MD

Avulsion of the abductor muscles of the hip may cause severe limp and pain. Limited literature is available on treatment approaches for this problem, and each has shortcomings. This study describes a muscle transfer technique to treat complete irreparable avulsion of the hip abductor muscles and tendons.