Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

Navigation is Equal to Estimation by Eye and Palpation in Preventing Psoas Impingement in THA

Markus Weber MD, Michael Woerner MD, Benedikt Messmer Cand Med, Joachim Grifka MD, Tobias Renkawitz MD

Iliopsoas tendon impingement is one possible reason for persistent groin pain and diminished functional outcome after THA. So far, estimation by eye and palpation is the standard procedure to intraoperatively assess the distance of the cup to the anterior rim. However, novel technologies such as imageless navigation enable intraoperative measurements of the cup in relation to the psoas tendon and bony landmarks.

Acetabular Wall Indices Help to Distinguish Acetabular Coverage in Asymptomatic Adults With Varying Morphologies

Lucas A. Anderson MD, Mike B. Anderson MSc, Jill A. Erickson PA-C, Jesse Chrastil MD, Christopher L. Peters MD

The anterior wall index (AWI) and posterior wall index (PWI) have been proposed to quantify anterior and posterior acetabular coverage using AP pelvic radiographs. However, these indices have only been reported in symptomatic patients with apparent pathomorphologies (dysplasia, overcoverage, and retroversion) undergoing osteochondroplasty or reorientation osteotomy.

What Are the Results of Surgical Treatment of Hip Dysplasia With Concomitant Cam Deformity?

Jens Goronzy MD, Lea Franken MD, Albrecht Hartmann MD, Falk Thielemann MD, Anne Postler MD, Tobias Paulus MD, Klaus-Peter G√ľnther MD

Periacetabular osteotomy (PAO) is a reliable procedure to correct the deficient acetabular coverage in hips with developmental dysplasia. It is unclear how the presence of additional femoral cam-type deformity might influence the clinical and radiographic treatment results of PAO.

What Are the Risk Factors for Dislocation of Hip Bipolar Hemiarthroplasty Through the Anterolateral Approach? A Nested Case-control Study

Lianhua Li MD, Jixin Ren MD, Jia Liu MD, Hao Wang MD, Qinghua Sang MD, Zhi Liu MD, Tiansheng Sun MD

Hip dislocation after treatment of a femoral neck fracture with a hemiarthroplasty remains an important problem in the treatment of hip fractures, but the associations between patient factors and surgical factors, and how these factors contribute to dislocation in patients who have undergone bipolar hemiarthroplasty through an anterolateral approach for femoral neck fracture currently are only poorly characterized.

Acetabular Version Increases After Closure of the Triradiate Cartilage Complex

Christoph E. Albers MD, Andrea Schwarz MD, Markus S. Hanke MD, Karl-Philipp Kienle MD, Stefan Werlen MD, Klaus A. Siebenrock MD

Although the etiology of primary femoroacetabular impingement (FAI) is considered developmental, the underlying pathogenic mechanisms remain poorly understood. In particular, research identifying etiologic factors associated with pincer FAI is limited. Knowledge of the physiologic growth patterns of the acetabulum during skeletal maturation might allow conclusions on deviations from normal development that could contribute to pincer-related pathomorphologies.

What MRI Findings Predict Failure 10 Years After Surgery for Femoroacetabular Impingement?

Markus S. Hanke MD, Simon D. Steppacher MD, Helen Anwander MD, Stefan Werlen MD, Klaus A. Siebenrock MD, Moritz Tannast MD

Magnetic resonance arthrogram (MRA) with radial cuts is presently the best available preoperative imaging study to evaluate chondrolabral lesions in the setting of femoroacetabular impingement (FAI). Existing followup studies for surgical treatment of FAI have evaluated predictors of treatment failure based on preoperative clinical examination, intraoperative findings, and conventional radiography. However, to our knowledge, no study has examined whether any preoperative findings on MRA images might be associated with failure of surgical treatment of FAI in the long term.

Surgical Risks and Costs of Care are Greater in Patients Who Are Super Obese and Undergoing THA

Menachem M. Meller MD, PhD, Nader Toossi MD, Mark H. Gonzalez MD, PhD, Min-Sun Son PhD, Edmund C. Lau MS, Norman Johanson MD

Patients with morbid obesity, defined as a BMI greater than 40 kg/m, and super obesity, defined as a BMI greater than 50 kg/m, increasingly present for total hip replacement. There is disagreement in the literature whether these individuals have greater surgical risks and costs for the episode of care, and the magnitude of those risks and costs. There also is no established threshold for obesity as defined by BMI in identifying increased complications, risks, and costs of care. Until recently, analysis of higher BMI data was limited to small cohorts from hospital-based data banks, based on BMI or height and weight only, often as part of a multivariate analysis. On October 1, 2010 the Centers for Medicare & Medicaid Services added a fifth digit to the BMI data, V85.xx, in the Medicare data bank, which allowed data mining of cases of patients with higher BMI. To our knowledge, our study is the first large retrospective Medicare data mining study, which allows us to examine BMI levels greater than 40 and 50 kg/mto delineate risks, complications, and costs for these patients.

Increased Hip Stresses Resulting From a Cam Deformity and Decreased Femoral Neck-Shaft Angle During Level Walking

K. C. Geoffrey Ng MASc, Giulia Mantovani PhD, Mario Lamontagne PhD, Michel R. Labrosse PhD, Paul E. Beaulé MD, FRCSC

It is still unclear why many individuals with a cam morphology of the hip do not experience pain. It was recently reported that a decreased femoral neck-shaft angle may also be associated with hip symptoms. However, the effects that different femoral neck-shaft angles have on hip stresses in symptomatic and asymptomatic individuals with cam morphology remain unclear.

A Resident-led Initiative Improves Screening and Treatment for Vitamin D Deficiency in Patients with Hip Fractures

Drew A. Lansdown MD, Amanda Whitaker MD, Rosanna Wustrack MD, Aenor Sawyer MD, Erik N. Hansen MD

Acute hip fractures carry a high risk of morbidity and are associated with low vitamin D levels. Improvements in screening and treating low vitamin D levels may lead to lower fall rates and a lower likelihood of additional fragility fractures. However, patients with low vitamin D levels often remain unassessed and untreated, even after they experience these fractures.

What Risks are Associated with Primary THA in Recipients of Hematopoietic Stem Cell Transplantation?

Brian P. Chalmers MD, Cameron K. Ledford MD, Joseph M. Statz MD, Tad M. Mabry MD, Arlen D. Hanssen MD, Matthew P. Abdel MD

As patients who receive hematopoietic stem cell transplantation are at increased risk of avascular necrosis (AVN) and subsequent degenerative arthritis, THA may be considered in some of these patients, particularly as overall patient survival improves for patients undergoing stem-cell transplants. Patients receiving hematopoietic stem cell transplantation theoretically are at increased risk of experiencing complications, infection, and poorer implant survivorship owing to the high prevalence of comorbid conditions, immunosuppressive therapy regimens including corticosteroids, and often low circulating hematopoietic cell lines; however, there is a paucity of studies elucidating these risks.