Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles

Articles

What is the Diagnostic Accuracy of Aspirations Performed on Hips With Antibiotic Cement Spacers?

Jared M. Newman MD, Jaiben George MBBS, Alison K. Klika MS, Stephen F. Hatem MD, Wael K. Barsoum MD, W. Trevor North MD, Carlos A. Higuera MD

Periprosthetic joint infection is a serious complication after THA and commonly is treated with a two-stage revision. Antibiotic-eluting cement spacers are placed for local delivery of antibiotics. Aspirations may be performed before the second-stage reimplantation for identification of persistent infection. However, limited data exist regarding the diagnostic parameters of synovial fluid aspiration with or without saline lavage from a hip with an antibiotic-loaded cement spacer.

Nonmodular Tapered Fluted Titanium Stems Osseointegrate Reliably at Short Term in Revision THAs

Nemandra A. Sandiford MBBS, MSc, FRCS(Tr&Orth), Donald S. Garbuz MD, MHSc, FRCS(C), Bassam A. Masri MD, FRCS(C), Clive P. Duncan MB, MSc, FRCS(C)

The ideal femoral component for revision THA is undecided. Cylindrical nonmodular stems have been associated with stress shielding, whereas junctional fractures have been reported with tapered fluted modular titanium stems. We have used a tapered fluted nonmodular titanium femoral component (Wagner Self-locking [SL] femoral stem) to mitigate this risk. This component has been used extensively in Europe by its designer surgeons, but to our knowledge, it has not been studied in North America. Added to this, the design of the component has changed since early reports.

Estimating the Societal Benefits of THA After Accounting for Work Status and Productivity: A Markov Model Approach

Lane Koenig PhD, Qian Zhang PhD, Matthew S. Austin MD, Berna Demiralp PhD, Thomas K. Fehring MD, Chaoling Feng PhD, Richard C. Mather MD, Jennifer T. Nguyen MPP, Asha Saavoss BA, Bryan D. Springer MD, Adolph J. Yates MD

Demand for total hip arthroplasty (THA) is high and expected to continue to grow during the next decade. Although much of this growth includes working-aged patients, cost-effectiveness studies on THA have not fully incorporated the productivity effects from surgery.

Do Radiographic Parameters of Dysplasia Improve to Normal Ranges After Bernese Periacetabular Osteotomy?

Eduardo N. Novais MD, Stephen Duncan MD, Jeffrey Nepple MD, Gail Pashos BS, Perry L. Schoenecker MD, John C. Clohisy MD

The goal of periacetabular osteotomy (PAO) is to improve the insufficient coverage of the femoral head and achieve joint stability without creating secondary femoroacetabular impingement. However, the complex tridimensional morphology of the dysplastic acetabulum presents a challenge to restoration of normal radiographic parameters. Accurate acetabular correction is important to achieve long-term function and pain improvement. There are limited data about the proportion of patients who have normal radiographic parameters restored after PAO and the factors associated with under- and overcorrection.

Operative Fluoroscopic Correction Is Reliable and Correlates With Postoperative Radiographic Correction in Periacetabular Osteotomy

James D. Wylie MD, MHS, Jeremy A. Ross MD, Jill A. Erickson PA-C, Mike B. Anderson MSc, Christopher L. Peters MD

Intraoperative fluoroscopy is commonly used to both guide the osteotomy and judge correction of the acetabular fragment in periacetabular osteotomy (PAO). Prior studies that have compared intraoperative fluoroscopic correction with postoperative radiographic correction were small studies that did not report intra- or interreader reliability.

Is Increased Acetabular Cartilage or Fossa Size Associated With Pincer Femoroacetabular Impingement?

Stephanie Y. Pun MD, Andreas Hingsammer MD, Michael B. Millis MD, Young-Jo Kim MD, PhD

Surgical treatment for pincer femoroacetabular impingement (FAI) of the hip remains controversial, between trimming the prominent acetabular rim and reverse periacetabular osteotomy (PAO) that reorients the acetabulum. However, rim trimming may decrease articular surface size to a critical threshold where increased joint contact forces lead to joint degeneration. Therefore, knowledge of how much acetabular articular cartilage is available for resection is important when evaluating between the two surgical options. In addition, it remains unclear whether the acetabulum rim in pincer FAI is a prominent rim because of increased cartilage size or increased fossa size.

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.