Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 723 articles

Articles

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.

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.