Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles


Growth Plate Alteration Precedes Cam-type Deformity in Elite Basketball Players

Klaus A. Siebenrock MD, Anna Behning MD, T. Charles Mamisch MD, Joseph M. Schwab MD

Vigorous sporting activity during the growth years is associated with an increased risk of having a cam-type deformity develop. The underlying cause of this osseous deformity is unclear. One may speculate whether this is caused by reactive bone apposition in the region of the anterosuperior head-neck junction or whether sports activity alters the shape of and growth in the growth plate. If the latter is true, then one would expect athletes to show an abnormal shape of the capital growth plate (specifically, the epiphyseal extension) before and/or after physeal closure.

The Shape of the Proximal Femur Influences Acetabular Wear Patterns Over Time

Jonathan J. Streit MD, Ari Levine MD, Ian J. Barrett BS, Daniel R. Cooperman MD, Victor Goldberg MD

Femoroacetabular impingement has been proposed as a cause of early osteoarthritis, but it is not known how this develops over time or whether the shape of the proximal femur influences this risk.

Is Limited Incision Better Than Standard Total Hip Arthroplasty? A Meta-analysis

Joseph T. Moskal MD, Susan G. Capps PhD

The literature comparing limited incision and standard incision THAs is confusing regarding whether limited incision THA improves short-term recovery without compromising long-term durability and survival. Further, previously published meta-analyses cannot conclude that limited incision THA is better. With new data, we seek to discover if the answers now exist.

Case Reports: Acetabular Damage After Mild Slipped Capital Femoral Epiphysis

Cara Beth Lee MD, Travis Matheney MD, Yi-Meng Yen MD, PhD

Slipped capital femoral epiphysis (SCFE) is a common hip problem in adolescents that results in a cam-type femoroacetabular impingement (FAI) deformity. Although the treatment for mild (slip angle of 0°–30°) and moderate (slip angle of 31°–60°) SCFE has historically been in situ fixation, recent studies have demonstrated impingement-related articular damage, irrespective of slip severity. Our series confirms previous reports that acetabular chondral injury occurs in mild to low-moderate (slip angle of ≤ 40°) SCFE.

Contact Patch to Rim Distance Predicts Metal Ion Levels in Hip Resurfacing

James P. Yoon BA, Michel J. Le Duff MA, Alicia J. Johnson BA, Karren M. Takamura BA, Edward Ebramzadeh PhD, Harlan C. Amstutz MD

Component design, size, acetabular orientation, patient gender, and activity level have been suggested as factors leading to elevated metal ion concentrations after-on-metal hip resurfacing arthroplasty (MMHRA). The calculation of the contact patch to rim (CPR) distance integrates component size, design, and acetabular orientation and may be a good predictor of elevated metal ion levels.

Does Femoral Rotation Influence Anteroposterior Alpha Angle, Lateral Center-edge Angle, and Medial Proximal Femoral Angle? A Pilot Study

Shafagh Monazzam MD, James D. Bomar MPH, Mandar Agashe MD, Harish S. Hosalkar MD

Femoral rotation on AP radiographs affects several parameters used to assess morphologic features of the proximal femur but its effect on femoroacetabular impingement parameters remains unknown.

Can a Triple Pelvic Osteotomy for Adult Symptomatic Hip Dysplasia Provide Relief of Symptoms for 25 Years?

Renee Anne Stralen MD, Gijs G. Hellemondt MD, PhD, Navin N. Ramrattan MD, Enrico Visser MD, PhD, Marinus Kleuver MD, PhD

Many surgeons recommend pelvic osteotomy to treat symptomatic hip dysplasia in younger patients. We previously reported a cohort of patients at 10 and 15 years followup in which 65% of the patients showed no progression of osteoarthritis (OA).

Pelvic Flexion Measurement From Lateral Projection Radiographs is Clinically Reliable

Norio Imai MD, Tomoyuki Ito PhD, Ken Suda MD, Dai Miyasaka PhD, Naoto Endo PhD

Pelvic flexion affects orientation of the acetabular cup; however, pelvic position is not static in daily activities. During THA it is difficult to know the degree of pelvic flexion with the patient in the lateral position and that position is static. However, surgeons need to appropriately determine pelvic tilt to properly insert the acetabular component.

Is the Acetabulum Retroverted in Slipped Capital Femoral Epiphysis?

Shafagh Monazzam MD, Venkatadass Krishnamoorthy MD, Bernd Bittersohl MD, James D. Bomar MPH, Harish S. Hosalkar MD

Recent biplanar radiographic studies have demonstrated acetabular retroversion and increased superolateral femoral head coverage in hips with slipped capital femoral epiphysis (SCFE), seemingly divergent from earlier CT-based studies suggesting normal acetabular version.

Emerging Ideas: Novel 3-D Quantification and Classification of Cam Lesions in Patients With Femoroacetabular Impingement

Richard W. Kang MD, Adam B. Yanke MD, Alejandro Espinoza Orias PhD, Nozomu Inoue PhD, Shane J. Nho MD

Femoroacetabular impingement (FAI) can lead to labral injury, osseous changes, and even osteoarthritis. The literature contains inconsistent definitions of the alpha angle and other nonthree-dimensional (3-D) radiographic measures. We present a novel approach to quantifying cam lesions in 3-D terms. Our method also can be used to develop a classification system that describes the exact location and size of cam lesions.