Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles


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.

The Crossover Sign Overestimates Acetabular Retroversion

Ira Zaltz MD, Bryan T. Kelly MD, Iftach Hetsroni MD, Asheesh Bedi MD

The crossover sign is a radiographic finding associated with cranial acetabular retroversion and has been associated with pincer-type femoroacetabular impingement (FAI) in patients with hip pain. Variable morphology, location, and size of the anterior inferior iliac spine (AIIS) may contribute to the crossover sign even in the absence of retroversion. Thus, the sign may overestimate the incidence of acetabular retroversion.

What Are the Risks of Prophylactic Pinning to Prevent Contralateral Slipped Capital Femoral Epiphysis?

Wudbhav N. Sankar MD, Eduardo N. Novais MD, Christopher Lee MD, Ali A. Al-Omari MD, Paul D. Choi MD, Benjamin J. Shore MD, FRCSC

Two decision analyses on managing the contralateral, unaffected hip after unilateral slipped capital femoral epiphysis (SCFE) have failed to yield consistent recommendations. Missing from both, however, are sufficient data on the risks associated with prophylactic pinning using modern surgical techniques.

Should We Worry About Periacetabular Interference Gaps in Hip Resurfacing?

Bruno Gomes MBBS, FRACS(Orth), Michael Olsen PhD, Michael Donnelly MD, MCh, FRCS(Tr&Orth), Ashesh Kumar MD, FRCS(C), Emil H. Schemitsch MD, FRCS(C)

Press-fit acetabular component seating in hip resurfacing can be challenging as a strong interference fit is required. It has not been established whether reducing the acetabular underream minimizes incomplete component seating or leads to increased acetabular loosening.

Three-dimensional Morphologic Study of the Child’s Hip: Which Parameters Are Reproducible?

Virginie Rampal MD, Jérome Hausselle PhD, Patricia Thoreux PhD, Philippe Wicart MD PhD, Waffa Skalli PhD

Biplanar x-ray images obtained with patients in a standing weightbearing position allow reconstruction of three-dimensional (3-D) bone geometries, with lower radiation exposure than CT scans and better bone definition than MRI.