Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles


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.

Can Radiographic Morphometric Parameters for the Hip Be Assessed on MRI?

David Stelzeneder MD, Andreas Hingsammer MD, Sarah D. Bixby MD, Young-Jo Kim MD, PhD

Although morphometric hip parameters measured on radiographs are valuable tools guiding diagnosis and therapy in patients with hip disorders, some clinicians use MRI for such measurements, although it is unclear whether the parameters assessed on MRI differ from those assessed on radiographs.

Lateral Center-edge Angle on Conventional Radiography and Computed Tomography

Shafagh Monazzam MD, James D. Bomar MPH, Krishna Cidambi MD, Peter Kruk MD, Harish Hosalkar MD

Lateral center-edge angle (LCEA), originally described and validated on AP radiographs, has been used increasingly in CT-based studies, but it is unclear whether the measure is reliable and whether it correlates with that on AP radiographs.

Patients Report Improvement in Quality of Life and Satisfaction After Hip Resurfacing Arthroplasty

Wael A. Rahman MD, Nelson V. Greidanus MD, MPH, Alexander Siegmeth MD, Bassam A. Masri MD, Clive P. Duncan MD, MSc, Donald S. Garbuz MD, MHSc

A number of reconstructive procedures are available for the management of hip osteoarthritis. Hip resurfacing arthroplasty is now an accepted procedure, with implant survivorship comparable to THA at up to 10 years’ followup in certain series. Most reports focus on implant survivorship, surgeon-derived results, or complications. Fewer data pertain to patient-reported results, including validated measures of quality of life (QoL) and satisfaction and baseline measures from which to determine magnitude of improvement. Validated patient-reported results are essential to guide patients and surgeons in the current era of informed and shared decision making.

Intraprosthetic Dislocation: A Specific Complication of the Dual-mobility System

Remi Philippot MD, PhD, Bertrand Boyer MD, Frederic Farizon MD

The dual-mobility concept was proposed as an alternative to prevent postoperative dislocation events. However, intraprosthetic dislocation (IPD) is a troublesome and specific complication induced by the loss of the polyethylene retentive rim and escape of the femoral head from the polyethylene liner. The factors associated with IPD are unknown as only isolated cases have been reported and do not provide a clear understanding of the mechanisms of failure.

Surgical Technique: Endoscopic Gluteus Maximus Tendon Release for External Snapping Hip Syndrome

Giancarlo C. Polesello MD, PhD, Marcelo C. Queiroz MD, Benjamin G. Domb MD, Nelson K. Ono MD, PhD, Emerson K. Honda MD, PhD

While many authors have recommended surgery for patients with persistent symptoms of external snapping hip, it is unclear which one best relieves symptoms. Concerns with iliotibial band (ITB)-modifying techniques include altering the shape of the lateral thigh and overload of the contralateral abduction mechanism. We describe a new endoscopic technique that decreases the tension of the ITB complex by releasing the femoral insertion of the gluteus maximus tendon (GMT).

Is the Damage of Cartilage a Global or Localized Phenomenon in Hip Dysplasia, Measured by dGEMRIC?

Andreas Hingsammer MS, Jenny Chan MS, Leslie A. Kalish ScD, Tallal C. Mamisch MD, Young-Jo Kim MD, PhD

The mechanism of damage in osteoarthritis is believed to be multifactorial where mechanical and biological factors are important in its initiation and progression. Hip dysplasia is a classic model of increased mechanical loading on cartilage attributable to insufficient acetabular coverage that leads to osteoarthritis. If the damage is all attributable to direct mechanical damage then one initially would expect only local, not global changes.