Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles


Reliability of Bucholz and Ogden Classification for Osteonecrosis Secondary to Developmental Dysplasia of the Hip

Andreas Roposch MD, MSc, FRCS, John H. Wedge OC, MD, FRCS(C), Georg Riedl MD

Osteonecrosis is perhaps the most important serious complication after treatment of developmental dysplasia of the hip (DDH). The classification by Bucholz and Ogden has been used most frequently for grading osteonecrosis in this context, but its reliability is not established and unreliability could affect the validity of studies reporting the outcome of treatment.

The 2012 Otto Aufranc Award: The Interpretation of Metal Ion Levels in Unilateral and Bilateral Hip Resurfacing

Catherine Straeten MD, George Grammatopoulos MD, Harinderjit S. Gill BEng, DPhil, Alessandro Calistri MD, Patricia Campbell PhD, Koen A. Smet MD

The interpretation of metal ion concentrations and their role in clinical management of patients with metal-on-metal implants is still controversial.

Disclosure of Financial Conflicts of Interest: An Evaluation of Orthopaedic Surgery Patients’ Understanding

Jay R. Lieberman MD, Michael J. Pensak MD, Michael S. Kelleher MD, Robin R. Leger PhD, Gregory G. Polkowski MD

Industry and orthopaedic surgeons often partner to develop new technology, which can lead to orthopaedic surgeons having financial conflicts of interest (FCOI). It is essential these FCOI be conveyed clearly to patients. It is unclear, however, whether and to what degree patients understand the ramifications of physician FCOI.

Anterior Delayed Gadolinium-enhanced MRI of Cartilage Values Predict Joint Failure After Periacetabular Osteotomy

Sang Do Kim MD, Rebecca Jessel MD, David Zurakowski PhD, Michael B. Millis MD, Young-Jo Kim MD, PhD

Several available compositional MRIs seem to detect early osteoarthritis before radiographic appearance. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) has been most frequently used in clinical studies and reportedly predicts premature joint failure in patients undergoing Bernese periacetabular osteotomies (PAOs).

Patient Selection Criteria for Periacetabular Osteotomy or Rotational Acetabular Osteotomy

Yuji Yasunaga MD, Takuma Yamasaki MD, Mitsuo Ochi MD

Hip dysplasia is the most common cause of secondary osteoarthritis (OA). Periacetabular osteotomy (PAO) or rotational acetabular osteotomy (RAO) has been used as a joint-preserving procedure. However, the patient selection criteria are not clearly defined.

Acetabular Distraction: An Alternative for Severe Defects with Chronic Pelvic Discontinuity?

Scott M. Sporer MD, MS, John J. Bottros MD, Jonah B. Hulst MD, Vamsi K. Kancherla MD, Mario Moric MS, Wayne G. Paprosky MD

Stabilization of a pelvic discontinuity with a posterior column plate with or without an associated acetabular cage sometimes results in persistent micromotion across the discontinuity with late fatigue failure and component loosening. Acetabular distraction offers an alternative technique for reconstruction in cases of severe bone loss with an associated pelvic discontinuity.

Morbid Obesity May Increase Dislocation in Total Hip Patients: A Biomechanical Analysis

Jacob M. Elkins MS, Matej Daniel PhD, Douglas R. Pedersen PhD, Bhupinder Singh BS, H. John Yack PhD, John J. Callaghan MD, Thomas D. Brown PhD

Obesity has reached epidemic proportions in the United States. Recently, obesity, especially morbid obesity, has been linked to increased rates of dislocation after THA. The reasons are unclear. Soft tissue engagement caused by increased thigh girth has been proposed as a possible mechanism for decreased joint stability.

Hip Ontogenesis: How Evolution, Genes, and Load History Shape Hip Morphotype and Cartilotype

Tom Hogervorst MD, PhD, Wouter Eilander MD, Joost T. Fikkers MSc, Ingrid Meulenbelt PhD

Developmental hip disorders (DHDs), eg, developmental dysplasia of the hip, slipped capitis femoris epiphysis, and femoroacetabular impingement, can be considered morphology variants of the normal hip. The femoroacetabular morphology of DHD is believed to induce osteoarthritis (OA) through local cumulative mechanical overload acting on genetically controlled patterning systems and subsequent damage of joint structures. However, it is unclear why hip morphology differs between individuals with seemingly comparable load histories and why certain hips with DHD progress to symptomatic OA whereas others do not.

Do Plain Radiographs Correlate With CT for Imaging of Cam-type Femoroacetabular Impingement?

Jeffrey J. Nepple MD, John M. Martel MD, Young-Jo Kim MD, Ira Zaltz MD, John C. Clohisy MD

Three-dimensional imaging (CT and MRI) is the gold standard for detecting femoral head-neck junction malformations in femoroacetabular impingement, yet plain radiographs are used for initial diagnostic evaluation. It is unclear, however, whether the plain radiographs accurately reflect the findings on three-dimensional imaging.

Coxa Profunda: Is the Deep Acetabulum Overcovered?

Lucas A. Anderson MD, Ashley L. Kapron BS, Stephen K. Aoki MD, Christopher L. Peters MD

Coxa profunda, or a deep acetabular socket, is often used to diagnose pincer femoroacetabular impingement (FAI). Radiographically, coxa profunda is the finding of an acetabular fossa medial to the ilioischial line. However, the relative position of the acetabular fossa to the pelvis may not be indicative of acetabular coverage.