Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

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.

What Are the Factors Associated With Acetabular Correction in Perthes-like Hip Deformities?

John C. Clohisy MD, James R. Ross MD, Joshua D. North MD, Jeffrey J. Nepple MD, Perry L. Schoenecker MD

Perthes-like hip deformities encompass variable proximal femoral abnormalities and associated acetabular dysplasia that can be reconstructed with contemporary hip preservation procedures. Nevertheless, the necessity and indications for surgical correction of associated acetabular dysplasia have not been established.

Preliminary Pain and Function After Labral Reconstruction During Femoroacetabular Impingement Surgery

Justin A. Walker MD, Michael Pagnotto MD, Robert T. Trousdale MD, Rafael J. Sierra MD

Labral refixation rather than resection provides better pain relief and function after femoroacetabular impingement (FAI) surgery. When the labrum is absent, degenerated, or is irreparable, reconstruction may provide a favorable biomechanical environment for the hip. However, it is unclear whether labral reconstruction relieves pain and restores function.

Corrosion at the Cone/Taper Interface Leads to Failure of Large-diameter Metal-on-metal Total Hip Arthroplasties

Heiko Meyer MD, Tina Mueller BS, Gesine Goldau BS, Kathrin Chamaon PhD, Marcel Ruetschi MD, Christoph H. Lohmann MD

Metal-on-metal (MoM) THAs have reduced wear rates compared with metal-on-polyethylene. However, elevated serum metal ion levels and pseudotumors have been reported in large MoM articulations.

Aggressive Early Débridement for Treatment of Acutely Infected Cemented Total Hip Arthroplasty

Mohamed Sukeik MRCSEd, Shelain Patel MRCS, Fares Sami Haddad FRCS(Tr&O)

Up to 2% of THAs are complicated by infection, leading to dissatisfied patients with poor function and major social and economic consequences. The challenges are control of infection, restoration of full function, and prevention of recurrence. Irrigation and débridement with or without exchange of modular components remains an attractive alternative to two-stage reimplantation in acutely infected THAs but with variable results from previous studies.

Save the Torn Labrum in Hips With Borderline Acetabular Coverage

Niraj V. Kalore MD, William A. Jiranek MD

Hip arthroscopy for labral tears improves short-term function, but reoperations occur in 5% to 47% of patients. The effect of borderline acetabular coverage on reoperation rate has been debated. Labral repair rather than débridement has been proposed to improve function, but the effect on reoperation rate is unclear.

Do Revised Hip Resurfacing Arthroplasties Lead to Outcomes Comparable to Those of Primary and Revised Total Hip Arthroplasties?

William Desloges MD, Isabelle Catelas PhD, Toru Nishiwaki MD, Paul R. Kim MD, FRCSC, Paul E. Beaulé MD, FRCSC

A theoretical clinical advantage of hip resurfacing (HR) is the preservation of femoral bone. HR femoral component revision reportedly yields postoperative function comparable to that of primary THA. However, few studies have looked at the outcome of both HR femoral and acetabular side revisions.