Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

Case Report: Bilateral Femoral Neck Fractures in a Child and a Rare Complication of Slipped Capital Epiphysis After Internal Fixation

Nirmal Raj Gopinathan MS, Dip SICOT, Devendra Chouhan MS, Narendranadh Akkina MS, Prateek Behera MBBS

Bilateral traumatic femoral neck fractures are uncommon in children. The most commonly reported complications are nonunion, avascular necrosis of the femoral head, and chondrolysis. Slipped capital femoral epiphysis (SCFE) associated with nonunion after percutaneous partially threaded cancellous screw (PTCS) fixation of the fracture is an unreported complication.

Does Bone Wax Induce a Chronic Inflammatory Articular Reaction?

Lucian B. Solomon MD, PhD, FRACS, Carlos Guevara MD, PD, Lorenz Büchler MD, Donald W. Howie MBBS, PhD, FRACS, Roger W. Byard MD, Martin Beck MD, PD

Bone wax is used to control femoral neck bleeding during open femoroacetabular impingement (FAI) surgery. Despite its widespread use, only a few case reports and small case series describe side effects after extraarticular use. It is unclear whether intraarticular use of bone wax leads to such complications. However, during revision FAI surgery, we have observed various degrees of articular inflammatory reactions.

Parafoveal Chondral Defects Associated with Femoroacetabular Impingement

Ira Zaltz MD, Michael Leunig MD

Cam-type, pincer, and mixed femoroacetabular impingement (FAI) are accepted causes of labral and acetabular rim injury; however, the abnormal contact stresses associated with motion may damage other areas of the hip. Although cartilage damage to the femoral head has been reported previously in athletes, FAI-associated focal parafoveal chondral defects differ from previously reported lesions and represent a rare manifestation of the complex pathomechanics associated with FAI.

Slipped Capital Femoral Epiphysis: Prevalence, Pathogenesis, and Natural History

Eduardo N. Novais MD, Michael B. Millis MD

Obesity is a risk factor for developing slipped capital femoral epiphysis (SCFE). The long-term outcome after SCFE treatment depends on the severity of residual hip deformity and the occurrence of complications, mainly avascular necrosis (AVN). Femoroacetabular impingement (FAI) is associated with SCFE-related deformity and dysfunction in both short and long term.

Anterior Impingement Test for Labral Lesions Has High Positive Predictive Value

Takehito Hananouchi MD, PhD, Yukihiko Yasui MD, Kengo Yamamoto MD, Yukiyoshi Toritsuka MD, PhD, Kenji Ohzono MD, PhD

The anterior impingement test is intended to detect anterosuperior acetabular labral lesions. In patients treated for labral lesions its sensitivity is reportedly 95% to 100%, and in a small group of patients undergoing periacetabular osteotomy, its sensitivity was 59% and specificity 100%. However, the sensitivity, specificity, positive predictive value, and negative predict value of this test to detect these labral lesions in unselected patients with hip pain are unknown.

Report of Breakout Session: Strategies to Improve Hip Preservation Training

Christopher L. Peters MD, Paul E. Beaulé MD, Martin Beck MD, Moritz Tannast MD, William Jiranek MD, Rafael J. Sierra MD

The Biomechanical Case for Labral Débridement

Ira Zaltz MD

Labral repair is increasingly performed in conjunction with open and arthroscopic surgical procedures used to treat patients with mechanically related hip pain. The current rationale for labral repair is based on restoring the suction-seal function and clinical reports suggesting improved clinical outcome scores when acetabular rim trimming is accompanied by labral repair. However, it is unclear whether available scientific evidence supports routine labral repair.

Surgical Technique: The Capsular Arthroplasty: A Useful But Abandoned Procedure for Young Patients With Developmental Dysplasia of the Hip

Reinhold Ganz MD, Theddy Slongo MD, Klaus A. Siebenrock MD, Luigino Turchetto MD, Michael Leunig MD

Codivilla in 1901, Hey Groves in 1926, and Colonna in 1932 described similar capsular arthroplasties—wrapping the capsule around the femoral head and reducing into the true acetabulum—to treat completely dislocated hips in children with dysplastic hips. However, these procedures were associated with relatively high rates of necrosis, joint stiffness, and subsequent revision procedures, and with the introduction of THA, the procedure vanished despite some hips with high functional scores over periods of up to 20 years. Dislocated or subluxated hips nonetheless continue to be seen in adolescents and young adults, and survival curves of THA decrease faster for young patients than for patients older than 60 years. Therefore, joint preservation with capsular arthroplasty may be preferable if function can be restored and complication rates reduced.

Preoperative Anemia in Total Joint Arthroplasty: Is It Associated with Periprosthetic Joint Infection?

Max Greenky BA, Kishor Gandhi MD, MPH, Luis Pulido MD, Camilo Restrepo MD, Javad Parvizi MD

Anemia is common in patients undergoing total joint arthroplasty (TJA). Numerous studies have associated anemia with increased risk of infection, length of hospital stay, and mortality in surgical populations. However, it is unclear whether and to what degree preoperative anemia in patients undergoing TJA influences postoperative periprosthetic joint infection (PJI) and mortality.

Culture-negative Periprosthetic Joint Infection Does Not Preclude Infection Control

Ronald Huang MD, Chi-Chien Hu MD, Bahar Adeli BS, Javad Mortazavi MD, Javad Parvizi MD

Periprosthetic joint infection (PJI) is a devastating complication after total joint arthroplasty. Lack of confirmation of an infecting organism poses a challenge with regard to the selection of an appropriate antibiotic agent and surgical treatment. It is unclear whether patients with negative cultures presumed to have infections achieve similar rates of infection-free survival as those with positive cultures.