Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles


The Acetabular Wall Index for Assessing Anteroposterior Femoral Head Coverage in Symptomatic Patients

Klaus A. Siebenrock MD, Lea Kistler, Joseph M. Schwab MD, Lorenz Büchler MD, Moritz Tannast MD

Understanding acetabular pathomorphology is necessary to correctly treat patients with hip complaints. Existing radiographic parameters classify acetabular coverage as deficient, normal, or excessive but fail to quantify contributions of anterior and posterior wall coverage. A simple, reproducible, and valid measurement of anterior and posterior wall coverage in patients with hip pain would be a clinically useful tool.

What Are the Risks Accompanying the Reduced Wear Benefit of Low-clearance Hip Resurfacing?

Joseph Daniel FRCS MS(Orth), Hena Ziaee BSc(Hons), Amir Kamali PhD, MEng, Chandra Pradhan FRCS MCh(Orth), Derek McMinn MD, FRCS

Clearance is an important determinant of metal-metal bearing function. Tribologic theory and laboratory evidence suggest low clearance (LC) reduces wear but with a potential to increase friction and clinical reports show LC resurfacings have high implant failure rates. Thus, the role of LC is unclear.

Pelvic Morphology Differs in Rotation and Obliquity Between Developmental Dysplasia of the Hip and Retroversion

Moritz Tannast MD, Peter Pfannebecker MD, Joseph M. Schwab MD, Christoph E. Albers MD, Klaus A. Siebenrock MD, Lorenz Büchler MD

Developmental dysplasia of the hip (DDH) and acetabular retroversion represent distinct acetabular pathomorphologies. Both are associated with alterations in pelvic morphology. In cases where direct radiographic assessment of the acetabulum is difficult or impossible or in mixed cases of DDH and retroversion, additional indirect pelvimetric parameters would help identify the major underlying structural abnormality.

Is Posterior Hip Instability Associated with Cam and Pincer Deformity?

Aaron J. Krych MD, Matt Thompson MD, Christopher M. Larson MD, J. W. Thomas Byrd MD, Bryan T. Kelly MD

Posterior hip instability is an increasingly recognized injury in athletes; however, the function of patients after these injuries and an understanding of the pathoanatomy and underlying mechanism are currently unclear.

Surgical Technique: Second-generation Bone Marrow Stimulation via Surgical Dislocation to Treat Hip Cartilage Lesions

Michael Leunig MD, Lisa M. Tibor MD, Florian D. Naal MD, Reinhold Ganz MD, Matthias R. Steinwachs MD

Compared to knees, hips have more bony constraint and soft tissue coverage. Thus, repair of focal cartilage defects in hips requires more invasive and technically complex surgeries than simple arthroscopy or arthrotomy. Autologous matrix-induced chondrogenesis (AMIC) is a second-generation bone marrow stimulation technique. Improvement in Tegner, Lysholm, International Cartilage Repair Society (ICRS), and Cincinnati scores has been reported at 1 and 2 years after AMIC in knees. AMIC is potentially useful to repair defects in hips, but it is unknown whether it relieves symptoms or results in a durable construct.

Acetabular Component Positioning Using Anatomic Landmarks of the Acetabulum

Yong-Chan Ha MD, Jeong Joon Yoo MD, PhD, Young-Kyun Lee MD, Jin Young Kim MD, Kyung-Hoi Koo MD

The acetabular cup should be properly oriented to prevent dislocation and to reduce wear. However, achieving proper cup placement is challenging with potentially large variations of cup position. We propose a new technique to position the acetabular cup.

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.