Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles


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.

Coordinating Retrieval and Register Studies Improves Postmarket Surveillance

Peter Ellison PhD, Geir Hallan MD, PhD, Paul Johan Høl PhD, Nils Roar Gjerdet DDS, PhD, Leif I. Havelin MD, PhD

The relative risk of revision of the Titanfemoral stem due to aseptic loosening increased after 2000; however, the reasons for this have not been established. A retrieval analysis was initiated with the aim of delineating the failure mechanism.

The Vascularized Fibular Graft in Precollapse Osteonecrosis: Is Long-term Hip Preservation Possible?

William C. Eward DVM, MD, Craig A. Rineer MD, James R. Urbaniak MD, Marc J. Richard MD, David S. Ruch MD

Osteonecrosis of the femoral head (ONFH) is a debilitating condition affecting primarily young patients. Free vascularized fibular grafting (FVFG) may provide a durable means to preserve the femoral head. When used in the precollapse stages of ONFH, this treatment may alter the course of disease.

A Dual-mobility Cup Reduces Risk of Dislocation in Isolated Acetabular Revisions

Roberto Civinini MD, Christian Carulli MD, Fabrizio Matassi MD, Lorenzo Nistri MD, Massimo Innocenti MD

Isolated acetabular revisions using standard cups are at risk of dislocation. The introduction of a nonconstrained dual-mobility cup was designed to improve prosthetic stability without increasing loosening rates, but it is unclear whether the risk of dislocation is reduced.