Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

Do Bone Graft and Cracking of the Sclerotic Cavity Improve Fixation of Titanium and Hydroxyapatite-coated Revision Implants in an Animal Model?

Brian Elmengaard MD, PhD, Joergen Baas MD, PhD, Thomas Jakobsen MD, PhD, Soren Kold MD, PhD, Thomas B. Jensen MD, PhD, Joan E. Bechtold PhD, Kjeld Soballe MD, DSc

We previously introduced a manual surgical technique that makes small perforations (cracks) through the sclerotic bone shell that typically forms during the process of aseptic loosening (“crack” revision technique). Perforating just the shell (without violating the proximal cortex) can maintain overall bone continuity while allowing marrow and vascular elements to access the implant surface. Because many revisions require bone graft to fill defects, we wanted to determine if bone graft could further increase implant fixation beyond what we have experimentally shown with the crack technique alone. Also, because both titanium (Ti6Al4V) and hydroxyapatite (HA) implant surfaces are used in revisions, we also wanted to determine their relative effectiveness in this model.

Is Botulinum Toxin Type A a Valuable Adjunct During Femoral Lengthening? A Randomized Trial

Hoon Park MD, Soowan Shin BS, Han Sol Shin MD, Hyun Woo Kim MD, Dong Wook Kim MD, Dong Hoon Lee MD, PhD

Reduced joint ROM and distraction-induced pain are common complaints of patients who have undergone gradual femoral lengthening. Attempts to reduce the effects of lengthening on joint motion have included the use of botulinum toxin to reduce the muscle forces that restrict motion. The benefits of this approach during femoral lengthening, however, have not been conclusively established.

What is the Prevalence of Radiographic Hip Findings Associated With Femoroacetabular Impingement in Asymptomatic Asian Volunteers?

Taesoo Ahn MD, Chul-Ho Kim MD, Tae Hyung Kim MD, Jae Suk Chang MD, PhD, Mi Yeon Jeong RN, Kekatpure Aditya DNB, Pil Whan Yoon MD, PhD

Morphologic features of the proximal femur reminiscent of those seen in patients with femoroacetabular impingement (FAI) have been reported among asymptomatic individuals in Western populations, but whether this is the case in Asian populations is unknown.

T1ρ Hip Cartilage Mapping in Assessing Patients With Cam Morphology: How Can We Optimize the Regions of Interest?

Helen Anwander MD, Kawan S. Rakhra MD, Gerd Melkus PhD, Paul E. Beaulé MD

T1ρ MRI has been shown feasible to detect the biochemical status of hip cartilage, but various region-of-interest strategies have been used, compromising the reproducibility and comparability between different institutions and studies.

Does Surgeon Experience Impact the Risk of Complications After Bernese Periacetabular Osteotomy?

Eduardo N. Novais MD, Patrick M. Carry BA, Lauryn A. Kestel BS, Brian Ketterman BS, Christopher M. Brusalis BA, Wudbhav N. Sankar MD

Bernese periacetabular osteotomy (PAO) is a technically challenging procedure with potential risk for major complications and a previously reported steep learning curve. However, the impact of contemporary hip preservation fellowships on the learning curve of PAO has not been established.

Satisfying Results of Primary Hip Arthroplasty in Patients With Hip Dysplasia at a Mean Followup of 20 Years

Ena Colo MD, Wim H. C. Rijnen MD, PhD, Jean W. M. Gardeniers MD, PhD, Albert Kampen MD, PhD, B. Willem Schreurs MD, PhD

Developmental dysplasia of the hip (DDH) is a common cause of secondary osteoarthritis (OA) in younger patients, and when end-stage OA develops, a THA can provide a solution. Different options have been developed to reconstruct these defects, one of which is impaction bone grafting combined with a cemented cup. To determine the true value of a specific technique, it is important to evaluate patients at a long-term followup. As there are no long-term studies, to our knowledge, on THA in patients with DDH using impaction bone grafting with a cemented cup, we present the results of this technique at a mean of 15 years in patients with previous DDH.

What Is the Natural History of Asymptomatic Pseudotumors in Metal-on-metal THAs at Mid-term Followup?

Sujith Konan MBBS, MD (res), FRCS(Tr&Orth), Clive P. Duncan MD, MSc, FRCSC, Bassam S. Masri MD, FRCSC, Donald S. Garbuz MD, MSc, FRCSC

The risk of early revision because of pseudotumors in patients who have undergone large-head metal-on-metal (MoM) total hip arthroplasty (THA) is well documented. However, the natural history of asymptomatic pseudotumors or of MoM articulations without pseudotumors is less well understood. The aim of our study was to investigate the natural history of primary MoM THA at mid-term followup.

One-stage Revision With Catheter Infusion of Intraarticular Antibiotics Successfully Treats Infected THA

Leo A. Whiteside MD, M. E. Roy PhD

Two-stage revision surgery for infected total hip arthroplasty (THA) is commonly advocated, but substantial morbidity and expense are associated with this technique. In certain cases of infected THA, treatment with one-stage revision surgery and intraarticular infusion of antibiotics may offer a reasonable alternative with the distinct advantage of providing a means of delivering the drug in high concentrations.

Two- to 4-Year Followup of a Short Stem THA Construct: Excellent Fixation, Thigh Pain a Concern

Richard L. Amendola MS, Devon D. Goetz MD, Steve S. Liu MD, John J. Callaghan MD

Short stem cementless femoral components were developed to aid insertion through smaller incisions, preserve metaphyseal bone, and potentially decrease or limit the incidence of thigh pain. Despite some clinical success, the senior author (DDG) believed a higher percentage of his patients who had received a cementless short stem design were experiencing thigh pain, which, coupled with concerns about bone ingrowth fixation, motivated the review of this case series.