Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 723 articles


Is Administratively Coded Comorbidity and Complication Data in Total Joint Arthroplasty Valid?

Kevin J. Bozic MD, MBA, Ravi K. Bashyal MD, Shawn G. Anthony MD, MBA, Vanessa Chiu MPH, Brandon Shulman BS, Harry E. Rubash MD

Administrative claims data are increasingly being used in public reporting of provider performance and health services research. However, the concordance between administrative claims data and the clinical record in lower extremity total joint arthroplasty (TJA) is unknown.

Socket Position Determines Hip Resurfacing 10-Year Survivorship

Harlan C. Amstutz MD, Michel J. Duff MA, Alicia J. Johnson BA

Modern metal-on-metal hip resurfacing arthroplasty designs have been used for over a decade. Risk factors for short-term failure include small component size, large femoral head defects, low body mass index, older age, high level of sporting activity, and component design, and it is established there is a surgeon learning curve. Owing to failures with early surgical techniques, we developed a second-generation technique to address those failures. However, it is unclear whether the techniques affected the long-term risk factors.

High Survivorship of Cemented Sockets with Roof Graft for Severe Acetabular Dysplasia

Vincent J. J. F. Busch MD, Nicholas D. Clement MRCS, Ed, Philipp F. J. Mayer, Steffen J. Breusch FRCSEd, Colin R. Howie FRCSEd

Socket fixation in patients with acetabular dysplasia can be technically demanding but the use of structural grafts can help to reconstruct the original center of hip rotation. Because reported survival rates differ, construct survival seems to depend on the technique of graft preparation and fixation.

Joint-preserving Surgery Improves Pain, Range of Motion, and Abductor Strength After Legg-Calvé-Perthes Disease

Christoph Emanuel Albers MD, Simon Damian Steppacher MD, Reinhold Ganz MD, Klaus Arno Siebenrock MD, Moritz Tannast MD

Patients after Legg-Calvé-Perthes disease (LCPD) often develop pain, impaired ROM, abductor weakness, and progression of osteoarthritis (OA) in early adulthood. Based on intraoperative observations during surgical hip dislocation, we established an algorithm for more detailed characterization of the underlying pathomorphologies with a proposed joint-preserving surgical treatment.

LCPD: Reduced Range of Motion Resulting From Extra- and Intraarticular Impingement

Moritz Tannast MD, Markus Hanke, Timo M. Ecker MD, Stephen B. Murphy MD, Christoph E. Albers MD, Marc Puls PhD

Legg-Calvé-Perthes disease (LCPD) often results in a deformity that can be considered as a complex form of femoroacetabular impingement (FAI). Improved preoperative characterization of the FAI problem based on a noninvasive three-dimensional computer analysis may help to plan the appropriate operative treatment.

Reliability of a Complication Classification System for Orthopaedic Surgery

Ernest L. Sink MD, Michael Leunig MD, Ira Zaltz MD, Jennifer Claire Gilbert MS, John Clohisy MD

Quality of health care and safety have been emphasized by various professional and governmental groups. However, no standardized method exists for grading and reporting complications in orthopaedic surgery. Conclusions regarding outcomes are incomplete without a standardized, objective complication grading scheme applied concurrently. The general surgery literature has the Clavien-Dindo classification that meets the above criteria.

Surgical Technique: A Percutaneous Method of Subcutaneous Fixation for the Anterior Pelvic Ring: The Pelvic Bridge

Timothy G. Hiesterman DO, Brian W. Hill MD, Peter A. Cole MD

Management of pelvic ring injuries using minimally invasive techniques may be desirable if reduction and stability can be achieved. We present a new technique, the anterior pelvic bridge, which is a percutaneous method of fixing the anterior pelvis through limited incisions over the iliac crest(s) and pubic symphysis.

Clinical Stability of Slipped Capital Femoral Epiphysis does not Correlate with Intraoperative Stability

Kai Ziebarth MD, Stephan Domayer MD, Theddy Slongo MD, Young-Jo Kim MD, PhD, Reinhold Ganz MD

The most important objective of clinical classifications of slipped capital femoral epiphysis (SCFE) is to identify hips associated with a high risk of avascular necrosis (AVN) — so-called unstable or acute slips; however, closed surgery makes confirmation of physeal stability difficult. Performing the capital realignment procedure in SCFE treatment we observed that clinical estimation of physeal stability did not always correlate with intraoperative findings at open surgery. This motivated us to perform a systematic comparison of the clinical classification systems with the intraoperative observations.

Preoperative Three-dimensional CT Predicts Intraoperative Findings in Hip Arthroscopy

Benton E. Heyworth MD, Mark M. Dolan MD, Joseph T. Nguyen MPH, Neal C. Chen MD, Bryan T. Kelly MD

Currently, plain radiographs and MRI are the standard imaging modalities used for diagnosing femoroacetabular impingement (FAI) and preoperative planning for arthroscopic treatment of FAI. The value of three-dimensional (3D) CT for these purposes is unclear.

Edge Loading Has a Paradoxical Effect on Wear in Metal-on-Polyethylene Total Hip Arthroplasties

William H. Harris MD, DSc

Edge wear is an adverse factor that can negatively impact certain THAs. In some metal-on-metal THAs, it can lead to adverse tissue reactions including aseptic lymphocytic vasculitis-associated lesions and even to pseudotumor formation. In some ceramic-on-ceramic THAs, it can lead to squeaking and/or stripe wear. Edge wear in metal-on-metal and ceramic-on-ceramic THAs can also be associated with accelerated wear across the articulation of these joints.