Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

Reliability and Stability of Three Common Classifications for Legg-Calvé-Perthes Disease

Moon Seok Park MD, Chin Youb Chung MD, Kyoung Min Lee MD, Tae Won Kim MD, Ki Hyuk Sung MD

To predict the course of Legg-Calvé-Perthes disease (LCPD) and select between treatment options in the early stages, it is critical to have a reliable predictive classification.

Perioperative Clopidogrel and Postoperative Events after Hip and Knee Arthroplasties

Sumon Nandi MD, Mehran Aghazadeh MD, Carl Talmo MD, Claire Robbins DPT, James Bono MD

Hip and knee arthroplasties are widely performed and vascular disease among patients having these procedures is common. Clopidogrel is a platelet inhibitor that decreases the likelihood of thrombosis. It may cause intraoperative and postoperative bleeding, but its discontinuation increases the risk of vascular events. There is currently no consensus regarding the best perioperative clopidogrel regimen that balances these concerns.

High 10-Year Survival Rate with an Anatomic Cementless Stem (SPS)

Elhadi Sariali MD, PhD, Alexandre Mouttet MD, Philippe Mordasini MD, Yves Catonné MD

Proximal cementless fixation using anatomic stems reportedly increases femoral fit and avoids stress-shielding. However, thigh pain was reported with the early stem designs. Therefore, a new anatomic cementless stem design was based on an average three-dimensional metaphyseal femoral shape. However, it is unclear whether this stem reduces the incidence of thigh pain.

Treatment of Adolescents with a Periacetabular Osteotomy After Previous Pelvic Surgery

Adriana Rocha MS, Daniel J. Sucato MD, MS, Kirsten Tulchin MS, David A. Podeszwa MD

Although the success of the Bernese periacetabular osteotomy (PAO) has been reported for primary dysplasia, there is no study analyzing the radiographic, functional, and gait results of the PAO to correct residual hip dysplasia after previous pelvic surgery.

Total Hip Arthroplasty Versus Hemiarthroplasty for Displaced Femoral Neck Fractures: Meta-analysis of Randomized Trials

Ligang Yu MM, Yan Wang MD, Jiying Chen MD

Most patients with displaced femoral neck fractures are treated by THA and hemiarthroplasty, but it remains uncertain which if either is associated with better function and lower risks of complications.

Measuring Acetabular Component Version After THA: CT or Plain Radiograph?

Benjamin McArthur MD, Michael Cross MD, Christina Geatrakas MD, David Mayman MD, Bernard Ghelman MD

Although cross-table lateral radiographs are commonly used to measure acetabular component version after THA, recent studies suggest that CT-based measurement is more accurate. This has been attributed to variations in pelvic tilt, pelvic rotation, and component inclination. Furthermore, it has been suggested, based on limited data, that even with ideal positioning of the cross-table lateral radiograph, CT remains the more accurate modality.

High Survival of Dome Pelvic Osteotomy in Patients with Early Osteoarthritis from Hip Dysplasia

Takashi Sakai MD, PhD, Takashi Nishii MD, PhD, Masaki Takao MD, PhD, Kenji Ohzono MD, PhD, Nobuhiko Sugano MD, PhD

The Chiari osteotomy reportedly has a 60% to 91% survival rate at a minimum 20 years followup. The dome pelvic osteotomy (DPO) has the advantage of allowing a larger weightbearing surface, and congruity in the sagittal plane presumably would reduce the joint contact stress and perhaps increase longevity.

High Rate of Ceramic Sandwich Liner Fracture

Ronny Lopes MD, Jean M. Philippeau MD, Norbert Passuti MD, PhD, François Gouin MD, PhD

Ceramic bearing surfaces for THA were introduced to reduce the risk of wear. However, owing to liner fracture in some of the early series and presumption that the fractures were the result of the modulus mismatch of the implant and the bone, a ceramic sandwich liner with lower structural rigidity was introduced. Fractures of these devices also were reported subsequently, although the incidence is unclear and it is unknown whether there are any risk factors associated with the fractures.

Is Helical Blade Nailing Superior to Locked Minimally Invasive Plating in Unstable Pertrochanteric Fractures?

Matthias Knobe MD, Wolf Drescher MD, PhD, Nicole Heussen MD, Richard Martin Sellei MD, Hans-Christoph Pape MD

Technical advancements have produced many challenges to intramedullary implants for unstable pertrochanteric fractures. Helical blade fixation of the femoral head has the theoretical advantages of higher rotational stability and cutout resistance and should have a lower rate of reoperation than a locked plating technique.

Anatomic Mapping of Short External Rotators Shows the Limit of Their Preservation During Total Hip Arthroplasty

Yoshiaki Ito MD, Isao Matsushita MD, PhD, Hiroki Watanabe MD, PhD, Tomoatsu Kimura MD, PhD

The direct anterior approach in THA requires no detachment of muscle insertions. However, damage to the short external rotator muscles may occur when attempting to elevate the femur for exposure. Although the anatomic insertions of these muscles are approximately known, there are no quantitative data regarding their locations.