Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 721 articles


What Is the Evidence Supporting the Prevention of Osteoarthritis and Improved Femoral Coverage After Shelf Procedure for Legg-Calvé-Perthes Disease?

Jason E. Hsu MD, Keith D. Baldwin MD, Moritz Tannast MD, Harish Hosalkar MD

The evidence supporting continued use of shelf acetabuloplasty in Legg-Calvé-Perthes disease (LCPD) is not well-defined, and there is controversy regarding the long-term benefits related to clinical and functional improvement.

Fixation Failures of Dual Mobility Cups: A Mid-term Study of 2601 Hip Replacements

Philippe Massin MD, PhD, Vincent Orain MD, Rémi Philippot MD, Frederic Farizon MD, PhD, Michel Henry Fessy MD, PhD

The use of dual-mobility cups has increased because of a low rate of dislocations combined with a 96% 15-year survival rate. However, late cup migrations have been attributed to their fixation (tripod - exact fit with two pegs and one extraacetabular screw) and the absence of porous coating. In a second-generation device, the designs were modified to achieve press-fit fixation and a layer of titanium beads was sintered on stainless steel cups.

Constrained Cups Appear Incapable of Meeting the Demands of Revision THA

Philip C. Noble PhD, Salim K. Durrani MD, Molly M. Usrey BS, Kenneth B. Mathis MD, Nikolaos V. Bardakos MD

Failure rates of constrained cups for treating recurrent dislocation in revision THA range from 40% to 100%. Although constrained liners are intended to stabilize the hip by mechanically preventing dislocation, the resulting loss of range of motion may lead to impingement and, ultimately, implant failure.

Case Report: Multifocal Subchondral Stress Fractures of the Femoral Heads and Tibial Condyles in a Young Military Recruit

Pil Whan Yoon MD, Jeong Joon Yoo MD, Kang Sup Yoon MD, Hee Joong Kim MD

Subchondral stress fractures of the femoral head may be either of the insufficiency-type with poor quality bone or the fatigue-type with normal quality bone but subject to high repetitive stresses. Unlike osteonecrosis, multiple site involvement rarely has been reported for subchondral stress fractures. We describe a case of multifocal subchondral stress fractures involving femoral heads and medial tibial condyles bilaterally within 2 weeks.

Pseudotumors Are Common in Well-positioned Low-wearing Metal-on-Metal Hips

Ashley K. Matthies BSc, John A. Skinner FRCS(Orth), Humza Osmani BSc, Johann Henckel MRCS, Alister J. Hart MD, FRCSG(Orth)

Pseudotumors are sterile inflammatory lesions found in the soft tissues surrounding metal-on-metal (MOM) and metal-on-polyethylene hip arthroplasties. In patients with MOM hip arthroplasties, pseudotumors are thought to represent an adverse reaction to metal wear debris. However, the pathogenesis of these lesions remains unclear. Currently, there is inconsistent evidence regarding the influence of adverse cup position and increased wear in the formation of pseudotumors.

Predictors of Participation in Sports After Hip and Knee Arthroplasty

Daniel H. Williams MBBCh, MSc, Nelson V. Greidanus MD, MPH, Bassam A. Masri MD, Clive P. Duncan MD, MSc, Donald S. Garbuz MD, MHSc

While the primary objective of joint arthroplasty is to improve patient quality of life, pain, and function, younger active patients often demand a return to higher function that includes sporting activity. Knowledge of rates and predictors of return to sports will help inform expectations in patients anticipating return to sports after joint arthroplasty.

Factors Affecting Modular Acetabular Ceramic Liner Insertion: A Biomechanical Analysis

James P. McAuley MD, Douglas A. Dennis MD, Justin Grostefon, William G. Hamilton MD

Ceramic liner fracture is a concern in THA. However, it is unclear what factors influence the risk of facture. To study these factors under controlled conditions, we created a laboratory model to avoid fractures in vitro.

Triple Innominate Osteotomy for Legg-Calvé-Perthes Disease in Children: Does the Lateral Coverage Change With Time?

Harish Hosalkar MD, Ana Laura Munhoz da Cunha MD, Keith Baldwin MD, MPH, Kai Ziebarth MD, Dennis R. Wenger MD

Triple innominate osteotomy (TIO) is one of the modalities of surgical containment in Legg-Calvé-Perthes disease (LCPD). However, overcoverage with TIO can lead to pincer impingement.

Environmental Tobacco and Wood Smoke Increase the Risk of Legg-Calvé-Perthes Disease

Anjali Benjamin Daniel MD, Hitesh Shah MS Orth, Asha Kamath PhD, Vasudev Guddettu MSc, Benjamin Joseph MCh Orth

The etiology of Legg-Calvé-Perthes disease (LCPD) remains unknown. A few studies have suggested passive smoke inhalation may be a risk factor, although the association is not confirmed and a causal relationship has not been established.

Second-generation Annealed Highly Cross-linked Polyethylene Exhibits Low Wear

James A. D’Antonio MD, William N. Capello MD, Rama Ramakrishnan MS

Compared with conventional polyethylene, first-generation highly cross-linked polyethylenes have low wear, but controversy exists regarding their reduced mechanical strength and/or retained free radicals. Second-generation highly cross-linked polyethylenes have been developed to reduce wear, maintain mechanical strength, and have oxidative resistance, but it is unclear whether they do so.