Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles


Hip Injuries in the Overhead Athlete

Gregory G. Klingenstein MD, RobRoy Martin PhD, PT, CSCS, Ben Kivlan PT, SCS, OCS, CSCS, Bryan T. Kelly MD

The overhead athlete is at risk for shoulder and elbow injuries. However, the mechanics associated with overhead sports also place athletes at risk for hip injuries. Advancements in hip arthroscopy have identified femoroacetabular impingement (FAI) and instability as potential contributors to labral and chondral pathology in this athletic population.

Periarticular Local Anesthesia does not Improve Pain or Mobility after THA

I. Dobie MPhil, MRCS, D. Bennett PhD, D. J. Spence MRCS, J. M. Murray MD, FRCA, FFARCSI, D. E. Beverland MD, FRCS

Periarticular infiltration of local anesthetic, NSAIDs, and adrenaline have been reported to reduce postoperative pain, improve mobility, and reduce hospital stay for patients having THAs, but available studies have not determined whether local anesthetic infiltration alone achieves similar improvements.

Evidence for Using Bisphosphonate to Treat Legg-Calvé-Perthes Disease

Megan L. Young MD, David G. Little FRACS(Orth), PhD, Harry K. W. Kim MD, MS, FRCSC

The rationale for using bisphosphonate (BP) therapy for Legg-Calvé-Perthes disease (LCPD) is the potential to prevent substantial femoral head deformity during the fragmentation phase by inhibiting osteoclastic bone resorption. However, it is unclear whether BP therapy decreases femoral head deformity.

Minimally Invasive Total Hip Arthroplasty Using a Transpiriformis Approach: A Preliminary Report

Douglas J. Roger MD, David Hill PA‐C

Continuing efforts have been made to develop minimally invasive surgery techniques for THA. One of the most commonly performed of these techniques is the mini-posterior approach. All reported series using this approach describe surgical detachment of the short external rotators of the hip. In 2008, Penenberg et al. described an innovative surgical technique that preserves the short external rotators. We present the results of a single-incision modification of this technique in 135 patients.

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.