Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 716 articles


Low Incidence of Groin Pain and Early Failure with Large Metal Articulation Total Hip Arthroplasty

John B. Meding MD, Lindsey K. Meding, E. Michael Keating MD, Michael E. Berend MD

Large-diameter metal-on-metal articulations reportedly improve stability and wear in THAs. However, some reports suggest some patients have unexplained hip and early failures with these implants. Thus, the potential benefits may be offset by these concerns. However, the incidence of these problems is not clearly established.

A Short Tapered Stem Reduces Intraoperative Complications in Primary Total Hip Arthroplasty

Ryan G. Molli DO, Adolph V. Lombardi MD, FACS, Keith R. Berend MD, Joanne B. Adams BFA, Michael A. Sneller BS

While short-stem design is not a new concept, interest has surged with increasing utilization of less invasive techniques. Short stems are easier to insert through small incisions. Reliable long-term results including functional improvement, pain relief, and implant survival have been reported with standard tapered stems, but will a short taper perform as well?

Stable Fixation of Short-stem Femoral Implants in Patients 70 Years and Older

Ronak M. Patel MD, Matthew C. Smith MD, Chase C. Woodward BA, S. David Stulberg MD

Limitations of conventional uncemented femoral stems persist, including proximal-distal mismatch, nonideal load transfer, loss of bone, and difficulties with minimally invasive surgery. Metaphyseal-engaging short-stem implants have been designed to address these issues in THA. While these devices have been studied in younger patients, it is unclear whether they offer advantages in older patients.

The John Charnley Award: An Accurate and Extremely Sensitive Method to Separate, Display, and Characterize Wear Debris Part 2: Metal and Ceramic Particles

Fabrizio Billi PhD, Paul Benya PhD, Aaron Kavanaugh BS, John Adams MD, PhD, Harry McKellop PhD, Edward Ebramzadeh PhD

Metal-on-metal and ceramic-on-ceramic bearings were introduced as alternatives to conventional polyethylene in hip arthroplasties to reduce wear. Characterization of wear particles has been particularly challenging due to the low amount and small size of wear particles. Current methods of analysis of such particles have shortcomings, including particle loss, clumping, and inaccurate morphologic and chemical characterization.

The John Charnley Award: An Accurate and Sensitive Method to Separate, Display, and Characterize Wear Debris: Part 1: Polyethylene Particles

Fabrizio Billi PhD, Paul Benya PhD, Aaron Kavanaugh BS, John Adams MD, PhD, Edward Ebramzadeh PhD, Harry McKellop PhD

Numerous studies indicate highly crosslinked polyethylenes reduce the wear debris volume generated by hip arthroplasty acetabular liners. This, in turns, requires new methods to isolate and characterize them.

The Effect of Poly Sterilization on Wear, Osteolysis and Survivorship of a Press-fit Cup at 10-Year Followup

Charles A. Engh MD, Cara C. Powers MD, Henry Ho MS, Sarah E. Beykirch-Padgett BS, Robert H. Hopper PhD, C. Anderson Engh MD

During the mid-1990s when our institution was using a press-fit porous-coated cup without supplemental initial fixation for primary THA, the manufacturer transitioned from gamma irradiation to gas plasma for the terminal sterilization of their polyethylene liners.

Which Factors Influence Preservation of the Osteonecrotic Femoral Head?

Jay R. Lieberman MD, Stephen M. Engstrom BS, R. Michael Meneghini MD, Nelson Fong SooHoo MD

Although surgeons use many procedures to preserve the femoral head in patients with hip osteonecrosis, there is no consensus regarding the best procedure.

Accumulation of Fatty Marrow in the Osteonecrotic Hip Mimicking Joint Infection

Tae-Young Kim MD, Sun-Joo Kim MD, Young-Kyun Lee MD, Kyung-Hoi Koo MD

Factors such as lipids or cholesterol crystals in body fluids can cause a spurious elevation of leukocytes (WBC) in an automated cell count. This artifact can occur in automated WBC counts of hip fluid from femoral head osteonecrosis (ON), and an erroneous diagnosis of septic arthritis can be made.

Alumina-on-alumina THA in Patients with Juvenile Idiopathic Arthritis: A 5-year Followup Study

Ana Cruz-Pardos MD, Eduardo García-Rey MD, Eduardo García-Cimbrelo MD, Jose Ortega-Chamarro MD

THA is a concern in juvenile idiopathic arthritis (JIA) owing to patients’ youth, poor bone stock, and small physical size.

Measuring the Value of Total Hip and Knee Arthroplasty: Considering Costs Over the Continuum of Care

Deborah A. Marshall PhD, Tracy Wasylak MSc, CHE, Hoa Khong MD, Robyn D. Parker BSc, Peter D. Faris PhD, Cy Frank MD FRCSC

Controlling escalating costs of hip (THA) and knee arthroplasty (TKA) without compromising quality of care has created the need for innovative system reorganization to inform sustainable solutions.