Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 723 articles

Articles

Satisfying Results of Primary Hip Arthroplasty in Patients With Hip Dysplasia at a Mean Followup of 20 Years

Ena Colo MD, Wim H. C. Rijnen MD, PhD, Jean W. M. Gardeniers MD, PhD, Albert Kampen MD, PhD, B. Willem Schreurs MD, PhD

Developmental dysplasia of the hip (DDH) is a common cause of secondary osteoarthritis (OA) in younger patients, and when end-stage OA develops, a THA can provide a solution. Different options have been developed to reconstruct these defects, one of which is impaction bone grafting combined with a cemented cup. To determine the true value of a specific technique, it is important to evaluate patients at a long-term followup. As there are no long-term studies, to our knowledge, on THA in patients with DDH using impaction bone grafting with a cemented cup, we present the results of this technique at a mean of 15 years in patients with previous DDH.

What Is the Natural History of Asymptomatic Pseudotumors in Metal-on-metal THAs at Mid-term Followup?

Sujith Konan MBBS, MD (res), FRCS(Tr&Orth), Clive P. Duncan MD, MSc, FRCSC, Bassam S. Masri MD, FRCSC, Donald S. Garbuz MD, MSc, FRCSC

The risk of early revision because of pseudotumors in patients who have undergone large-head metal-on-metal (MoM) total hip arthroplasty (THA) is well documented. However, the natural history of asymptomatic pseudotumors or of MoM articulations without pseudotumors is less well understood. The aim of our study was to investigate the natural history of primary MoM THA at mid-term followup.

One-stage Revision With Catheter Infusion of Intraarticular Antibiotics Successfully Treats Infected THA

Leo A. Whiteside MD, M. E. Roy PhD

Two-stage revision surgery for infected total hip arthroplasty (THA) is commonly advocated, but substantial morbidity and expense are associated with this technique. In certain cases of infected THA, treatment with one-stage revision surgery and intraarticular infusion of antibiotics may offer a reasonable alternative with the distinct advantage of providing a means of delivering the drug in high concentrations.

Two- to 4-Year Followup of a Short Stem THA Construct: Excellent Fixation, Thigh Pain a Concern

Richard L. Amendola MS, Devon D. Goetz MD, Steve S. Liu MD, John J. Callaghan MD

Short stem cementless femoral components were developed to aid insertion through smaller incisions, preserve metaphyseal bone, and potentially decrease or limit the incidence of thigh pain. Despite some clinical success, the senior author (DDG) believed a higher percentage of his patients who had received a cementless short stem design were experiencing thigh pain, which, coupled with concerns about bone ingrowth fixation, motivated the review of this case series.

Is There a Difference in Revision Risk Between Metal and Ceramic Heads on Highly Crosslinked Polyethylene Liners?

Guy Cafri PhD, MStat, Elizabeth W. Paxton MA, Rebecca Love MPH, RN, Stefano A. Bini MD, Steven M. Kurtz PhD

The most common bearing surface used among primary THAs worldwide is a metal or ceramic femoral head that articulates against a highly crosslinked ultrahigh-molecular-weight polyethylene (HXLPE) acetabular liner. Despite their widespread use, relatively little is known about the comparative effectiveness of ceramic versus metal femoral heads with respect to risk of revision and dislocation as well as the role of head size in this relationship.

The Role of Highly Selective Implant Retention in the Infected Hip Arthroplasty

Moataz El-Husseiny MB BCh, MRCS, Dip Sport M, MD (Res), Fares S. Haddad BSc, MCh(Orth), FRCS(Orth), MD (Res), FFSEM

There is debate around how to treat patients with periprosthetic joint infection of the hip. When there is an ingrown component on one side of the arthroplasty and a loose component on the other, treatment is typically revision of the entire construct. There is an argument to retain an ingrown implant in instances in which removal would result in severe bone damage. However, little has been reported on the likelihood of success with this approach.

Does Surface Topography Play a Role in Taper Damage in Head-neck Modular Junctions?

Robin Pourzal PhD, Deborah J. Hall BS, Nguyen Q. Ha BA, Robert M. Urban, Brett R. Levine MD, Joshua J. Jacobs MD, Hannah J. Lundberg PhD

There are increasing reports of total hip arthroplasty failure subsequent to modular taper junction corrosion. The surfaces of tapers are machined to have circumferential machining marks, resulting in a surface topography of alternating peaks and valleys on the scale of micrometers. It is unclear if the geometry of this machined surface topography influences the degree of fretting and corrosion damage present on modular taper junctions or if there are differences between modular taper junction material couples.

Is Model-based Radiostereometric Analysis Suitable for Clinical Trials of a Cementless Tapered Wedge Femoral Stem?

Sanaz Nazari-Farsani MSc, Sami Finnilä BM, Niko Moritz PhD, Kimmo Mattila MD, PhD, Jessica J. Alm MSc, Hannu T. Aro MD, PhD

In clinical trials of THA, model-based radiostereometric analysis (RSA) techniques may be less precise than conventional marker-based RSA for measurement of femoral stem rotation. We verified the accuracy and clinical precision of RSA based on computer-aided design models of a cementless tapered wedge femoral stem.

Cementless Total Hip Arthroplasty With Metasul Bearings Provides Good Results in Active Young Patients: A Concise Followup

Christian P. Delaunay MD, Sophie Putman MD, Benjamin Puliéro MD, Matthieu Bégin MD, Henri Migaud MD, François Bonnomet MD

A primary concern of younger, more active patients who have undergone total hip arthroplasty (THA) is the longevity of the implant. Cementless fixation and hard-on-hard bearings are recognized as options to enhance THA durability. Earlier, we published a series of 83 cementless primary THAs using 28-mm metal-on-metal (MoM) bearings in patients aged 50 years or younger; here we provide concise followup on that same group after an additional 8-year survey period.

Do the Reasons for Ceramic-on-ceramic Revisions Differ From Other Bearings in Total Hip Arthroplasty?

Henri Migaud MD, Sophie Putman MD, Grégory Kern MD, Ronald Isida MD, Julien Girard MD, PhD, Nassima Ramdane PhD, Christian P. Delaunay MD, Moussa Hamadouche MD, PhD

Despite widespread use of ceramic-on-ceramic (CoC) in total hip arthroplasty (THA) during the past 10 years, little is known about why revisions are performed in hips with this bearing or the time elapsed before revision.