Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 723 articles

Articles

The Otto Aufranc Award: Demineralized Bone Matrix Around Porous Implants Promotes Rapid Gap Healing and Bone Ingrowth

Letitia Lim MD, J. Dennis Bobyn PhD, Kristian M. Bobyn BA, Louis-Philippe Lefebvre MEng, Michael Tanzer MD

Noncemented revision arthroplasty is often complicated by the presence of bone implant gaps that reduce initial stability and biologic fixation. Demineralized bone matrix has osteoinductive properties and therefore the potential to enhance gap healing and porous implant fixation.

Does International Normalized Ratio Level Predict Pulmonary Embolism?

Patricia Hansen BS, Benjamin Zmistowski BS, Camilo Restrepo MD, Javad Parvizi MD, FRCS, Richard H. Rothman MD, PhD

Preventing pulmonary embolism is a priority after major musculoskeletal surgery. The literature contains discrepant data regarding the influence of anticoagulation on the incidence of pulmonary embolism after joint arthroplasty. The American College of Chest Physicians guidelines recommend administration of oral anticoagulants (warfarin), aiming for an international normalized ratio (INR) level between 2 and 3. However, recent studies show aggressive anticoagulation (INR > 2) can lead to hematoma formation and increased risk of subsequent infection.

A More Reliable Method to Assess Acetabular Component Position

John V. Tiberi MD, Nicholas Pulos MD, Michael Kertzner BS, Thomas P. Schmlazried MD

Acetabular component position is associated with joint function and bearing wear. Current techniques for determining acetabular component version on standard radiographs lack reliability. Other, more consistent techniques are time-consuming and require additional equipment or software.

Stem and Osteotomy Length are Critical for Success of the Transfemoral Approach and Cementless Stem Revision

Daniel F. A. Menezes MD, Pierre B├ęguec MD, Hans-Peter Sieber MD, Mathias Goldschild MD

The transfemoral approach is an extensile surgical approach that is performed routinely to facilitate cement and implant removal and improve exposure for revision stem implantation. Previous studies have looked at clinical results of small patient groups. The factors associated with fixation failure of cementless revision stems when using this approach have not been examined.

Increased Anteversion of Press-fit Femoral Stems Compared With Anatomic Femur

Roger H. Emerson MD

With contemporary canal-filling press-fit stems, there is no adjustability of stem position in the canal and therefore the canal anatomy determines stem version. Stem version will affect head/neck impingement, polyethylene wear from edge loading, and hip stability, but despite this, the postoperative version of a canal-filling press-fit stem is unclear.

High Dislocation Cumulative Risk in THA versus Hemiarthroplasty for Fractures

Alexandre Poignard MD, Mohamed Bouhou MD, Olivier Pidet MD, Charles-Henri Flouzat-Lachaniette MD, Philippe Hernigou MD

Although not all elderly patients with femoral neck fractures are candidates for THA, active, mentally competent, independent patients achieve the most durable functional scores with THA compared with hemiarthroplasty. However, a relatively high frequency of early or late dislocation could reduce the potential benefits with THA.

Deep Venous Thrombosis and Pulmonary Embolism are Uncommon in East Asian Patients after Total Hip Arthroplasty

Bun Jung Kang MD, Young-Kyun Lee MD, Hee Joong Kim MD, Yong-Chan Ha MD, Kyung-Hoi Koo MD

In Western countries, deep vein thrombosis (DVT) and pulmonary embolism (PE), are relatively common after THA and many surgeons recommend routine pharmacologic thromboprophylaxis. There is some suggestion in the literature that the incidences of DVT and PE may be lower in East Asian patients. Therefore, it would be important to establish the incidences in a large number of East Asian patients who did not receive pharmacologic thromboprophylaxis.

Radiographic Risk Factors for Labral Lesions in Femoroacetabular Impingement

Thomas Kappe MD, Tugrul Kocak MD, Ralf Bieger MD, Heiko Reichel MD, Christian R. Fraitzl MD

Tears of the acetabular labrum can lead to pain, disability, and osteoarthritis. Several pathomechanisms have been proposed, including femoroacetabular impingement (FAI). Labral tears have been reported to occur in the presence of even subtle deformities of the acetabulum and femoral head-neck junction.

Surgical Technique: Transfer of the Anterior Portion of the Gluteus Maximus Muscle for Abductor Deficiency of the Hip

Leo A. Whiteside MD

Loss of the abductor portions of the gluteus medius and gluteus minimus muscles due to THA causes severe limp and often instability.

Age and Obesity Are Risk Factors for Adverse Events After Total Hip Arthroplasty

James I. Huddleston MD, Yun Wang PhD, Carlos Uquillas BS, James H. Herndon MD, MBA, William J. Maloney MD

Defining the epidemiology of adverse events after THA will aid in the development of strategies to enhance perioperative care.