Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles

Articles

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.

A Quantitative Method to Assess Focal Acetabular Overcoverage Resulting From Pincer Deformity Using CT Data

Ryan J. Murphy MS, Ty K. Subhawong MD, Avneesh Chhabra MD, John A. Carrino MD, MPH, Mehran Armand PhD, Marc Hungerford MD

Current assessment techniques for focal acetabular overcoverage are neither consistent nor quantitatively accurate.

Second-generation Modular Acetabular Components Provide Fixation at 10 to 16 Years

Paul F. Lachiewicz MD, Elizabeth S. Soileau BSN

First-generation modular titanium fiber-metal-coated acetabular components had high rates of wear, pelvic osteolysis, and liner dissociation. Second-generation components were designed to reduce the incidence of these problems but it is unclear whether the changes achieved these goals.

The Cam-type Deformity of the Proximal Femur Arises in Childhood in Response to Vigorous Sporting Activity

K. A. Siebenrock MD, F. Ferner MD, P. C. Noble MD, PhD, R. F. Santore MD, PhD, S. Werlen MD, T. C. Mamisch MD

The prevalence of a cam-type deformity in athletes and its association with vigorous sports activities during and after the growth period is unknown.

Insufficient Acetabular Version Increases Blood Metal Ion Levels after Metal-on-metal Hip Resurfacing

Alister J. Hart FRCSG(Orth), John A. Skinner FRCS(Orth), Johann Henckel MRCS, Barry Sampson MRSC CChem, Fabiana Gordon PhD

Many factors affect the blood metal ion levels after metal-on-metal (MOM) hip arthroplasty. The main surgically adjustable variable is the amount of coverage of the head provided by the cup which is a function of the inclination and version angles. However, most studies have used plain radiographs which have questionable precision and accuracy, particularly for version and large diameter metal heads; further, these studies do not simultaneously assess version and inclination. Thus the relationship between version and blood metal ions levels has not been resolved.

Does Open Reduction of the Developmental Dislocated Hip Increase the Risk of Osteonecrosis?

Renata Pospischill MD, Julia Weninger MD, Rudolf Ganger MD, PhD, Johannes Altenhuber MD, Franz Grill MD

Osteonecrosis (ON) of the femoral head is one of the main complications associated with treatment of developmental dysplasia of the hips (DDH). The reported rates of ON vary widely between 6% and 48%, suggesting varying factors in these studies influence the rate. Several studies suggest open reduction combined with femoral shortening provides protection against ON. However, it is unclear whether confounders such as failed Pavlik harness treatment, preliminary traction, closed versus open reduction, and redislocation influence the rate of ON.

Do Higher Hospital-wide Nurse Staffing Levels Reduce In-hospital Mortality in Elderly Patients with Hip Fractures: A Pilot Study

Peter Schilling MD, MSc, James A. Goulet MD, Paul J. Dougherty MD

There is increasing recognition that lower nurse staffing levels are associated with higher morbidity and mortality among medical and surgical patients. The degree to which this applies to elderly patients with hip fractures is unclear.

Is Metal-on-Metal Squeaking Related to Acetabular Angle of Inclination?

Thomas Bernasek MD, David Fisher MD, David Dalury MD, Melissa Levering BS, Kirk Dimitris MD

Postoperative audible squeaking has been well documented in ceramic-on-ceramic hip prostheses, and several metal-on-metal (MOM) THA designs, specifically those used for large-head resurfacing and MOM polyethylene sandwich designs, and are attributed to different implant- and patient-specific factors. Current literature does not identify the incidence of squeaking in modular MOM THA or possible etiologic factors.

Leukocytosis Is Common After Total Hip and Knee Arthroplasty

Gregory K. Deirmengian MD, Benjamin Zmistowski BS, Christina Jacovides BS, Joseph O’Neil BA, Javad Parvizi MD, FRCS

Postoperative infection is a potentially devastating complication after THA and TKA. In the early postoperative period, clinicians often find nonspecific indicators of infection. Although leukocytosis may be a sign of a developing infection in the early postoperative period, it may also be part of a normal surgical response.