Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

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.

Sterility of the Personal Protection System in Total Joint Arthroplasty

Kenneth A. Kearns MD, Dan Witmer BS, Junaid Makda MD, Javad Parvizi MD, FRCS, Donald Jungkind PhD

Bacteria shed by operating room personnel is a source of wound contamination and postoperative infections. The personal protection system (PPS) was designed to decrease airborne bacteria and intraoperative contamination in total joint arthroplasty.

Micro-mobile Foot Compression Device Compared with Pneumatic Compression Device

Michael Dohm MD, Kim M. Williams MPH, Tim Novotny PhD

A combination mechanical-pharmacologic regimen is an accepted prophylactic treatment against symptomatic venous thromboembolism for patients undergoing total hip and knee arthroplasties. Foot pumps have been recognized as effective mechanical devices. Research suggests pharmacologic prophylaxis for venous thromboembolism is associated with complications and foot pumps offer an adjunct or alternative approach. Presumably the effectiveness of foot pumps relate to enhancement of venous flow.

Aspirin Decreases Heterotopic Ossification After Hip Resurfacing

Ryan M. Nunley MD, Jinjun Zhu MD, PhD, John C. Clohisy MD, Robert L. Barrack MD

Heterotopic ossification (HO) is a concern for patients undergoing hip surgery, especially surface replacement arthroplasty (SRA) who tend to be younger, more active, and anticipate good motion. It is unclear, however, whether HO occurs more frequently after SRA than traditional total hip arthroplasty (THA) and whether aspirin influences the risk.

Ethnic and Racial Factors Influencing Well-being, Perceived Pain, and Physical Function After Primary Total Joint Arthroplasty

Carlos J. Lavernia MD, Jose C. Alcerro MD, Juan S. Contreras MD, Mark D. Rossi PhD

Studies suggest, even when controlling for disease severity, socioeconomic status, education, and access to care, racial and ethnic minorities receive lower-quality health care and have worse perceived pain and function before and after total joint arthroplasty.

Optimizing Screening for Osteoporosis in Patients With Fragility Hip Fracture

Archana Roy MD, Michael G. Heckman MSc, Mary I. O’Connor MD

Osteoporosis, the underlying cause of most hip fractures, is underdiagnosed and undertreated. The 2008 Joint Commission reportshowed only an average of 20% of patients with low-impact fracture are ever tested or treated for osteoporosis. We developed an integrated model utilizing hospitalists and orthopaedic surgeons to improve care of osteoporosis in patients with hip fracture.

Pelvic Positioning Creates Error in CT Acetabular Measurements

Harold J. P. Bosse MD, Duron Lee MD, Eric R. Henderson MD, Debra A. Sala MS, PT, David S. Feldman MD

CT allows for accurate measurement of acetabular orientation and shape, but malpositioning of the pelvis may lead to measurement variance.