Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles


Two-stage Total Hip Arthroplasty: How Often Does It Control Methicillin-resistant Infection?

Fay Leung MD, FRCSC, Corey J. Richards MD, MASc, FRCSC, Donald S. Garbuz MD, MHSc, FRCSC, Bassam A. Masri MD, FRCSC, Clive P. Duncan MB, MSc, FRCSC

Methicillin-resistant hip infections are increasingly common. Reports of the surgical management of these patients using two-stage THA show variable control of infection, but all reports used static spacers.

Do Tissues From THA Revision of Highly Crosslinked UHMWPE Liners Contain Wear Debris and Associated Inflammation?

Ryan M. Baxter MS, Theresa A. Freeman PhD, Steven M. Kurtz PhD, Marla J. Steinbeck PhD

Polyethylene wear debris is a major contributor to inflammation and the development of implant loosening, a leading cause of THA revisions. To reduce wear debris, highly crosslinked ultrahigh-molecular-weight polyethylene (UHMWPE) was introduced to improve wear properties of bearing surfaces. As highly crosslinked UHMWPE revision tissues are only now becoming available, it is possible to examine the presence and association of wear debris with inflammation in early implant loosening.

Europium Stearate Additives Delay Oxidation of UHMWPE for Orthopaedic Applications: A Pilot Study

Luis A. Gallardo MS, Ilenia Carpentieri PhD, Michel P. Laurent PhD, Luigi Costa PhD, Markus A. Wimmer PhD

Ultrahigh-molecular-weight polyethylene (UHMWPE) is used as an articulating surface in prosthetic devices. Its failure under various mechanisms after oxidation is of utmost concern. Free radicals formed during the sterilization process using high-energy irradiation result in oxidation. Europium, an element of the lanthanide family, has a unique electron configuration with an unusual lack of preference for directional bonding and notable bonding to oxygen. Because of this, it currently is used in studies for stabilization of polymers such as polyvinyl chloride.

The Iliocapsularis Muscle: An Important Stabilizer in the Dysplastic Hip

D. Babst MD, S. D. Steppacher MD, R. Ganz MD, K. A. Siebenrock MD, M. Tannast MD

The iliocapsularis muscle is a little known muscle overlying the anterior hip capsule postulated to function as a stabilizer of dysplastic hips. Theoretically, this muscle would be hypertrophied in dysplastic hips and, conversely, atrophied in stable and well-constrained hips. However, these observations have not been confirmed and the true function of this muscle remains unknown.

Is Total Hip Arthroplasty after Hip Arthrodesis as Good as Primary Arthroplasty?

Mariano Fernandez-Fairen PhD, MD, Antonio Murcia-Mazón PhD, MD, Ana Torres MD, Virginia Querales MD, Antonio Murcia MD

Conversion of hip arthrodesis to a THA reportedly provides a reasonable solution, improving function, reducing back and knee pain, and slowing degeneration of neighboring joints associated with a hip fusion. Patients generally are satisfied with conversion despite the fact that range of mobility, muscle strength, leg-length discrepancy (LLD), persistence of limp, and need for assistive walking aids generally are worse than those for conventional primary THA.

Intraoperative Radiographs for Placing Acetabular Components in Hip Resurfacing Arthroplasty

Thomas P. Gross MD, Fei Liu PhD, Lee Webb NP

Various clinical and biomechanical studies suggest certain acetabular positions may be associated with higher wear and failure rates in modern metal-on-metal hip resurfacing arthroplasties. However, there are no widely available, reliable, and cost-effective surgical techniques that ensure surgeons are able to place an acetabular component within the safe range of inclination angles after hip resurfacing surgeries.

Direct Anterior Approach for Hip Resurfacing: Surgical Technique and Complications

Stefan Kreuzer MD, Kevin Leffers BS, Suneel Kumar MD

The direct anterior approach (DAA) for hip resurfacing arthroplasty is a technically difficult approach but theoretically reduces the soft tissue trauma to the hip because it does not require muscle detachments from the bone. Furthermore, the patient is in the supine position facilitating fluoroscopy to control component placement. However, the complications associated with the learning curve and functional outcome scores are not well defined in the literature.

Early Markers of Nephrotoxicity in Patients With Metal-on-metal Hip Arthroplasty

Massimo Corradi MD, Joseph Daniel FRCS, Hena Ziaee BSc (Hons), Rossella Alinovi BSc, Antonio Mutti MD, Derek J. W. McMinn FRCS

Metal ions released from arthroplasty devices are largely cleared in urine, leading to high exposure in renal tissues. Validated early markers of renal damage are routinely used to monitor workers in heavy metal industries, and renal risk can be quantified in these industries. It is unclear if the ion levels in patients with metal-on-metal hips are sufficient to cause renal damage.

A Comparison of Two Implant Systems in Restoration of Hip Geometry in Arthroplasty

Michael J. Archibeck MD, Tamara Cummins RT(R)(ARRT), Joshua Carothers MD, Daniel W. Junick MD, Richard E. White MD

Restoration of hip offset and leg length during THA is often limited by available implant geometries. The recent introduction of femoral components with a modular junction at the base of the neck (two modular junction components) has expanded the options to restore femoral offset and leg length.

Does Trochanteric Transfer Eliminate the Trendelenburg Sign in Adults?

Flávio L. Garcia MD, PhD, Celso H. F. Picado MD, PhD, Luís P. Cardinali MD

Premature closure of the proximal femoral growth plate results in coxa brevis, which usually is associated with insufficiency of the hip abductors. Distal and lateral transfer of the greater trochanter sometimes is recommended to correct this problem. Most of what is known arises from studies of children and adolescents.