Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles


Risk Factors for Revision of Hip Arthroplasties in Patients Younger Than 30 Years

Julien Girard MD, MSc, Christophe Glorion MD, François Bonnomet MD, Damien Fron MD, Henri Migaud MD

Numerous reports of THAs in patients younger than 30 years indicate a high risk of revision. Although risk factors for revision have been reported for older patients, it is unclear whether these risk factors are the same as those for patients younger than 30 years.

Hip Dislocation: Are Hip Precautions Necessary in Anterior Approaches?

Camilo Restrepo MD, S. M. Javad Mortazavi MD, Justin Brothers BS, Javad Parvizi MD FRCS, Richard H. Rothman MD, PhD

In 2005, we reported removal of functional restriction after primary THA performed through the anterolateral approach did not increase the incidence of dislocation.

No Strength or Gait Benefit of Two-incision THA: A Brief Followup at 1 Year

Aaron J. Krych MD, Mark W. Pagnano MD, Krista Coleman Wood PhD, PT, R. Michael Meneghini MD, Kenton Kaufman PhD, PE

Using comprehensive gait analysis and strength testing, we previously investigated the early (2-month) functional outcome after THA using two-incision and mini-posterior surgical approaches and found an advantage for the mini-posterior approach. Benefits included improved muscle strength, a less antalgic gait, and better hip function as reflected by changes in hip moments during level walking and stair climbing. We questioned how these differences in function would fare with longer followup.

Markers of Thrombin Generation During Resurfacing and Noncemented Total Hip Arthroplasty: A Pilot Study

Edwin P. Su MD, Nikos Chatzoudis MD, Vasileios Sioros MD, George Go BS, Nigel E. Sharrock BMedSci, MB, ChB

Hip resurfacing arthroplasty (HRA) could be associated with an increased risk of deep vein thrombosis (DVT) compared to traditional noncemented THA because it involves greater dissection, increased kinking and distortion of the femoral vessels, takes longer to perform, and involves insertion of some cement into the femur.

Survival of Hard-on-Hard Bearings in Total Hip Arthroplasty: A Systematic Review

Michael G. Zywiel MD, Siraj A. Sayeed MD, Aaron J. Johnson MD, Thomas P. Schmalzried MD, Michael A. Mont MD

Improvements in prosthetic materials, designs, and implant fixation for THA have led to bearing surface wear being the limitation of this technology. Hard-on-hard bearings promise decreased wear rates and increased survival. However, there may be different survival rates based on bearing materials, manufacturing technologies, and femoral component designs. Additionally, survival rate variability may be based on study design.

Custom Cementless THA in Patients with Skeletal Dysplasia Results in Lower Apparent Revision Rates than Other Types of Femoral Fixation

Mathew D. Sewell BSc (Hons), MRCS (Eng), Sammy A. Hanna MRCS (Eng), Sarah K. Muirhead-Allwood BSc, FRCS, Stephen R. Cannon MA, MCh (Orth), FRCS, Timothy W. R. Briggs MD (Res), MCh (Orth), FRCS

Patients with skeletal dysplasia are prone to degenerative hip disease thus requiring THA at a younger age than the general population. This is a technically demanding procedure with high complication and revision rates. Achieving good femoral fixation can be challenging because of the abnormal features of the hip.

Is Resurfacing Arthroplasty Appropriate for Posttraumatic Osteoarthritis?

Aaron J. Johnson MD, Michael G. Zywiel MD, Uma I. Maduekwe MD, Fei Liu PhD, Michael A. Mont MD, Thomas P. Gross MD

High survival has been reported for resurfacing arthroplasty in patients with femoral deformities. Also, hardware removal may not always be necessary with resurfacing arthroplasty and may eliminate some of the difficulties performing total hip arthroplasty (THA) in patients with posttraumatic osteoarthritis.

Perivascular and Diffuse Lymphocytic Inflammation are not Specific for Failed Metal-on-metal Hip Implants

Takaaki Fujishiro MD, PhD, Dirk Jan F. Moojen MD, PhD, Naomi Kobayashi MD, PhD, Wouter J. A. Dhert MD, PhD, FBSE, Thomas W. Bauer MD, PhD

Several studies suggest that histologic findings from tissues obtained at revision arthroplasty for failed metal-on-metal (MOM) total hip implants may reflect an immune reaction to particles or ions in some patients. However, only a limited number of cases without MOM implants were reported as controls in those studies.

Surgical Variables Influence Metal Ion Levels After Hip Resurfacing

Nicholas M. Desy MD, Stephane G. Bergeron MD, Alain Petit PhD, Olga L. Huk MD, MSc, John Antoniou MD, PhD

Metal-on-metal bearings in surface arthroplasty are associated with prolonged periods of elevated ion circulation. However, there exists some controversy regarding the effect of different surgical variables on the concentration of metal ions in whole blood of patients after hip resurfacing.

Hard-on-Hard Total Hip Impingement Causes Extreme Contact Stress Concentrations

Jacob M. Elkins MS, Megan K. O’Brien BS, Nicholas J. Stroud BSE, Douglas R. Pedersen PhD, John J. Callaghan MD, Thomas D. Brown PhD

Impingement events, in addition to their role immediately proximate to frank dislocation, hold the potential to damage new-generation hard-on-hard bearings as a result of the relatively unforgiving nature of the materials and designs. Because of the higher stiffness and tighter design tolerances of metal-on-metal and ceramic implants, surgical positioning plausibly has become even more important.