Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 721 articles


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.

Femoral Head Size Does Not Affect Ion Values in Metal-on-Metal Total Hips

Mitchell Bernstein MD, Alan Walsh MD, Alain Petit PhD, David J. Zukor MD, John Antoniou MD, PhD

Metal-on-metal articulations can release substantial amounts of particles containing cobalt and chromium into the surrounding milieu, causing concern for cellular toxicity and adverse local soft tissue reactions. The diameter of the femoral head has been one of the variables that inversely affects wear of metal-on-metal total hip arthroplasty (THA). The oxidative stress of increased metal ions can be measured with serum markers. It is still controversial if larger femoral head diameters decrease wear rates in patients with metal-on-metal THA and if the increased metal ions alter the body’s antioxidant status.

Hip Resurfacing in Patients Who Have Osteonecrosis and are 25 Years or Under

Siraj A. Sayeed MD, Aaron J. Johnson MD, D. Alex Stroh BS, Thomas P. Gross MD, Michael A. Mont MD

Young patients with osteonecrosis (ON) treated with THA often have suboptimal function and radiographic failure with eventual revision. Resurfacing may be an option because of potentially increased functionality and decreased radiographic failure, although neither has been confirmed in the literature.

Are There Benefits to One- versus Two-stage Procedures in Bilateral Hip Resurfacing?

Harlan C. Amstutz MD, Edwin P. Su MD, Michel J. Duff MA, Vincent A. Fowble MD

Short-term studies report comparable complication rates of one-stage bilateral versus two-stage procedures in hip resurfacing, although the long-term effects of such procedures on survivorship, quality of life, and disease-specific scores are currently unknown.