Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 721 articles


Validity of the Alpha Angle Measurement on Plain Radiographs in the Evaluation of Cam-type Femoroacetabular Impingement

Cefin Barton MB BCh, MRCS (Ed), FRCS (Tr&Orth), Matias J. Salineros MD, Kawan S. Rakhra MD, FRCPC, Paul E. Beaulé MD, FRCSC

Cam-type femoroacetabular impingement is secondary to lack of concavity at the anterosuperior femoral head-neck junction, resulting in reduced femoral head-neck offset and femoral head asphericity. This morphologic deformity can be detected by MRI and plain radiographs and quantified using the alpha angle.

Does Acetabular Inclination Angle Affect Survivorship of Alumina-ceramic Articulations?

Henning R. Johansson MD, Aaron J. Johnson MD, Michael G. Zywiel MD, Marybeth Naughton BS, Michael A. Mont MD, Peter M. Bonutti MD

Reports in the literature have linked high acetabular inclination angles to increased wear of ceramic-on-ceramic bearings. However, many of these studies were only conducted in vitro and did not address the clinical relevance of such findings.

Revisions of Extensive Acetabular Defects with Impaction Grafting and a Cement Cup

Nienke Egmond MD, Daniel C. J. Kam MD, Jean W. M. Gardeniers MD, PhD, B. Willem Schreurs MD, PhD

Loosening of acetabular components often leads to bony defects. Management of extensive acetabular bone loss in hip revision arthroplasty can be a tremendous challenge.

A Periacetabular Osteotomy for the Treatment of Severe Dysplastic Hips

Hirotaka Karashima MD, Masatoshi Naito PhD, Kei Shiramizu PhD, Takahiko Kiyama PhD, Akira Maeyama PhD

We believe a curved periacetabular osteotomy is indicated for treatment of severe dysplastic hips with center-edge angles less than 0°, classified as Severin Group IV-b. However, the lower limit of the center-edge angle in hips classified as Severin Group IV-b is not clearly defined to determine which patients should receive periacetabular osteotomy alone.

The Otto Aufranc Award: Enhanced Biocompatibility of Stainless Steel Implants by Titanium Coating and Microarc Oxidation

Young Wook Lim MD, Soon Yong Kwon MD, Doo Hoon Sun MD, Yong Sik Kim MD

Stainless steel is one of the most widely used biomaterials for internal fixation devices, but is not used in cementless arthroplasty implants because a stable oxide layer essential for biocompatibility cannot be formed on the surface. We applied a Ti electron beam coating, to form oxide layer on the stainless steel surface. To form a thicker oxide layer, we used a microarc oxidation process on the surface of Ti coated stainless steel. Modification of the surface using Ti electron beam coating and microarc oxidation could improve the ability of stainless steel implants to osseointegrate.

THA After Acetabular Fracture Fixation: Is Frozen Section Necessary?

Robert S. Sterling MD, Erik M. Krushinski MD, Vincent D. Pellegrini MD

Infection is uncommon after THA performed for failed acetabular fracture repair, despite a high reported incidence of culture-positive fixation implants. The use of frozen section analysis at the time of THA after acetabular fracture fixation surgery is unknown.

Avoiding Short-term Femoral Neck Fracture With Imageless Computer Navigation for Hip Resurfacing

Michael Olsen PhD, Emil H. Schemitsch MD, FRCS(C)

Femoral neck fracture in hip resurfacing has been attributed to technical error during femoral head preparation. In the absence of fracture, several radiographic findings have been speculated to increase the risk of femoral component failure.

Does a Plastic Drape Reduce Incidence of Heterotopic Ossification After Hip Resurfacing?

John S. Shields MD, Ali Mofidi MB, BAO, BCh, M Med Sci, FRCS(Orth), William G. Ward MD, Riyaz H. Jinnah MD, FRCS

High rates of heterotopic ossification have been associated with hip resurfacing as compared to THA. Bone debris from femoral head reamings is cited as one of the risk factors linked to increased rates of heterotopic ossification.

Do Large Heads Enhance Stability and Restore Native Anatomy in Primary Total Hip Arthroplasty?

Adolph V. Lombardi MD, FACS, Michael D. Skeels DO, Keith R. Berend MD, Joanne B. Adams BFA, Orlando J. Franchi MD

Dislocation remains a serious complication in hip arthroplasty. Resurfacing proponents tout anatomic femoral head restoration as an advantage over total hip arthroplasty. However, advances in bearings have expanded prosthetic head options from traditional sizes of 22, 26, 28, and 32 mm to diameters as large as 60 mm. Large heads reportedly enhance stability owing to increased range of motion before impingement and increased jump distance to subluxation. Available larger diameter material combinations include metal- or ceramic-on-highly crosslinked polyethylene and metal-on-metal, each with distinct advantages and disadvantages.

Long-term Results for Minor Column Allografts in Revision Hip Arthroplasty

Paul T. H. Lee MB BCh, FRCS (Eng), FRCS (Orth), Guy Raz MD, Oleg A. Safir MD, MED, FRCSC, David J. Backstein MD, MED, FRCSC, Allan E. Gross MD, FRCSC, OOnt

While acetabular structural allografts provide an important alternative for reconstructions, concerns remain with long-term graft resorption, collapse, and failure. Midterm studies of minor column (shelf) allograft suggest reasonable survival but long-term survival is unknown.