Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 725 articles


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.

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.