Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 716 articles

Articles

Early Subsidence Predicts Failure of a Cemented Femoral Stem With Minor Design Changes

Per-Erik Johanson MD, Martin Antonsson MStat MScCSE, Bita Shareghi BSc, Johan Kärrholm MD, PhD

Radiostereometry (RSA) measurements of early micromotion can predict later failure in hip and knee prostheses. In hip implants, RSA has been particularly helpful in the evaluation of composite-beam stem designs. The Spectron EF Primary stem (Smith & Nephew, London, UK) has shown inferior performance compared with its predecessors in both clinical studies and registry reports. Early RSA studies have shown somewhat greater subsidence for the Spectron EF Primary stem compared with the earlier Spectron EF, but still within boundaries considered to be safe.

Poor Survivorship and Frequent Complications at a Median of 10 Years After Metal-on-Metal Hip Resurfacing Revision

Gulraj S. Matharu BSc (Hons), MRCS, MRes, Hemant G. Pandit DPhil, FRCS (Tr & Orth), David W. Murray MD, FRCS (Orth)

High short-term failure rates have been reported for several metal-on-metal hip resurfacing (MoMHR) designs. Early observations suggested that MoMHRs revised to total hip arthroplasties (THAs) for pseudotumor had more major complications and inferior patient-reported outcomes compared with other revision indications. However, little is known about implant survivorship and patient-reported outcomes at more than 5 years after MoMHR revision.

The Frank Stinchfield Award

William W. Schairer MD, Joseph M. Lane MD, David A. Halsey MD, Richard Iorio MD, Douglas E. Padgett MD, Alexander S. McLawhorn MD, MBA

Hip fractures are a major public health concern. For displaced femoral neck fractures, the needs for medical services during hospitalization and extending beyond hospital discharge after total hip arthroplasty (THA) may be different than the needs after THA performed for osteoarthritis (OA), yet these differences are largely uncharacterized, and the Medicare Severity Diagnosis-Related Groups system does not distinguish between THA performed for fracture and OA.

No Benefit After THA Performed With Computer-assisted Cup Placement: 10-year Results of a Randomized Controlled Study

Sebastien Parratte MD, PhD, Matthieu Ollivier MD, Alexandre Lunebourg MD, Xavier Flecher MD, PhD, Jean-Noel A. Argenson MD, PhD

Computer-assisted surgery (CAS) for cup placement has been developed to improve the functional results and to reduce the dislocation rate and wear after total hip arthroplasty (THA). Previously published studies demonstrated radiographic benefits of CAS in terms of implant position, but whether these improvements result in clinically important differences that patients might perceive remains largely unknown.

Are Females at Greater Risk for Revision Surgery After Hip Resurfacing Arthroplasty With the Articular Surface Replacement Prosthesis?

Gabrielle S. Donahue BA, Viktor Lindgren MD, PhD, Vincent P. Galea BA, Rami Madanat MD, PhD, Orhun Muratoglu PhD, Henrik Malchau MD, PhD

Female patients undergoing hip resurfacing arthroplasties may be at greater risk of revision surgery than males, but it is unclear whether this is related to sex or other factors. We focused our analysis on data from a prospective multicenter cohort study monitoring the ASRhip resurfacing arthroplasty prosthesis on the potential association of sex on patient-reported outcome measures (PROMs), metal ion levels, revision surgery, and presence of adverse local tissue reaction. As thousands of patients with the ASRprosthesis are still undergoing followup it is critical to optimize the protocol for monitoring these patients.

Dual-mobility or Constrained Liners Are More Effective Than Preoperative Bariatric Surgery in Prevention of THA Dislocation

Philippe Hernigou MD, Matthieu Trousselier MD, François Roubineau MD, Charlie Bouthors MD, Charles Henri Flouzat Lachaniette MD

Obesity is associated with an increased risk of dislocation after total hip arthroplasty (THA). However, in patients with obesity, it is not known whether the risk is only in the early postoperative period or whether it persists several years after surgery, and whether having bariatric surgery before undergoing THA and/or receiving a specific device (such as a dual-mobility or constrained acetabular liner) is more effective in terms of decreasing the risk of dislocation.

Early Migration Predicts Aseptic Loosening of Cementless Femoral Stems: A Long-term Study

Marcus R. Streit MD, MSc, Daniel Haeussler MD, Thomas Bruckner PhD, Tanja Proctor BSc, Moritz M. Innmann MD, Christian Merle MD, MSc, Tobias Gotterbarm MD, PhD, Stefan Weiss MD, PhD

Excessive early migration of cemented stems and cups after THA has been associated with poor long-term survival and allows predictable evaluation of implant performance. However, there are few data regarding the relationship between early migration and aseptic loosening of cementless femoral components, and whether early migration might predict late failure has not been evaluated, to our knowledge. Einzel-Bild-Röntgen-Analyse-femoral component analysis (EBRA-FCA) is a validated technique to accurately measure axial femoral stem migration without the need for tantalum markers, can be performed retrospectively, and may be a suitable tool to identify poor performing implants before their widespread use.

Rotational Acetabular Osteotomy for Pre- and Early Osteoarthritis Secondary to Dysplasia Provides Durable Results at 20 Years

Yuji Yasunaga MD, Mitsuo Ochi MD, Takuma Yamasaki MD, Takeshi Shoji MD, Sotaro Izumi MD

Hip dysplasia is a common cause of secondary osteoarthritis (OA). Periacetabular osteotomy or rotational acetabular osteotomy has been used as joint-preserving procedures. However, only a few reports of long-term results with these operations have been reported.

Is Assessment of Femoral Head Perfusion During Modified Dunn for Unstable Slipped Capital Femoral Epiphysis an Accurate Indicator of Osteonecrosis?

Eduardo N. Novais MD, Ernest L. Sink MD, Lauryn A. Kestel BS, Patrick M. Carry BA, João C. M. Abdo MD, Travis C. Heare MD

The modified Dunn procedure, which is an open subcapital realignment through a surgical dislocation approach, has gained popularity for the treatment of unstable slipped capital femoral epiphysis (SCFE). Intraoperative monitoring of the femoral head perfusion has been recommended as a method of predicting osteonecrosis; however, the accuracy of this assessment has not been well documented.

The John Charnley Award: Redefining the Natural History of Osteoarthritis in Patients With Hip Dysplasia and Impingement

Cody C. Wyles BS, Mark J. Heidenreich MD, Jack Jeng MD, Dirk R. Larson MD, Robert T. Trousdale MD, Rafael J. Sierra MD

Structural hip deformities including developmental dysplasia of the hip (DDH) and femoroacetabular impingement (FAI) are thought to predispose patients to degenerative joint changes. However, the natural history of these malformations is not clearly delineated.