Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 719 articles

Articles

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.

Low Frequency of Early Complications With Dual-mobility Acetabular Cups in Cementless Primary THA

Morad Chughtai MD, Jaydev B. Mistry MD, Aloise M. Diedrich BS, Julio J. Jauregui MD, Randa K. Elmallah MD, Peter M. Bonutti MD, Steven F. Harwin MD, Arthur L. Malkani MD, Frank R. Kolisek MD, Michael A. Mont MD

Dislocation complicates 1% to 5% of primary total hip arthroplasties (THAs). As a result, some surgeons consider dual-mobility articulations, which are usually used in the revision setting to decrease the likelihood of dislocation, as an option for primary THA. However, few studies have evaluated their use in this setting.

Complications Are Not Increased With Acetabular Revision of Metal-on-metal Total Hip Arthroplasty

Colin T. Penrose BS, Thorsten M. Seyler MD, PhD, Samuel S. Wellman MD, Michael P. Bolognesi MD, Paul F. Lachiewicz MD

Isolated revision of the acetabular component in the setting of total hip arthroplasty has an increased risk of dislocation. With local soft tissue destruction frequently associated with failed metal-on-metal (MoM) bearings, it is presumed that acetabular revision of these hips will have even greater risk of complications. However, no study directly compares the complications of MoM with metal-on-polyethylene (MoP) acetabular revisions.

Higher Pavlik Harness Treatment Failure Is Seen in Graf Type IV Ortolani-positive Hips in Males

Eduardo N. Novais MD, Lauryn A. Kestel BS, Patrick M. Carry BA, Mariana L. Meyers MD

Patients with developmental dysplasia of the hip (DDH) whose hips are dislocated but reducible (Ortolani positive) are more likely to experience Pavlik harness treatment failure than are patients with dysplastic and reduced but dislocatable (Barlow positive) hips. However, data regarding factors associated with failure are limited and conflicting.

Modular to Monoblock: Difficulties of Detaching the M2 a-MagnumTM Head Are Common in Metal-on-metal Revisions

Heikki Mäntymäki, Keijo T. Mäkelä, Tero Vahlberg, Joni Hirviniemi, Tuukka Niinimäki

Modern hip implants typically feature modular heads, which allow for easy exchange and removal from the femoral stem at the time of revision. However, owing to fretting, corrosion, or cold welding, the modular head may be difficult or impossible to separate from the underlying trunnion, especially if the implant has titanium interfaces between the head and the stem. We have repeatedly encountered difficulty removing the titanium sleeve adapter in the Ma-Magnumimplant. Although the manufacturer warns about this complication and cases with these difficulties have been reported to the United States FDA, we believed this topic is important to study, because the frequency of difficulties in head removal is unknown and the complications related to this event have not been characterized.

Supine and Standing AP Pelvis Radiographs in the Evaluation of Pincer Femoroacetabular Impingement

Timothy J. Jackson MD, Allyson A. Estess MD, Gregory J. Adamson MD

Pelvic tilt can affect the presence of the ischial spine sign and crossover sign. Numerous studies of pelvic tilt on radiographic measurements of pincer impingement have shown that increasing anterior tilt is associated with more radiographic signs of pincer impingement. However, to our knowledge, no study has directly compared supine and standing plain radiographs in patients with respect to lateral center-edge (LCE) angle, acetabular inclination, crossover sign, and ischial spine sign.

Hard-on-Hard Bearings Are Associated With Increased Noise Generation in Young Patients Undergoing Hip Arthroplasty

Denis Nam MD, MSc, Toby Barrack BA, Staci R. Johnson MEd, Ryan M. Nunley MD, Robert L. Barrack MD

Patient-perceived noise from prostheses after total hip arthroplasty (THA) does occur, yet questions remain including the overall frequency of this finding, demographic and prosthesis-related factors, and the association of noise generation with patient-reported outcomes.

Does Preadmission Cutaneous Chlorhexidine Preparation Reduce Surgical Site Infections After Total Hip Arthroplasty?

Bhaveen H. Kapadia MD, Julio J. Jauregui MD, Daniel P. Murray BA, Michael A. Mont MD

Periprosthetic hip infections are among the most catastrophic complications after total hip arthroplasty (THA). We had previously proven that the use of chlorhexidine cloths before surgery may help decrease these infections; hence, we increased the size of the previously reported cohort.