Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hip 723 articles

Articles

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.

What Is the Impact of Center Variability in a Multicenter International Prospective Observational Study on Developmental Dysplasia of the Hip?

Kishore Mulpuri MBBS, MS(Ortho) MHSc(Epi), Emily K. Schaeffer PhD, Simon P. Kelley MBChB, FRCS (Tr and Ortho), Pablo Castañeda MD, Nicholas M. P. Clarke ChM, DM, FRCS, FRCS Ed, Jose A. Herrera-Soto MD, Vidyadhar Upasani MD, Unni G. Narayanan MBBS, MSc, FRCSC, Charles T. Price MD, FAAP

Little information exists concerning the variability of presentation and differences in treatment methods for developmental dysplasia of the hip (DDH) in children < 18 months. The inherent advantages of prospective multicenter studies are well documented, but data from different centers may differ in terms of important variables such as patient demographics, diagnoses, and treatment or management decisions. The purpose of this study was to determine whether there is a difference in baseline data among the nine centers in five countries affiliated with the International Hip Dysplasia Institute to establish the need to consider the center as a key variable in multicenter studies.

How Often Does Femoroacetabular Impingement Occur After an Innominate Osteotomy for Acetabular Dysplasia?

Pablo Castañeda MD, Carlos Vidal-Ruiz MD, Alfonso Méndez MD, Diego Pérez Salazar MD, Armando Torres MD, MSc, FACS

Femoroacetabular impingement is increasingly recognized as a cause of hip pain but its incidence after an innominate osteotomy for the correction of acetabular dysplasia has not been determined. This information would be essential for the orthopaedic surgeon because it has the potential to produce a poor outcome in the long term when trying to balance acetabular instability and overcorrection.

Validation of the HOOS, JR: A Short-form Hip Replacement Survey

Stephen Lyman PhD, Yuo-Yu Lee MS, Patricia D. Franklin MD, MBA, MPH, Wenjun Li PhD, David J. Mayman MD, Douglas E. Padgett MD

Patient-reported outcome measures (PROMs) are increasingly in demand for outcomes evaluation by hospitals, administrators, and policymakers. However, assessing total hip arthroplasty (THA) through such instruments is challenging because most existing measures of hip health are lengthy and/or proprietary.

Inaccuracies in the Use of Magnification Markers in Digital Hip Radiographs

Michael J. Archibeck MD, Tamara Cummins RT, Krishna R. Tripuraneni MD, Joshua T. Carothers MD, Cristina Murray-Krezan MS, Mohammad Hattab PhD, Richard E. White MD

With the ubiquity of digital radiographs, the use of digital templating for arthroplasty has become commonplace. Although improved accuracy with digital radiographs and magnification markers is assumed, it has not been shown.

Ceramic Heads Decrease Metal Release Caused by Head-taper Fretting and Corrosion

Sevi B. Kocagoz BS, Richard J. Underwood PhD, Daniel W. MacDonald MS, Jeremy L. Gilbert PhD, Steven M. Kurtz PhD

Metal release resulting from taper fretting and corrosion is a clinical concern, because wear and corrosion products may stimulate adverse local tissue reactions. Unimodular hip arthroplasties have a conical taper between the femoral head (head bore taper) and the femoral stem (stem cone taper). The use of ceramic heads has been suggested as a way of reducing the generation of wear and corrosion products from the head bore/stem cone taper junction. A previous semiquantitative study found that ceramic heads had less visual evidence of fretting-corrosion damage compared with CoCr heads; but, to our knowledge, no studies have quantified the volumetric material loss from the head bore and stem cone tapers of a matched cohort of ceramic and metal heads.

The Radiographic Union Score for Hip (RUSH) Identifies Radiographic Nonunion of Femoral Neck Fractures

Tym Frank MD, Georg Osterhoff MD, Sheila Sprague PhD, Alisha Garibaldi MSc, Mohit Bhandari MD, PhD, Gerard P. Slobogean MD, MPH

The Radiographic Union Score for Hip (RUSH) is a previously validated outcome instrument designed to improve intra- and interobserver reliability when describing the radiographic healing of femoral neck fractures. The ability to identify fractures that have not healed is important for defining nonunion in clinical trials and predicting patients who will likely require additional surgery to promote fracture healing. We sought to investigate the utility of the RUSH score to define femoral neck fracture nonunion.