The importance of femoral head-neck morphology in the development of early hip osteoarthritis is recognized in femeroacetabular impingement (FAI), however no studies have examined FAI morphology in the developing hip, i.e. pre-closure of the proximal femoral physis. We developed a pilot project to study prevalence of CAM-type FAI hip morphology in both the pre- and post-closure proximal femoral physes of asymptomatic children using MR-imaging. We also examined biologic markers possibly related to FAI etiology, including Vitamin D metabolites, BMI, family history, and activity levels. Recruitment included volunteers with asymptomatic lower extremities, and either pre- or post-closure of the proximal femoral physis. Males were 10–12 years (pre-closure) or 15–18 years (post-closure); females were 8–10 years or 14 18 years. Phlebotomy and urine sampling were used to assess metabolic markers. MRI of bilateral hips and a clinical exam including hip impingement tests were conducted. MR imaging assessment was independent and blinded and recorded using established parameters including alpha angles measured at both the 3:00 (anterior head-neck junction) and 1:30 (antero-superior head-neck junction) radial image positions.Purpose
Method
The purpose of the study was to determine the rate of conversion from RSA to THR in a number of Canadian centers performing resurfacings Retrospective review was undertaken in 12 Canadian Centers to determine the rate of revision and reason for conversion from RSA to THR. Averages and cross-tabulation with Chi-Squared analysis was performed. kaplan Meier survivorship was calculated.Purpose
Method
Primary uncemented total hip arthroplasty is the fixation of choice for most patients undergoing hip replacement in North America. Initial stem stability will be detected by the fit and fill of the implant to the bone as well as the overall stem geometry as it relates to its mechanical stability. This study aims to determine the geometric and structural parameters of common cementless tapered femoral stems to better understand their early clinical performance with respect to bony fixation. Templates for six proximally coated tapered uncemented femoral stems: Accolade (Stryker), Profemur (Wright), Taperloc (Biomet), M/L Taper (Zimmer), Anthology (Smith-Nephew) and Trilock (Depuy) were scanned and saved as images on a PC. Stem sizes were assigned according to AP plane width measurements taken at the most lateral implant shoulder, and images analyzed using ImageJ (US National Institutes of Health). Measurements were made of stem length, and at various locations, the width and thickness of the stem. Coronal plane stiffness was calculated according to beam theory, assuming an elastic modulus of 114 GPa for the Profemur, Taperloc M/L Taper, Anthology and Trilock stems. The Accolade stem has a modulus of 85.5 GPa. due to TMZF alloy which is 25% more flexible. Stem thickness and taper ratios were calculated as a measure of lateral vs. AP fill of the femur. All measurements were plotted as manufacturer-specific curves relative to stem width.Purpose
Method
Use of a large femoral head metal-on-metal bearing in total hip arthroplasty may offer an advantage in terms of dislocation rates and more natural joint kinematics. The acetabular component is more rigid however in these prostheses and if not placed accurately can lead to increased levels of metal ion release. A prospective randomized controlled trial was conducted to quantify bone mineral density on the acetabular side, as well as compare metal ion levels from a standard metal-on-polyethylene bearing to a large head metal-on-metal bearing in primary total hip arthroplasty. Fifty patients were randomized to receive total hip arthroplasty with either the CONSERVE A-Class Total Hip with BFH femoral head or the Lineage acetabular component with polyethylene insert and cobalt chrome femoral head. There were 27 females (11 BFH) and 23 males (14 BFH), with a mean overall age of 61.6 (range 47.7–73.2). Serum levels of cobalt, chromium, and titanium were measured at regular intervals up to two years. Harris Hip Score, WOMAC, UCLA, and RAND-36 were completed at these same intervals. Standard radiographs as well as periprosthetic BMD were performed.Purpose
Method
Transfusion rates after primary total hip has been reported up to 39.2%. The purpose of our study was to evaluate the efficacy of TXA in minimizing risk of allogeneic blood transfusion after primary total hip and hip resurfacing arthroplasty. Retrospective data on a cohort of 88 patients undergoing total hip arthroplasty and 44 who undergoing hip resurfacing arthroplasty who received a single pre-operative bolus of 1g TXA was compared with a control group matched for starting haemoglobin (Hg), body mass index (BMI), age, gender, blood loss, surgical time, and surgeon. All procedures were completed at a single institution with standardized post-operative care. Endpoints included allogeneic blood transfusion rate, post operative day one Hg, and overall Hg decrease.Purpose
Method
