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Hip Diseases: From Joint Preservation to Hip Arthroplasty Revision

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 2919

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Prof. Dr. Christoph Böhler

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Guest Editor

Department of Orthopaedics and Trauma Surgery, Medizinische Universität Wien, Vienna, Austria
Interests: periprosthetic joint infections; arthroplasty hip and knee arthroplasty revision arthroplasty

Special Issue Information

Dear Colleagues,

We kindly invite you to contribute to JCM’s Special Issue on “Hip Diseases: From Joint Preservation to Hip Arthroplasty Revision”. Hip surgery covers a broad and evolving field, from hip preservation and pediatric orthopedics to primary total hip replacement, complex revision surgery, and periprosthetic joint infections. The surge in research is driving remarkable progress in innovative therapies, cutting-edge surgical techniques, advanced technologies, and personalized treatment approaches.

This Special Issue seeks to highlight the latest advancements in hip surgery, including state-of-the-art techniques and emerging treatments across a wide range of hip-related conditions. To capture the diverse landscape of this field, our goal is to present an overview of the most pressing topics in hip surgery research, from clinical innovations to novel approaches in personalized care, supported by both experimental and clinical data.

This Special Issue’s scope includes the following:

- Hip preservation surgery;

- Primary total hip arthroplasty;

- Complex THA revisions.

We highly encourage authors to submit research articles, meta-analyses, and literature reviews on these topics. Your insights will be vital in guiding and redefining the future of hip surgery, and we look forward to your contributions.

Prof. Dr. Christoph Böhler
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

hip preservation surgery
pelvic osteotomies
hip arthroscopy
total hip replacement
THA revision ar-throplasty
pelvic discontinuity
pelvic fracture management
periprosthetic fractures
robotic surgery
peripros-thetic joint infection

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Published Papers (5 papers)

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Research

14 pages, 3298 KiB

Open AccessArticle

Foam Splint—The Comfortable Way of Postoperative Immobilization After Surgical Hip Reconstruction in Children—A Randomized Clinical Trial

by Manuel Gahleitner, Christina Haas, Gerhard Großbötzl, Matthias Christoph Michael Klotz, Tobias Gotterbarm and Lorenz Pisecky

J. Clin. Med. 2025, 14(10), 3485; https://doi.org/10.3390/jcm14103485 - 16 May 2025

Viewed by 130

Abstract

Hip joint reconstruction is often necessary for children and adolescents with conditions like developmental dysplasia of the hip (DDH), neurogenic dislocation of the hip (NDH), or Legg–Calvé–Perthes disease (LCPD) when non-surgical treatments are ineffective. Background: Post-operative immobilization after hip reconstruction in children is crucial to promote proper healing and reduce the risk of complications. While spica casting has been the traditional method, it can lead to various issues. Foam splinting has emerged as an alternative approach. This study aimed to compare the effectiveness and satisfaction of the patient and the caregivers of spica casting and foam splinting after pelvic osteotomies in young patients with DDH, NDH, and LCPD. Methods: A prospective randomized clinical trial included patients aged 3 to 16 undergoing pelvic reconstruction (iliac and proximal femoral osteotomy, open reduction, and soft tissue procedures). Participants were randomized into two groups: one receiving spica casts and the other foam splints, both for a six-week period post-surgery. Quality of life (QOL) assessments like CPCHILD, SF-36, and EQ-5D were conducted using various scores to measure patient and caregiver satisfaction preoperative and at six and twelve weeks postoperative. The surgical techniques were consistent across both groups. Results: The study included 34 patients, with one excluded due to non-adherence. The spica cast group experienced statistically significant declines in QOL scores, while the foam splint group showed decreases that were not statistically significant. Complications were reported in 11 patients, with a higher prevalence in the spica cast group. Conclusions: The foam splint group demonstrated superior satisfaction levels and fewer complications, which leads to the conclusion that foam splinting should be the preferred option to spica casting for post-operative immobilization in these cases. Full article

(This article belongs to the Special Issue Hip Diseases: From Joint Preservation to Hip Arthroplasty Revision)

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10 pages, 979 KiB

Open AccessArticle

Good Mid-Term Clinical Outcomes and Low Arthroplasty Conversion Rates After Hip Arthroscopy with Labral Debridement Without Refixation or Reconstruction

by Manuel Gahleitner, Daniel Hofer, Rainer Hochgatterer, Tobias Gotterbarm and Antonio Klasan

J. Clin. Med. 2025, 14(9), 3236; https://doi.org/10.3390/jcm14093236 - 7 May 2025

Viewed by 202

Abstract

Introduction: The present study investigates the five-year outcomes of hip arthroscopy for cam or pincer-type femoroacetabular impingement (FAI) and associated labral tears in a defined patient population. Methods: Patients who underwent hip arthroscopy for cam or pincer-type arthroscopy femoroacetabular impingement (FAI) and labral tears at our hospital in the past five years were included. All patients who underwent revision—like a total hip arthroplasty (THA), a subsequent hip arthroscopy at another hospital, or had primary osseous diseases—were excluded. Patients were contacted via mail and asked to answer a clinical questionnaire called the “Hip Osteoarthritis Outcome Score” (HOOS) and to indicate whether there was a second surgery like a subsequent arthroscopy or THA. Results: There were 77 hip arthroscopies in 75 patients the last 5 years. A total of 29 patients responded. Those who did not respond were contacted via phone. All in all, we obtained the results of 49 patients (50 hips—29 right, 19 left, and 1 bilateral) who underwent hip arthroscopy over the past five years. The mean age at the time of operation was 41 years. Our results were as follows: 24 hips had an isolated labral tear, 49 hips a combined FAI pathology with cam and/or pincer-type impingement and labral tears, 3 patients had a posttraumatic FAI, and 1 patient suffered from hip chondromatosis, who was subsequently excluded; further, 22 patients (23 procedures) were lost to follow-up. HOOS contains various subscales; only the postoperative result of subscale 1 (symptoms) did not show a statistically significant improvement compared with the preoperative value. All other subscales showed a statistically significant improvement in comparison with the preoperative condition. Five patients (10.2%) still experienced symptoms, so we performed a total hip arthroplasty (THA) as a second surgical procedure. One patient was revised due to chondromatosis. One patient was revised at another center, and another was excluded because of chondromatosis. Conclusions: The five-year follow-up results of hip arthroscopy proved successful outcomes. Hip arthroscopy is an effective treatment for FAI in order to delay primary THA, regaining mobility and range of motion and reducing pain. Longer-term studies with a larger cohort are necessary. Full article

(This article belongs to the Special Issue Hip Diseases: From Joint Preservation to Hip Arthroplasty Revision)

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11 pages, 3969 KiB

Open AccessArticle

Long Term Changes of the Axis of the Lower Limb After Chiari Pelvic Osteotomy—A Retrospective Analysis of 111 Osteotomies After 34 Years

by Eleonora Schneider, Katharina Metzinger, Markus Schreiner, Jennifer Straub, Kevin Staats, Christoph Böhler, Reinhard Windhager and Catharina Chiari

J. Clin. Med. 2025, 14(4), 1039; https://doi.org/10.3390/jcm14041039 - 7 Feb 2025

Viewed by 591

Abstract

Background/Objectives: The Chiari pelvic osteotomy (CPO) creates a bony roof by medialization of the acetabulum, thus improving the biomechanics of dysplastic hip joints. Long-term results have already been examined in various studies. However, the impact on the axis of the lower limb has not been investigated yet. The aim of this study was the analysis of changes in the alignment of the lower limb and leg length caused by a CPO and, consecutively, the impact on conversion total hip arthroplasty and primary knee arthroplasty. Methods: A total of 85 patients with 111 CPOs were clinically examined, patient reported outcome measures collected, and long leg standing radiographs analysed according to Paley. Results: The patients were examined an average of 34 years (±7.8; 23–53) after CPO. Unilaterally operated patients (N = 59 hips) showed a pathological MAD in 71% (N = 42) on the operated side (90% valgus, 10% varus). On the unaffected side, we could identify 56% (N = 33 hips) pathological cases (70% valgus, 30% varus). When patients underwent CPO bilaterally (N = 52 hips), the MAD was abnormal in 34 operated hips (65%; 97% valgus, 3% varus). If a leg length discrepancy occurred after the operation, the pelvis and the femur contributed the most to the total leg length discrepancy. Conclusions: Shifts in the mechanical axis following a CPO must be considered in order to inform patients appropriately preoperatively and quantified postoperatively by performing long leg standing radiographs in order to plan following joint replacement therapy adequately and maximize the chance of a successful long-term outcome on a functional level as well as for the patient’s satisfaction. Full article

(This article belongs to the Special Issue Hip Diseases: From Joint Preservation to Hip Arthroplasty Revision)

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13 pages, 776 KiB

Open AccessArticle

Pediatric Voluntary Habitual Hip Dislocation: Clinical Characteristics, Family Dynamics, and Long-Term Outcomes—A Retrospective Study

by Mehmet Yılmaz, İbrahim Ulusoy, Mehmet Fırat Tantekin, İsmail Güzel and Aybars Kıvrak

J. Clin. Med. 2025, 14(3), 1022; https://doi.org/10.3390/jcm14031022 - 6 Feb 2025

Viewed by 676

Abstract

Background/Objectives: Recurrent hip dislocations are a rare occurrence in pediatric patients. As there are few cases of voluntary habitual dislocation documented in the literature, there is a paucity of information available regarding its pathogenesis, risk factors, and classification. The prognosis for these patients is generally good. A long-term follow-up duration of two years was conducted to evaluate outcomes. Statistical analysis was performed to assess the impact of family structure and treatment approaches on outcomes. Methods: From January 2010 to December 2022, patients with voluntary habitual hip dislocation were retrospectively identified through the hospital information system. Data regarding demographic characteristics, clinical findings, and treatment outcomes were analyzed. A total of 13 patients (14 hips) met the inclusion criteria. Conservative treatment methods, including orthosis and family therapy, were applied. Statistical analysis was performed to assess the impact of family structure and treatment approaches on outcomes. Results: The mean age at diagnosis was 48.7 months, with 77% of cases being female. Posterior dislocation was observed in all cases, and no underlying bone pathology was detected on imaging. The prognosis for these patients is generally good. At the one-year follow-up, 85% of patients achieved a complete resolution of dislocations, increasing to 100% by the two-year follow-up. Patients from larger families demonstrated significantly slower recovery rates at the first- and sixth-month evaluations (p = 0.033 and p = 0.048, respectively), but outcomes were comparable by one year. A unique aspect of this study is the emphasis on family dynamics, which significantly influenced treatment adherence and recovery. Statistical analysis was performed to assess the impact of family structure and treatment approaches on outcomes. Conclusions: Voluntary habitual hip dislocation is a rare condition with good long-term outcomes under conservative management. This study highlights the importance of addressing family dynamics in the treatment plan, especially in larger families, where attention and psychological factors may play a significant role in delayed recovery. Full article

(This article belongs to the Special Issue Hip Diseases: From Joint Preservation to Hip Arthroplasty Revision)

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10 pages, 1866 KiB

Open AccessArticle

Long-Term Outcome of Treating Periprosthetic Hip Joint Infection with Local Antibiotics Delivered Through Antibiotic-Impregnated Calcium Hydroxyapatite

by Hiroki Wakabayashi, Masahiro Hasegawa, Yohei Naito, Shine Tone and Akihiro Sudo

J. Clin. Med. 2024, 13(23), 7469; https://doi.org/10.3390/jcm13237469 - 8 Dec 2024

Viewed by 856

Abstract

Background/Objectives: This study explores the long-term clinical outcomes of antibiotic-impregnated calcium hydroxyapatite (CHA) as an antibiotic delivery system in treating periprosthetic joint infection (PJI) following total hip arthroplasty (THA). Methods: We conducted a retrospective analysis of 12 patients (13 hips) who were treated with antibiotic-impregnated CHA for PJI after THA and followed for more than 10 years at our institution between 1999 and 2011. The study group comprised six men (seven hips) and six women, with a mean age of 61.4 years. Results: The mean follow-up duration was 13.8 years. After irrigation and debridement with modular component exchange, seven hips in six patients underwent revision surgery; however, PJI relapsed in two hips of two patients with a history of diabetes. Two-stage revision surgery was performed on the two relapsed hips and six scheduled hips with antibiotic-impregnated CHA used to treat all cases of PJI. Infection control (100% rate) was achieved in all joints, and revision surgeries were completed. Two patients died 12 years after the initial procedure, and one died 14 years after the first procedure due to unrelated internal diseases; no infection recurrence was observed. No complications related to antibiotic-impregnated CHA were observed. Conclusions: Our results indicate that antibiotic-impregnated CHA is associated with high success rates in treating PJI after THA, even in cases with advanced disease, and yields satisfactory functional outcomes postoperatively. Full article

(This article belongs to the Special Issue Hip Diseases: From Joint Preservation to Hip Arthroplasty Revision)

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