As it does each year, the Proceedings of The Hip Society provide readers with stimulating new clinical and basic research, alongside commentaries on current topics that are relevant to surgeons who perform adult reconstructive procedures of the hip. The topics chosen for presentation encompassed a wide variety of subjects, including preoperative planning and surgical technique particularly for difficult cases, selection and outcomes of different bearing couples and new implants, standardized definitions for and listing of complications and adverse events, and novel imaging techniques for diagnosis and treatment of hip arthritis.
Governmental agencies, payers, specialty societies, state and hospital accreditation boards, as well as patient-advocacy groups all want information concerning costs, surgical outcomes, and complications of reconstructive procedures about the hip. However, if there is to be meaningful discussion, there has to be an agreed upon standardization of terms so that all interested parties can discuss the above issues using common language. In this regard, The Hip Society has taken a leading role in standardizing nomenclature concerning complications and adverse events, so that reasonable data can be accumulated. Furthermore, measuring important patient-reported clinical outcomes both pre- and post-operatively will facilitate a clearer understanding of the functional and financial utility of different adult reconstructive procedures.
Which bearing couples for total hip replacement function best in the short- and long-terms? Although large femoral heads are associated with increased stability, are they associated with unintended complications, like metal degradation and corrosion at the trunnion? Has highly crosslinked polyethylene eliminated osteolysis well into the second decade of use? Is Lewinnek’s described “safe zone” for acetabular positioning (to avoid hip dislocation after total hip replacement) clinically evidence-based? The thought-provoking papers in this year’s Proceedings address these questions and others. So as not to spoil the reader’s enjoyment of these excellent manuscripts, suffice it to say that many of our preconceived ideas concerning the effect of femoral head size on wear of the trunnion, different bearing couples, and surgical technique are challenged in this issue of CORR ®.
Hip surgeons continue to be confronted by complex clinical scenarios such as pelvic discontinuity, severe hip dysplasia, traumatic arthritis associated with previous acetabular fracture and others. Papers in the current Proceedings shed light on these important topics in ways that can help surgeons plan and perform these difficult procedures.
Finally, these Proceedings cover novel imaging techniques and preoperative assessment tools that may better aid the surgeon in further defining which hip can be salvaged versus in need of replacement. For example, radiostereometric analysis can help quantify migration of a prosthesis over time, and can help the surgeon decide when to revise the painful hip replacement. As always, the manuscripts published in this volume all underwent thorough peer review by experts in the field from around the world. The members of The Hip Society are delighted to present this new volume of papers to the readers of CORR ®, with the goal of improving patient care by stimulating further research and discussion.
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Goodman, S.B. Editorial Comment: 2015 Hip Society Proceedings. Clin Orthop Relat Res 474, 319–320 (2016). https://doi.org/10.1007/s11999-015-4586-1
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DOI: https://doi.org/10.1007/s11999-015-4586-1