Publications on Total Hip Arthroplasty by Anderson Orthopaedic Research Institute
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2000 Journal Publications

To see publication information, authors, and a summary or abstract, click on the specific publication.

Acetabular Revision Using Oblong Cementless Components in Patients with Acetabular Bone Stock Deficiency (Feb. 2000)

Characterization of Long-term Femoral Head Penetration Rates: Association with and Prediction of Osteolysis (Aug. 2000)

Comparison of Head Penetration into Hylamer and Enduron Polyethylene Liners: A Follow-up Report (Apr. 2000)

Comparison of in vivo wear Between Polyethylene Liners Articulating with Ceramic and Cobalt-chrome Femoral Heads. (Sep. 2000)

Extended Slide Trochanteric Osteotomy for Revision Total Hip Arthroplasty

Extensively Porous-coated Stems: A Choice for All Seasons  (Sept. 2000)

Migration of Polyethylene Wear Debris in One Type of Uncemented Femoral Component with Circumferential Porous Coating: An Autopsy Study of Five Femurs (Jan. 2000)

Osteonecrosis of the Femoral Head Treated with Cementless Total Hip Arthroplasty. (Oct. 2000)

The Accuracy and Reproducibility of Radiographic Assessment of Stress-shielding: A Postmortem Analysis (Oct. 2000)

The Effect of Weight Bearing on the Radiographic Measurement of the Position of the Femoral Head after Total Hip Arthroplasty (Jan. 2000)

The Influence of Porous Coating Level on Proximal Femoral Remodeling: A Postmorten Analysis. (Feb. 2000)

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1999 Publications

Analysis of Prosthetic Femoral Heads Retrieved at Autopsy. CJ Sychterz, CA Engh Jr., SW Swoope, DE McNulty, and CA Engh Sr. Clinical Orthopaedics and Related Research 358: 223-234, 1999. Abstract

Analysis of Temporal Wear Patterns for Porous-Coated Acetabular Components: Separating True Wear from So-Called Bedding-In. CJ Sychterz, CA Engh Jr., AM Yang, and CA Engh Sr. Abstract

Factors Affecting Bone Remodeling after Cementless THA: A Report of Two Cases. CA Engh Jr, Sychterz CJ, and Engh CA Sr. ournal of Arthroplasty 14(5): 637-644, 1999. Abstract

Two-dimensional Versus Three-dimensional Radiographic Measurements Polyethylene Wear. CJ Sychterz, AM Yang, JP McAuley, CA Engh, Sr. Clinical Orthopaedics and Related Research. 365: 117-123. 1999.

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2000-2001 Publication Summaries (alphabetical order)

A clinically practical method of manually assessing polyethylene liner thickness David Pollock, MD, CJ Sychterz, MS, CA Engh, MD, Journal of Bone and Joint Surgery, 83-A:1803-1809, 2001.	Summary: This comparative study of 3 manual methods of radiographically measuring polyethylene thickness of in vivo cementless acetabular cups showed that a new template method was the most accurate and simplest to use. The authors recommended the technique to clinicians who do not have access to computer-assisted techniques. See Abstract Top
Acetabular Revision Using Oblong Cementless Components in Patients with Acetabular Bone Stock Deficiency Wei-Ming Chen, M.D., C. Anderson Engh Jr., M.D., Robert H. Hopper, Jr., Ph.D., James P. McAuley, M.D., Charles A. Engh, M.D. Journal of Bone and Joint Surgery, Vol. 82-A, No.2 (Feb. 2000): 1215-1219.	Summary: This study assessed the results of a bilobed cementless acetabular component for revision reconstruction in hips with acetabular bone deficiency, clarified indications for its use, and identified factors that influenced clinical and radiographic outcomes. See abstract Top
Characterization of Long-term Femoral Head Penetration Rates: Association With and Prediction of Osteolysis James E. Dowd, MD, Christi J. Sychterz, MS, Anthony M. Young, BS, Charles A. Engh, MD. Journal of Bone and Joint Surgery-A. 82-A(8) (Aug. 2000:1102-7.	Summary: The purposes of this study were to characterize the linearity of long-term head penetration patterns in cementless total hip arthroplasty over time, describe the relationship between 10-year true wear rates and osteolysis, and determine whether the occurrence of osteolysis at 10 years could be predicted by penetration data prior to five years. See abstract   Top
Comparison of head penetration into hylamer and enduron polyethylene liners: a follow-up report Christi J. Sychterz, MS, Anthony M. Young, BS, James P. McAuley, MD, Charles A. Engh, MD. Journal of Arthroplasty, 15:3: 372-374 (April 2000).	Summary: This study updates previously reported information: Hylamer polyethylene liners preferentially implanted in younger patients are no longer performing as well as Enduron liners. In a previous study, we found no difference in the rate of head penetration between Hylamer and Enduron liners. However, at mean 5.9-year follow-up, Hylamer liners had a significantly higher head penetration rate, a higher true wear rate, and a greater occurrence of osteolysis than Enduron liners.   Top
Comparison of In Vivo Wear Between Polyethylene Liners Articulating with Ceramic and Cobalt-Chrome Femoral Heads Christi J. Sychterz, MS, C. Anderson Engh, MD, Anthony M. Young, BS, Robert H. Hopper, Jr., PhD, Charles A. Engh, MD. Journal of Bone and Joint Surgery, 82-B(9):948-951 (Sept. 2000).	Summary: This study radiographically compared wear performance between alumina ceramic femoral heads and a well-matched group of cobalt-chrome heads. At mean 7-year follow-up, the ceramic group had a slightly greater true wear rate (0.09 mm/year; SD = 0.07) than the cobalt-chrome group (0.07 mm/year; SD = 0.04). Despite numerous theoretical advantages of ceramic heads, the in vivo wear performance of these heads was similar.   Top
Effect of Acetabular Modularity on Polyethylene Wear and Osteolysis in Total Hip Arthroplasty Anthony M. Young, BS, Christi J. Sychterz, MS, Robert H. Hopper, Jr, PhD, Charles A. Engh, MD. Journal of Bone and Joint Surgery, 84-A(1):58-63 (Jan. 2002).	Summary: In examining the effect of acetabular liner modularity on polyethylene wear and osteolysis in THA, the authors found that the nonmodular components had lower wear rates than modular components. Top
Effect of Radiographic Quality on Computer Assisted Head Penetration Measurements Christi J. Sychterz, MS, Anthony M. Young, BS, Charles A. Engh, MD. Clinical Orthopaedics and Related Research,386:150-158 (May 2001).	Summary: This study compared 3 methods of measuring wear from x-rays, including two computer-assisted techniques. The data revealed the importance of good quality x-rays for accurate measurements. See abstract Top
Extended Slide Trochanteric Osteotomy for Revision Total Hip Arthroplasty Wei-Ming Chen, MD, James P. McAuley, MD, C. Anderson Engh, Jr., MD, Robert H. Hopper Jr., PhD, Charles A. Engh, MD. Journal of Bone and Joint Surgery: 82-A(9):1215-1219.	Summary: The extended slide trochanteric osteotomy improves acetabular and femoral exposure, facilitates the removal of distal cement or a well-fixed, porous-coated stem, and provides reliable reattachment and healing of the trochanteric fragment. This study reviewed 45 hips in 44 patients who underwent a revision hip arthroplasty with an extended slide trochanteric osteotomy. See abstract  Top
Extensively Porous-Coated Stems: A Choice for All Seasons CA Engh, Sr., RH Hopper, Jr., Orthopedics, Vol. 23, No.9 (September 2000): 951-952.	Summary: Frequently, bone quality in the proximal femur is compromised in revision total hip arthroplasty. Consequently, at the Anderson Clinic we use diaphyseal fixation with an extensively porous-coated femoral component to obtain durable fixation. This article describes aspects of preoperative templating and the surgical approach for this procedure.   Top
Long-Term Results Using the Anatomic Medullary Locking Hip Prosthesis C. Anderson EnghJr, AM Claus, Robert H. Hopper Jr., and Charles A. Engh. To be published in Clinical Orthopaedics and Related Research, Dec. 2001.	Summary: At mean 13.9-year followup, the overall loosening rate for femoral components was 3% (seven of 204) for Anatomic Medullary Locking femoral components and 5% (11 of 204) for Anatomic Medullary Locking acetabular components, indicating long-term durability of these components. The results also raised questions regarding the relationship between osteolysis and loosening of components. See abstract Top
Migration of Polyethylene Wear Debris in One Type of Uncemented Femoral Component with Circumferential Porous Coating: An Autopsy Study of Five Femurs M von Knoch, CA Engh, Sr, CJ Sychterz, CA Engh, Jr., HG Willert. Journal of Arthroplasty, January 2000.	Summary: The findings in this study imply that circumferential porous coating of cementless femoral components could prevent distal migration of polyethylene wear debris along the bone-implant interface in both bone-ingrown and fibrous-encapsulated femoral implants. See abstract    Top
Modular Component Exchange for Treatment of Recurrent Dislocation of A Total Hip Replacement in Selected Patients SD Toomey, RH Hopper, JP McAuley, CA Engh. Journal of Bone and Joint Surgery-American, 83:1529-1533 (Oct. 2001).	Summary: In select cases modular component exchange to treat recurrent hip dislocation has a success rate comparable with more extensive operations. Top
Osteonecrosis of the Femoral Head Treated with Cementless Total Hip Arthroplasty William T. Hartley, M.D., James P. Mc Auley, M.D., William J. Culpepper, M.S., C. Anderson Engh, Jr., M.D., Charles A. Engh, Sr., M.D. The Journal of Bone and Joint Surgery, 82-A, 10 (Oct. 2000): 1408-1413.	Summary: The treatment of young patients with disabling hip pain due to advanced osteonecrosis remains a therapeutic challenge. Our study evaluated the results of cementless total hip arthroplasty in a consecutive series of young patients with advanced osteonecrosis. See abstract.  Top
Patient Self-Testing of Prothrombin Time Following Hip Arthroplasty C. Anderson Engh, Jr. M.D. William J. Culpepper, II, M.A. Patricia A. Charette, R.N. Rachel Brown, R.N. Journal of the Southern Orthopaedic Association, Vol. 10, No. 3 (Fall 2001): 140-146.	Summary: Patient self-testing of prothrombin time using the home device in this study was reliable and cost-effective for monitoring the anticoagulation status among select elderly THA patients. Top
Pattern of Osteolysis Around Different Cementless Metal-backed Cups: Retrospetive Radiographic Analysis at Minimum Ten-year Follow-up Alexandra M. Claus, MD, PhD, Christi J. Sychterz, Robert H. Hopper, PhD, Charles A. Engh, MD, The Journal of Arthroplasty, Dec. 2001	Summary: The incidence of osteolysis in 2 groups of cementless cups -- one with multiple dome holes and one with no shell holes -- showed that at minimum 10-year follow-up, the incidence of osteolysis between the groups was similar, but that the location of the lesions, largely a factor of cup design, differed significantly. See Abstract Top
The Accuracy and Reproducibility of Radiographic Assessment of Stress-Shielding: A Postmortem Analysis C. Anderson Engh, MD, James P. McAuley, MD, Christi J. Sychterz, MS, Marie E. Sacco, BS, Charles A. Engh, MD. Journal of Bone and Joint Surgery 82-A, 10 (Oct. 2000): 1414-1419.	Summary: Radiographic assessment of periprosthetic bone loss is both difficult and subjective. In this study, we assessed the ability of surgeons to reproducibly recognize changes in periprosthetic bone density from radiographs. The results led us to question the utility of such radiographic evaluation, since bone loss was not reproducibly recognized until 70% of the bone was gone. Top
The Effect of Femoral Stiffness on Bone Remodeling after Uncemented Arthroplasty CJ Sychterz, MS, LD Timmie Topeleski, PhD, M Sacco, BS, CA Engh, MD, Clinical Otrhopaedics and Related Research, 389 (Aug 2001):218-227.	Summary: The current study examined the relationships among femoral stiffness, implant stiffness, and bone remodeling in femurs retrieved at autopsy from unilateral uncemented hip replacements. Results showed that axial bone stiffness influenced bone loss, whereas stem stiffness did not significantly correlate with it. However, other physiologic and mechanical factors could account for variance not accounted for by this study's model. See abstract Top
The Effect of Weight Bearing on the Radiographic Measurement of the Position of the Femoral Head after Total Hip Arthroplasty KD Moore, RL Barrack, CJ Sychterz, J Sawhney, AM Yang, CA Engh, Sr., Journal of Bone and Joint Surgery, 82-A, No. 1 (Jan. 2000): 62-69.	Summary: Researchers have questioned the effect of weight bearing on measurements of head penetration. This study determined the effect of weight-bearing on the 2-D radiographic position of the femoral head within the acetabular cup. The findings gave no evidence that weight bearing is necessary to accurately measure the position of the femoral head within the polyethylene liner. Top
The Influence of Porous Coating Level on Proximal Femoral Remodeling: A Postmorten Analysis JP McAuley, MD, CJ Sychterz, MSE, CA Engh, MD. Clinical Orthopaedics and Related Research, Feb. 2000.	Summary: The results in this small group of cases challenge the common assumption that reducing the extent of porous surface and obtaining more proximal fixation results in less proximal femoral bone loss. See abstract Top
Wear-Through of a Modular Polyethylene Liner: Four Case Reports. CA Engh, Jr., RH Hopper, CA Engh, JP McAuley. Clinical Orthopaedics and Related Research, 383: 175-182, 2001	Summary: These cases involving the S-ROM Total Hip System Polydial polyethylene liner illustrate the difficulties in detecting polyethylene wear-through before a complete acetabular revision is necessary. They also showed the importance of followup evaluations, especially 10 or more years after surgery for patients with these implants. See abstract.   Top

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Comparison of In Vivo Wear Between Polyethylene Liners Articulating With Ceramic and Cobalt-Chrome Femoral Heads Christi J. Sychterz, MS, C. Anderson Engh, Jr., MD, Anthony M. Yang, BS, Robert H. Hopper, PhD, Charles A. Engh, MD.	Summary: Ceramic heads typically out-perform cobalt-chrome femoral heads during laboratory testing. This study compared the wear performance of these two heads in vivo, and found that the in vivo wear performance of both heads was surprisingly similar. Abstract Top
A Single Center's Experience with THA Using Porous-Coated Acetabular Components C.A.Engh, Jr., RH Hopper, CJ Sychterz, CA Engh	Summary: This study demonstrated long-term integrity for porous-coated cups. It presents the Anderson Orthopaedic Clinic's experience with 5 types of porous-coated cups implanted from 1982-1999: 263 AML, 449 Arthropor, 81 Harris-Gallante, 403 ACS, and 1739 Duraloc. Excluding the ACS components, cup survivorship was 96.8% at 10 years, using revisions for complications related to polyethylene wear as an endpoint. Top
Total Hip Arthroplasty Using Porous-Coated Femoral Components Among Rheumatoid Arthritis Patient C. Anderson Engh, Jr., MD, Phillip J. Lewandowski, MD, Robert H. Hopper, Jr., PhD, Charles A. Engh, Sr., MD.	Summary: Clinical results at 10-years demonstrate durable fixation via bone ingrowth using porous-coated stems among rheumatoid arthritis patients. Results using porous-coated femoral components were excellent. On the acetabular side, porous-coated and cemented acetabular components demonstrated similar survivorship, whereas threaded components had significantly lower survival rates Top

 

Book Chapters

This information has not been updated since 2000. If you desire information about more recent published chapters and books, please contact Research@aori.org.

CA Engh, Jr., JP McAuley, CA Engh Sr. Surgical Approaches for Revision Total Hip Replacement Surgery, The Anterior Trochanteric Slide and the Extended Conventional Osteotomy. AAOS Instructional Course Lectures, Vol. 48:3-8. 1999.

CA Engh Sr., CA Engh Jr, Femoral Revision: Non-Cemented. Revision Total Hip Arthroplasty, ME Steinberg, J P Garino, editors, Lippincott-Raven Publishers, 1999.

CA Engh Sr., CA Engh, Jr., Distal Fixation. Revision Total Hip Arthroplasty, JV Bone, JC McCarthy, Springer-Verlag, New York, Inc., 1999.

CA Engh Sr., RH Hopper. Hybrid Total Hip Replacement: A Step Forward or Sideways. Instructional Course Lecture, Vol. 48, 1999.

HE Rubash, RK Sinha, CA Engh Sr., WJ Maloney, WG Paprosky. A New Classification System for Acetabular Osteolysis of Total Hip Arthroplasty. Instructional Course Lecture. Vol. 48, 1999.

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