1.Outcomes of Isolated Femoral Head and Polyethylene Liner Exchange in Revision Total Hip Arthroplasty
Jonathan LIU ; Mohammad DAHER ; Noah GILREATH ; Jared SAIN ; Edward J. TESTA ; Nathaniel SMITH ; Matthew QUINN ; Stephen KAYIAROS ; Thomas J. BARRETT ; Valentin ANTOCI ; Eric M. COHEN
Hip & Pelvis 2026;38(2):155-161
Purpose:
In the existing literature, isolated femoral head and polyethylene liner exchange is commonly performed in revision total hip arthroplasty (THA) for a variety of indications with mixed outcomes. The purpose of this study is to investigate patient outcomes following head-liner exchange and risk factors associated with failure in THA.
Materials and Methods:
A retrospective chart review from May 2016 to November 2023 was conducted on patients who underwent isolated head-liner exchange at two institutions. Patients had minimum 1-year follow-up periods. For each patient, data such as indication for revision, surgical approach, revision head size, immediate and short-term complications, postoperative disposition, 90-day readmissions, and re-operations were recorded.
Results:
Out of 175 patients, there were 24 readmissions/emergency department visits within 90 postoperative days (13.7%), 21 subsequent revision surgeries (12.0%), 21 postoperative dislocations (12.0%), and 20 immediate postoperative complications (11.4%). A statistically significant association was demonstrated between indication for revision and postoperative instability (P=0.04). Patients operated upon for instability had higher rates of postoperative instability. Furthermore, patients with reported preoperative dislocation events had higher incidences of postoperative dislocations. Patients discharged to skilled nursing facilities (SNF) were associated with an increased number of hospital readmissions within 90 days of surgery, reoperation, and postoperative dislocation (P<0.05). No statistically significant associations were found between surgical approach and complications.
Conclusion
This study suggests that, in the context of isolated head-liner exchanges, factors such as preoperative dislocation history, indication for revision, and discharge to SNF are associated with poorer outcomes and complications.
2.Bibliometric Analysis of Dual Mobility Total Hip Arthroplasty
Marc BOUTROS ; Maroun AOUN ; Fong H. NHAM ; Eliana KASSIS ; Mohammad DAHER ; Mouhanad M. EL-OTHMANI
Hip & Pelvis 2025;37(1):45-52
Purpose:
For end stage arthritis of the hip joint, total hip arthroplasty (THA) is the treatment of choice. Dual mobility (DM) liner is an implant designed to provide enhanced stability. Long-term effects and implant survivability remain areas of active research despite modern advancements in increased jump distance and dislocation reductions. The aim of this study is to understand the current research landscape and emerging trends through a bibliometric analysis of DM THA.
Materials and Methods:
An analysis of THA DM publications from between 1982-2022 was conducted through an extensive review of Web of Science Core Collection literature. To identify key trends, contributions, and thematic areas of focus, data on publications, authors, institutions, and countries were extracted and analyzed.
Results:
The bibliographic search identified 314 articles, with a notable increase in publications over the period of study. Globally, the leading contributors were France and the USA. The analysis highlighted the Journal of Arthroplasty as the most relevant journal. Research themes included mechanical complications, comparative outcomes, metallosis, and corrosion concerns.
Conclusion
This study provides a comprehensive DM THA research landscape overview highlighting postoperative outcome value. In an effort to guide future research, contributors, sources, and thematic trends were analyzed.
3.Trends and Insights in Direct Anterior Total Hip Arthroplasty: A Comprehensive Bibliometric Analysis
Ralph CHALHOUB ; Maroun AOUN ; Fong H. NHAM ; Eliana KASSIS ; Mohammad DAHER ; Mouhanad M. EL-OTHMANI
Hip & Pelvis 2025;37(1):53-63
Purpose:
Total hip arthroplasty (THA), a commonly performed surgical procedure for management of end-stage osteoarthritis, is considered minimally invasive and the popularity of the direct anterior approach (DAA) is increasing. The objective of this study is to analyze the current literature on DAA THA through conduct of a comprehensive bibliometric analysis.
Materials and Methods:
A comprehensive search of the Web of Science Core Collection was conducted for identification of articles published between 1993 and 2022. Specific keywords associated with hip replacement and the anterior approach were used as an attempt to identify articles published in scientific journals.
Results:
As a result of the analysis, 743 articles were linked to DAA THA. The highest number of annual publications was reported for 2021, with 120 articles, followed by 2022 with 113 articles, 2020 with 104 articles, and 2018 with 69 articles. The United States led in contributions with 34.1% in production. The Medical University of Innsbruck contributed the highest number of studies with 263 articles, followed by the University of Ottawa with 229. The Journal of Arthroplasty emerged as the most influential journal with 903 articles and 4,571 citations. Keywords including “dislocation,” “posterior approach,” and “revision” were used frequently in 2015-2020, along with the increasing emphasis on perioperative complications and comparing different approaches.
Conclusion
The findings of this analysis provide helpful insights into the current attitude regarding DAA THA research, highlighting emerging trends and guiding the direction of future research. The increasing scientific production reflects growing interest in DAA THA.
4.Safety of Cement-augmented Femoral Cephalomedullary Nails: A Meta-analysis and Systematic Review
Jad MANSOUR ; Ziad ZALAQUETT ; Jean TARCHICHI ; Michel ESTEPHAN ; Joeffroy OTAYEK ; Mohammad DAHER
Hip & Pelvis 2025;37(1):17-25
Trochanteric fractures of the femur pose an increasing burden for elderly people. The standard treatment for these types of fractures includes cephalomedullary nailing, which can be augmented with cement. Although many studies have reported on the stability of this augmented construct, few studies have examined its clinical benefit and safety. Therefore, the objective of this meta-analysis is to examine the perioperative complications and postoperative mortality associated with cement-augmented nails in the management of intertrochanteric and pertrochanteric fractures of the hip. A search of PubMed, Cochrane, and Google Scholar (pages 1-20) until January 2024 was conducted. Analysis of the outcomes included perioperative complications and postoperative mortality. Seven studies were included in this meta-analysis. Fewer perioperative complications were observed when using a cemented femoral nail (P=0.002), although there was no difference in postoperative mortality (P=0.30). This meta-analysis is the first to assess the safety of a cement-augmented femoral nail in management of intertrochanteric and pertrochanteric fractures. The results showed a reduced rate of perioperative complications, which may be attributed to a more a solid construct, which reduced the duration of postoperative immobilization as well as use of a proper augmentation technique, resulting in a reduced rate of cement-associated complications.
5.Bibliometric Analysis of Dual Mobility Total Hip Arthroplasty
Marc BOUTROS ; Maroun AOUN ; Fong H. NHAM ; Eliana KASSIS ; Mohammad DAHER ; Mouhanad M. EL-OTHMANI
Hip & Pelvis 2025;37(1):45-52
Purpose:
For end stage arthritis of the hip joint, total hip arthroplasty (THA) is the treatment of choice. Dual mobility (DM) liner is an implant designed to provide enhanced stability. Long-term effects and implant survivability remain areas of active research despite modern advancements in increased jump distance and dislocation reductions. The aim of this study is to understand the current research landscape and emerging trends through a bibliometric analysis of DM THA.
Materials and Methods:
An analysis of THA DM publications from between 1982-2022 was conducted through an extensive review of Web of Science Core Collection literature. To identify key trends, contributions, and thematic areas of focus, data on publications, authors, institutions, and countries were extracted and analyzed.
Results:
The bibliographic search identified 314 articles, with a notable increase in publications over the period of study. Globally, the leading contributors were France and the USA. The analysis highlighted the Journal of Arthroplasty as the most relevant journal. Research themes included mechanical complications, comparative outcomes, metallosis, and corrosion concerns.
Conclusion
This study provides a comprehensive DM THA research landscape overview highlighting postoperative outcome value. In an effort to guide future research, contributors, sources, and thematic trends were analyzed.
6.Trends and Insights in Direct Anterior Total Hip Arthroplasty: A Comprehensive Bibliometric Analysis
Ralph CHALHOUB ; Maroun AOUN ; Fong H. NHAM ; Eliana KASSIS ; Mohammad DAHER ; Mouhanad M. EL-OTHMANI
Hip & Pelvis 2025;37(1):53-63
Purpose:
Total hip arthroplasty (THA), a commonly performed surgical procedure for management of end-stage osteoarthritis, is considered minimally invasive and the popularity of the direct anterior approach (DAA) is increasing. The objective of this study is to analyze the current literature on DAA THA through conduct of a comprehensive bibliometric analysis.
Materials and Methods:
A comprehensive search of the Web of Science Core Collection was conducted for identification of articles published between 1993 and 2022. Specific keywords associated with hip replacement and the anterior approach were used as an attempt to identify articles published in scientific journals.
Results:
As a result of the analysis, 743 articles were linked to DAA THA. The highest number of annual publications was reported for 2021, with 120 articles, followed by 2022 with 113 articles, 2020 with 104 articles, and 2018 with 69 articles. The United States led in contributions with 34.1% in production. The Medical University of Innsbruck contributed the highest number of studies with 263 articles, followed by the University of Ottawa with 229. The Journal of Arthroplasty emerged as the most influential journal with 903 articles and 4,571 citations. Keywords including “dislocation,” “posterior approach,” and “revision” were used frequently in 2015-2020, along with the increasing emphasis on perioperative complications and comparing different approaches.
Conclusion
The findings of this analysis provide helpful insights into the current attitude regarding DAA THA research, highlighting emerging trends and guiding the direction of future research. The increasing scientific production reflects growing interest in DAA THA.
7.Safety of Cement-augmented Femoral Cephalomedullary Nails: A Meta-analysis and Systematic Review
Jad MANSOUR ; Ziad ZALAQUETT ; Jean TARCHICHI ; Michel ESTEPHAN ; Joeffroy OTAYEK ; Mohammad DAHER
Hip & Pelvis 2025;37(1):17-25
Trochanteric fractures of the femur pose an increasing burden for elderly people. The standard treatment for these types of fractures includes cephalomedullary nailing, which can be augmented with cement. Although many studies have reported on the stability of this augmented construct, few studies have examined its clinical benefit and safety. Therefore, the objective of this meta-analysis is to examine the perioperative complications and postoperative mortality associated with cement-augmented nails in the management of intertrochanteric and pertrochanteric fractures of the hip. A search of PubMed, Cochrane, and Google Scholar (pages 1-20) until January 2024 was conducted. Analysis of the outcomes included perioperative complications and postoperative mortality. Seven studies were included in this meta-analysis. Fewer perioperative complications were observed when using a cemented femoral nail (P=0.002), although there was no difference in postoperative mortality (P=0.30). This meta-analysis is the first to assess the safety of a cement-augmented femoral nail in management of intertrochanteric and pertrochanteric fractures. The results showed a reduced rate of perioperative complications, which may be attributed to a more a solid construct, which reduced the duration of postoperative immobilization as well as use of a proper augmentation technique, resulting in a reduced rate of cement-associated complications.
8.Bibliometric Analysis of Dual Mobility Total Hip Arthroplasty
Marc BOUTROS ; Maroun AOUN ; Fong H. NHAM ; Eliana KASSIS ; Mohammad DAHER ; Mouhanad M. EL-OTHMANI
Hip & Pelvis 2025;37(1):45-52
Purpose:
For end stage arthritis of the hip joint, total hip arthroplasty (THA) is the treatment of choice. Dual mobility (DM) liner is an implant designed to provide enhanced stability. Long-term effects and implant survivability remain areas of active research despite modern advancements in increased jump distance and dislocation reductions. The aim of this study is to understand the current research landscape and emerging trends through a bibliometric analysis of DM THA.
Materials and Methods:
An analysis of THA DM publications from between 1982-2022 was conducted through an extensive review of Web of Science Core Collection literature. To identify key trends, contributions, and thematic areas of focus, data on publications, authors, institutions, and countries were extracted and analyzed.
Results:
The bibliographic search identified 314 articles, with a notable increase in publications over the period of study. Globally, the leading contributors were France and the USA. The analysis highlighted the Journal of Arthroplasty as the most relevant journal. Research themes included mechanical complications, comparative outcomes, metallosis, and corrosion concerns.
Conclusion
This study provides a comprehensive DM THA research landscape overview highlighting postoperative outcome value. In an effort to guide future research, contributors, sources, and thematic trends were analyzed.
9.Trends and Insights in Direct Anterior Total Hip Arthroplasty: A Comprehensive Bibliometric Analysis
Ralph CHALHOUB ; Maroun AOUN ; Fong H. NHAM ; Eliana KASSIS ; Mohammad DAHER ; Mouhanad M. EL-OTHMANI
Hip & Pelvis 2025;37(1):53-63
Purpose:
Total hip arthroplasty (THA), a commonly performed surgical procedure for management of end-stage osteoarthritis, is considered minimally invasive and the popularity of the direct anterior approach (DAA) is increasing. The objective of this study is to analyze the current literature on DAA THA through conduct of a comprehensive bibliometric analysis.
Materials and Methods:
A comprehensive search of the Web of Science Core Collection was conducted for identification of articles published between 1993 and 2022. Specific keywords associated with hip replacement and the anterior approach were used as an attempt to identify articles published in scientific journals.
Results:
As a result of the analysis, 743 articles were linked to DAA THA. The highest number of annual publications was reported for 2021, with 120 articles, followed by 2022 with 113 articles, 2020 with 104 articles, and 2018 with 69 articles. The United States led in contributions with 34.1% in production. The Medical University of Innsbruck contributed the highest number of studies with 263 articles, followed by the University of Ottawa with 229. The Journal of Arthroplasty emerged as the most influential journal with 903 articles and 4,571 citations. Keywords including “dislocation,” “posterior approach,” and “revision” were used frequently in 2015-2020, along with the increasing emphasis on perioperative complications and comparing different approaches.
Conclusion
The findings of this analysis provide helpful insights into the current attitude regarding DAA THA research, highlighting emerging trends and guiding the direction of future research. The increasing scientific production reflects growing interest in DAA THA.
10.Safety of Cement-augmented Femoral Cephalomedullary Nails: A Meta-analysis and Systematic Review
Jad MANSOUR ; Ziad ZALAQUETT ; Jean TARCHICHI ; Michel ESTEPHAN ; Joeffroy OTAYEK ; Mohammad DAHER
Hip & Pelvis 2025;37(1):17-25
Trochanteric fractures of the femur pose an increasing burden for elderly people. The standard treatment for these types of fractures includes cephalomedullary nailing, which can be augmented with cement. Although many studies have reported on the stability of this augmented construct, few studies have examined its clinical benefit and safety. Therefore, the objective of this meta-analysis is to examine the perioperative complications and postoperative mortality associated with cement-augmented nails in the management of intertrochanteric and pertrochanteric fractures of the hip. A search of PubMed, Cochrane, and Google Scholar (pages 1-20) until January 2024 was conducted. Analysis of the outcomes included perioperative complications and postoperative mortality. Seven studies were included in this meta-analysis. Fewer perioperative complications were observed when using a cemented femoral nail (P=0.002), although there was no difference in postoperative mortality (P=0.30). This meta-analysis is the first to assess the safety of a cement-augmented femoral nail in management of intertrochanteric and pertrochanteric fractures. The results showed a reduced rate of perioperative complications, which may be attributed to a more a solid construct, which reduced the duration of postoperative immobilization as well as use of a proper augmentation technique, resulting in a reduced rate of cement-associated complications.

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