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Credentials

Education ?

Medical School Score Rankings
Cornell University (1997)
  •  
Top 25%

Awards & Distinctions ?

Awards  
T. Campbell Thompson Award in Orthopaedic Surgery, Cornell Medical College
Magna Cum Laude with Highest Honors in Biology, Harvard University
Jean C. McDaniel Award for Graduating Orthopaedic Resident
Clarence Coryell Award in Surgery, Cornell Medical College
Alpha Omega Alpha, Cornell Medical College
Castle Connolly America's Top Doctors® (2015)
Castle Connolly Top Doctors: New York Metro Area™ (2012 - 2015)
Patients' Choice 5th Anniversary Award (2012 - 2014)
Patients' Choice Award (2008 - 2014)
Compassionate Doctor Award - 5 Year Honoree (2014)
Compassionate Doctor Recognition (2010 - 2014)
Top 10 Doctor - Neighborhood (2014)
Upper East Side
Orthopaedic Surgeon
Appointments
Weill-cornell University Medical College (2003 - Present)
Associations
American Academy of Orthopaedic Surgeons
American Board of Orthopaedic Surgery
Biomet.com
American Society for Dermatologic Surgery
American Association of Hip and Knee Surgeons

Affiliations ?

Dr. Su is affiliated with 5 hospitals.

Hospital Affiliations

Score

Rankings

  • Hospital For Special Surgery
    Orthopaedic Surgery
    535 E 70th St, New York, NY 10021
    •  
    Top 25%
  • NewYork-Presbyterian / Weill Cornell
    Orthopaedic Surgery
    525 E 68th St, New York, NY 10065
    •  
  • New York Presbyterian Hospital / Columbia
    Orthopaedic Surgery
    630 W 168th St, New York, NY 10032
    •  
  • New York Presbyterian HospitalNew York Weill Cornell Center
  • Nyp-Weill Cornell
  • Publications & Research

    Dr. Su has contributed to 26 publications.
    Title Rheumatoid Synovectomy: Does the Surgical Approach Matter?
    Date August 2011
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    Surgical synovectomy relieves pain in patients with rheumatoid arthritis (RA). The comparative effect of arthroscopic versus open synovectomy on pain reduction, recurrence of synovitis, radiographic progression, and need for subsequent total joint arthroplasty (TJA) is unclear. Whether synovectomy relieves pain in patients with advanced degenerative joint changes is also controversial.

    Title Markers of Thrombin Generation During Resurfacing and Noncemented Total Hip Arthroplasty: a Pilot Study.
    Date February 2011
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    Hip resurfacing arthroplasty (HRA) could be associated with an increased risk of deep vein thrombosis (DVT) compared to traditional noncemented THA because it involves greater dissection, increased kinking and distortion of the femoral vessels, takes longer to perform, and involves insertion of some cement into the femur.

    Title Stiffness After Tkr: How to Avoid Repeat Surgery.
    Date February 2011
    Journal Orthopedics
    Excerpt

    Stiffness after total knee replacement (TKR) is a frustrating complication that has many possible causes. Although the definition of stiffness has changed over the years, most would agree that flexion <75° and a 15° lack of extension constitutes stiffness. The management of this potentially unsatisfying situation begins preoperatively with guidance of the patient's expectations; it is well-known that preoperative stiffness is strongly correlated with postoperative lack of motion. At the time of surgery, osteophytes must be removed and the components properly sized and aligned and rotated. Soft tissue balancing must be attained in both the flexion/extension and varus/valgus planes. One must avoid overstuffing the tibiofemoral and/or patellofemoral compartments with an inadequate bone resection. Despite these surgical measures and adequate pain control and rehabilitation, certain patients will continue to frustrate our best efforts. These patients likely have a biological predisposition for formation of scar tissue. Other potential causes for the stiff TKR include complex regional pain syndrome or joint infection. Close follow-up of a patient's progress is crucial for the success in return of range of motion. Should motion plateau early in the recovery phase, the patient should be evaluated for manipulation under anesthesia. The results of reoperations for a stiff TKR are variable due to the multiple etiologies. A clear cause of stiffness such as component malposition, malrotation, or overstuffing of the joint has a greater chance of regaining motion than arthrofibrosis without a clear cause. Although surgical treatment with open arthrolysis, isolated component, or complete revision can be used to improve TKR motion, results have been variable and additional procedures are often necessary.

    Title Lysis in the Well-fixed Shell: "hold 'em" or "fold 'em".
    Date February 2011
    Journal Orthopedics
    Excerpt

    Periacetabular osteolysis is the greatest challenge for longevity of total hip arthroplasty. The generation of wear debris from the bearing surface is inevitably going to cause bone loss around the implants. The challenges for the arthroplasty surgeon in managing this problem are: detection, knowing when to intervene surgically, and choosing the best reconstructive option. From a surgical standpoint, the options for addressing osteolysis are: (1) liner exchange with or without bone grafting of lytic lesions; or (2) complete component revision. The advantages of "holding 'em" include a faster surgery, no bony disruption, a quicker recovery for the patient, and cost. The downside of isolated liner exchange is that there is a high rate of instability, there may be incomplete access to the lytic lesions, and the limitations of the existing component. There have been techniques developed to provide access to the retroacetabular lesions, particularly superolaterally via a trap-door technique. Alternatively, other surgeons have advocated injection of bone graft substitutes in the retroacetabular regions to fill osteolytic defects. However, one may not be able to take advantage of newer bearing materials, larger head sizes, or component reposition to improve stability and wear properties. The advantages of a complete component revision are access to lytic lesions, and the ability to modify component position and take advantage of newer technologies. The disadvantages are cost, a longer recovery, and bony disruption. Each method of addressing acetabular osteolysis has compelling reasons to use it; individual patient factors such as component type, size of lesion, and remaining bone will play a role in selecting the treatment.

    Title Comparison of Bone Removed During Total Hip Arthroplasty with a Resurfacing or Conventional Femoral Component: a Cadaveric Study.
    Date May 2010
    Journal The Journal of Arthroplasty
    Excerpt

    We sought to examine the amount of bone removed during total hip arthroplasty with a resurfacing femoral component, compared to with a conventional, stemmed femoral component, by using 6 male and 4 female cadaveric pelves with attached bilateral proximal femora. Using randomized assignment and order, a total hip arthroplasty with a resurfacing femoral implant was performed on one side, and total hip arthroplasty with a cementless, stemmed femoral implant was performed on the contralateral side. The relationship between native femoral head diameter and the implanted acetabular socket was on average within 2 mm for both procedures. No significant difference was observed in the amount of acetabular bone removed (9.8 g for hip resurfacing vs 8.8 g). However, a resurfacing component resulted in approximated 3 x less bone removal from the femur (25.8 g vs 75.1 g). This study shows that the preservation of femoral bone with a resurfacing femoral component does not result in an increased removal of acetabular bone when compared to the use of a conventional, stemmed femoral component.

    Title Retrieval Analysis of Failed Constrained Acetabular Liners.
    Date January 2010
    Journal The Journal of Arthroplasty
    Excerpt

    Despite the large loads placed upon constrained acetabular liners, little is known of their mechanical performance. We analyzed retrieved liners to determine wear and other damage modes and assess associations between types and severity of damage and clinical, radiographic, and implant variables. Outer rim impingement frequency and severity were higher than that for the inner rim. The 20 degrees elevation was most frequently affected by impingement. Inner rim impingement was more frequent with small heads. Outer bearing surface wear scores were higher than inner bearing scores. Liners removed for infection or stem failure had similar damage compared with other groups, demonstrating the complex relationship of impingement and wear with clinical performance. No association was found between liner damage and clinical and radiographic variables.

    Title Incidence of Ceramic Liner Malseating in Trident Acetabular Shell.
    Date June 2009
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    The low wear rates associated with ceramic hip articulations have made them a popular bearing for younger patients. Although few complications have been observed, one report revealed several instances of incomplete seating of the ceramic liner in the metallic shell. We performed a cohort study of consecutive THAs using a ceramic-ceramic bearing. Radiographic analysis showed 50 (7.2%) of the group of 694 hips had evidence of incomplete seating of the liner in the metallic shell. Although we observed no adverse effects at 6 to 12 weeks, we encourage surgeons to carefully assess liner placement in the metal shell at the time of surgery to avoid this unintended consequence and to assess placement at the time of followup so patients can be properly followed when incomplete seating is identified. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

    Title Failure Mechanisms and Closed Reduction of a Constrained Tripolar Acetabular Liner.
    Date May 2009
    Journal The Journal of Arthroplasty
    Excerpt

    Unlike traditional bipolar constrained liners, the Osteonics Omnifit constrained acetabular insert is a tripolar device, consisting of an inner bipolar bearing articulating within an outer, true liner. Every reported failure of the Omnifit tripolar implant has been by failure at the shell-bone interface (Type I failure), failure at the shell-liner interface (Type II failure), or failure of the locking mechanism resulting in dislocation of the bipolar-liner interface (Type III failure). In this report we present two cases of failure of the Omnifit tripolar at the bipolar-femoral head interface. To our knowledge, these are the first reported cases of failure at the bipolar-femoral head interface (Type IV failure). In addition, we described the first successful closed reduction of a Type IV failure.

    Title Use of Joint Mobilization in a Patient with Severely Restricted Hip Motion Following Bilateral Hip Resurfacing Arthroplasty.
    Date January 2009
    Journal Physical Therapy
    Excerpt

    Hip resurfacing arthroplasty (HRA) is an alternative for management of end-stage osteoarthritis (OA) in young patients with high activity demands and offers several advantages over total hip arthroplasty. Severely restricted hip motion is a rare complication of the surgery. The purpose of this case report is to describe the treatment for a patient who developed severely restricted hip motion following bilateral HRA.

    Title Revision of Metal-on-metal Resurfacing Arthroplasty of the Hip: the Influence of Malpositioning of the Components.
    Date October 2008
    Journal The Journal of Bone and Joint Surgery. British Volume
    Excerpt

    We have reviewed 42 patients who had revision of metal-on-metal resurfacing procedures, mostly because of problems with the acetabular component. The revisions were carried out a mean of 26.2 months (1 to 76) after the initial operation and most of the patients (30) were female. Malpositioning of the acetabular component resulted in 27 revisions, mostly because of excessive abduction (mean 69.9 degrees ; 56 degrees to 98 degrees ) or insufficient or excessive anteversion. Seven patients had more than one reason for revision. The mean increase in the diameter of the component was 1.8 mm (0 to 4) when exchange was needed. Malpositioning of the components was associated with metallosis and a high level of serum ions. The results of revision of the femoral component to a component with a modular head were excellent, but four patients had dislocation after revision and four required a further revision.

    Title Wear Data and Clinical Results for a Compression Molded Monoblock Elliptical Acetabular Component: 5- to 9-year Data.
    Date January 2008
    Journal The Journal of Arthroplasty
    Excerpt

    Polyethylene wear rates correlate with osteolysis. Modular acetabular components may fail because of backside polyethylene wear or liner/shell dissociation. A monoblock acetabular component avoids these problems, and we report its midterm results. A total of 221 primary total hip arthroplasties with a titanium monoblock, elliptical acetabular component, performed by 1 surgeon, were followed up for a mean period of 7.2 years (range, 5-9 years). X-rays were scanned, digitized, and examined for osteolysis. Wear rates were determined with the Martell hip analysis software. No acetabular components were revised for polyethylene wear or dissociation, acetabular osteolysis, or loosening. Average yearly wear rate was 0.079 mm (range, 0-0.31 mm.) Midterm results with this monoblock design demonstrate excellent survival and absence of osteolysis.

    Title Failure at the Taper Lock of a Modular Stemmed Femoral Implant in Revision Knee Arthroplasty. A Report of Two Cases and a Retrieval Analysis.
    Date November 2007
    Journal The Journal of Bone and Joint Surgery. American Volume
    Title Integrity of Repaired Posterior Structures After Tha.
    Date July 2006
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    Various studies have questioned the benefit of repairing the posterior structures after total hip arthroplasty because their integrity can appear disrupted at followup. However, these studies did not directly examine the posterior structures. We hypothesized that repaired posterior structures remain intact after total hip arthroplasty, and that their integrity could be evaluated by ultrasonography. We performed evaluations in the hips of 18 patients that had either the short external rotators and capsule repaired, or the capsule, short external rotators, and quadratus femoris repaired. Nine patients in each group were examined using ultrasonography at 6 weeks and 3 months postoperatively. The short external rotators and capsule were intact in 89% of patients in both groups at 6 weeks and 3 months postoperatively. At both time points, the quadratus femoris had continuity in 44% of hips with the standard posterior repair and 78% of hips with the enhanced posterior repair (p = 0.15). Ultrasonography can be used to effectively assess the integrity of the posterior repair after total hip arthroplasty. The posterior structures were intact in the majority of patients 3 months after total hip arthroplasty.

    Title Locking Mechanism Failure in Semiconstrained Total Elbow Arthroplasty.
    Date May 2006
    Journal Journal of Shoulder and Elbow Surgery / American Shoulder and Elbow Surgeons ... [et Al.]
    Excerpt

    Between 1988 and 2000, we performed 170 total elbow replacements using a semiconstrained implant (custom or standard). We are aware of 9 implants (5.3%) that have had late failure of the locking mechanism, as evidenced by migration of the connecting axle on radiographic examination. The mean time to failure of the locking mechanism was 5.5 years. Eight elbows required surgery for revision of the polyethylene bushing and locking mechanism by use of a custom-made locking clip. A limited approach was devised that allowed sufficient exposure to change the bushing and axle. In 1 of the 8 cases, the revised locking mechanism failed at 5.5 years, necessitating a reoperation. Of the 8 patients, 7 have not had recurrence of the failure at a mean of 1.4 years (minimum follow-up of 1 year). These 7 patients have good or excellent results based on the Hospital for Special Surgery elbow scoring system, with a mean arc of motion of 130 degrees.

    Title Orthopedic Management of Hemophilia.
    Date January 2006
    Journal American Journal of Orthopedics (belle Mead, N.j.)
    Excerpt

    Hemophilia is an X-linked inherited bleeding disorder characterized by a deficiency of clotting factor VIII or IX in the intrinsic pathway of the coagulation cascade. This disease can have a profound, debilitating effect on the musculoskeletal system through recurrent hemarthroses and intermuscular hematomas. Although medical management with replacement factor is often effective, patients with severe hemophilia may develop chronic synovitis and arthropathy best treated with more invasive means. Radioactive synovectomy performed at select hemophilia centers and arthroscopic or open synovectomy are helpful for chronic, active synovitis. Arthroplasty helps improve function and pain relief for most patients, but complication rates, particularly for infection, are higher than those for arthroplasty performed on patients without hemophilia.

    Title Implant Migration After Early Weightbearing in Cementless Hip Replacement.
    Date September 2005
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    Twenty-nine patients (five women and 24 men) with an average age of 47 years (range, 24-59 years) had 37 total hip arthroplasties using a hydroxyapatite-coated double-wedge press-fit femoral component. All patients had a Type A bone quality. Patients were either mobilized with weightbearing as tolerated or toe-touch weightbearing for 6 weeks postoperatively. After 6 weeks all patients were advanced to weightbearing as tolerated. Radiostereometric analysis radiographs were taken at 3 days, 6 weeks, and 6 months postoperatively to measure migration of the femoral component. Radiostereometric analysis revealed no difference in stem migration between the two groups as defined by maximal total point migration. There was a difference in the vertical (proximal-distal) migration within the first 6 weeks between groups (0.81 mm versus 0.13 mm), but not afterwards (0.17 mm versus 0.18 mm). Continuous migration after 6 weeks was observed in three patients from each group. There was no loosening in either group within a 2-year followup. Weightbearing as tolerated is recommended for young patients with excellent bone quality after cementless total hip arthroplasty with a double-wedge press-fit femoral component. LEVEL OF EVIDENCE: Diagnostic study, Level I (testing of previously developed diagnostic criteria in series of consecutive patients--with previously applied reference gold standard). See the Guidelines for Authors for a complete description of levels of evidence.

    Title Surface Arthroplasty in Young Patients with Hip Arthritis Secondary to Childhood Disorders.
    Date June 2005
    Journal The Orthopedic Clinics of North America
    Excerpt

    Legg-Calvé-Perthes disease (LCP) and slipped capital femoral epiphysis (SCFE) may result in alterations of the proximal femoral morphology, leading to the development of hip osteoarthritis as a young adult. Hip surface arthroplasty presents special technical challenges in these patients because of the abnormal anatomy of the head and neck. The authors reviewed the radiographic and clinical results of patients with a history of LCP or SCFE who underwent hip resurfacing between 1996 and 2002. Despite the challenges in performing hip resurfacing in this patient population and the inability to completely normalize hip anatomy, biomechanics, and leg length discrepancy, the results to date have been encouraging.

    Title Total Ankle Replacement in Patients with Rheumatoid Arthritis.
    Date August 2004
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    Patients with rheumatoid arthritis commonly experience involvement of the ankle and hindfoot. Severe pain and functional limitations may develop as a result of tibiotalar arthritis, requiring surgical treatment. The advantages of total ankle arthroplasty over ankle arthrodesis include preservation of motion and decreased stresses on the midfoot and subtalar joints. Previous experience with early design ankle replacements revealed high complication rates and as much as 75% of component loosening. Modern ankle implants have been designed to achieve uncemented fixation with less articular constraint. Patients with rheumatoid arthritis who had total ankle replacement using two different types of second-generation ankle implants were examined clinically and radiographically. The average postoperative American Orthopaedic Foot and Ankle Society ankle-hindfoot score was 81 of a possible 100, at a mean of 6.4 years after surgery. Radiographically, 88.5% of implants were stable without evidence of subsidence at a mean of 6.3 years. Three tibial components had subsided at an average of 7 years. There was evidence of tibial osteolysis with the Buechel Pappas Low Contact Stress implant in 11.5% of patients. Total ankle replacement in patients with rheumatoid arthritis, using a second-generation prosthesis, can provide reliable relief of pain and good functional results at intermediate-term followup, although the incidence of osteolysis warrants close followup.

    Title Using Suture Anchors for Coracoclavicular Fixation in Treatment of Complete Acromioclavicular Separation.
    Date August 2004
    Journal American Journal of Orthopedics (belle Mead, N.j.)
    Excerpt

    For the repair of acromioclavicular separations, we describe a new method of securing the clavicle to the coracoid process using suture anchors. We have repaired 11 consecutive complete acromioclavicular separations in this manner with very good results. We find this to be an easy and reproducible method of anatomical fixation.

    Title Operative Treatment of Tibial Plateau Fractures in Patients Older Than 55 Years.
    Date June 2004
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    Surgical treatment of tibial plateau fractures in the older patient poses an additional challenge because of the underlying condition of the bone and articular surface. We sought to identify risk factors for poorer outcomes in the operative treatment of displaced tibial plateau fractures in older patients. Thirty-nine displaced tibial plateau fractures in patients 55 years and older were treated operatively. Patients were evaluated objectively with Rasmussen clinical and radiologic scoring techniques, and the Short Musculoskeletal Function Assessment and the Short-Form 36 self-assessment instruments. The Rasmussen clinical and radiologic scoring systems, used on average 2.54 years postoperatively, found acceptable results in 87.2% and 82.1% of patients, respectively. The fracture classification of Schatzker was not predictive of results. External fixation was associated with significantly poorer results. Increasing age was associated with poorer clinical and self-assessment scores, although preexisting degenerative joint disease was not. The results from the Short-Form 36 indices were not significantly worse for our study patients. The average Short Musculoskeletal Function Assessment score of our study patients indicated poorer function for mobility than a normative group. Operative treatment of this injury in this population can result in favorable outcomes as evaluated by clinical, radiographic, and self-assessment criteria.

    Title The Role of Constrained Liners in Total Hip Arthroplasty.
    Date April 2004
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    Recurrent instability after total hip replacement is a complex problem with extensive literature detailing multiple etiologies and solutions. It has been shown that the success of surgical treatment depends on the identification of the cause. Unfortunately, in certain situations, there may not be an optimal solution for dealing with the cause, or the cause may remain unidentified. In these cases, the success rate of surgical treatment of the unstable total hip replacement is only 40% to 50%. Constrained acetabular liners were developed to address the problem of recurrent instability by holding the femoral head captive within the socket. Before the use of constrained liners, there were no reliable solutions to dislocation arising from inadequate soft tissues, a deficient abductor mechanism, or neuromuscular disorders. We have used a constrained liner for these situations, with poor patient compliance and instability without a clear cause as relative indications for its use. Our experience with attaining joint stability using one type of constrained liner has resulted in a 97.6% success rate (83 of 85 hips) at 4.8 years, surpassing the outcomes achieved by other means. The intermediate followup after implantation of a constrained liner has not shown significant rates of component wear or loosening.

    Title Salvage Reconstruction for Lateral Ankle Instability Using a Tendon Allograft.
    Date December 2003
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    Lateral ligamentous instability may result after an inversion injury to the ankle. Although it generally responds well to nonsurgical treatment, recurrent cases may warrant surgical intervention. There is extensive literature detailing various procedures designed to restore lateral ankle stability. We describe a case in which a patient had a distal fibulectomy for multiple symptomatic osteochondromas, with reconstruction of the lateral ligament complex using peroneus brevis tendon. The patient subsequently disrupted this surgical construct with a severe inversion injury and had recurrent lateral ankle instability. The lateral ligament complex then was reconstructed using a tibiotalar bone-tendon allograft directed to counteract inversion forces. Fourteen years after the procedure, the patient remains satisfied with a painless, stable ankle. The described technique provides a salvage reconstruction of the lateral ligament complex using allograft tissue, in the unique setting of an absent fibula and deficient peroneus brevis tendon.

    Title The Bubble Sign: a New Radiographic Sign in Total Hip Arthroplasty.
    Date May 2003
    Journal The Journal of Arthroplasty
    Excerpt

    The production of metallic debris from the wear of nonbearing surfaces of a total hip arthroplasty is encountered frequently. We describe a case of extreme generation of metallic debris that resulted in the radiographic outlining of the joint cavity. A 71-year-old woman with a total hip arthroplasty experienced dislodgment of the polyethylene liner from its acetabular shell, resulting in metal-on-metal articulation of the femoral head and the cup. This articulation created severe metallosis that could be seen on preoperative radiographs, producing the described bubble sign. At the time of revision surgery, copious metallic debris was seen macroscopically. This newly described radiographic sign should alert the arthroplasty surgeon to the extent of metallic wear.

    Title The Use of Hypotensive Technique in Conjunction with Brachial Plexus Block Anesthesia for Surgery of the Upper Extremity.
    Date December 2001
    Journal Anesthesiology
    Title Growth and Viability of Streptomyces Coelicolor Mutant for the Cell Division Gene Ftsz.
    Date February 1995
    Journal Molecular Microbiology
    Excerpt

    A homologue of the bacterial cell division gene ftsZ was cloned from the filamentous bacterium Streptomyces coelicolor. The gene was located on the physical map of the chromosome at about '11 o'clock' (in the vicinity of glkA, hisA and trpB). Surprisingly, a null mutant in which the 399-codon ftsZ open reading frame was largely deleted was viable, even though the mutant was blocked in septum formation. This indicates that cell division may not be essential for the growth and viability of S. coelicolor. The ftsZ mutant was able to produce aerial hyphae but was unable to produce spores, a finding consistent with the idea that ftsZ is required in order for aerial hyphae to undergo septation into the uninucleoid cells that differentiate into spores.

    Title Are There Benefits to One- Versus Two-stage Procedures in Bilateral Hip Resurfacing?
    Date
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    BACKGROUND: Short-term studies report comparable complication rates of one-stage bilateral versus two-stage procedures in hip resurfacing, although the long-term effects of such procedures on survivorship, quality of life, and disease-specific scores are currently unknown. QUESTIONS/PURPOSES: We compared clinical scores, length of stay, complication rates, and survivorship in patients who underwent bilateral hip resurfacing grouped on the basis of one-stage versus two-stage operation. PATIENTS AND METHODS: We retrospectively reviewed 75 patients who underwent a one-stage procedure and 87 patients who had both hips resurfaced in separate procedures. The demographics and etiologies were similar for the two groups. The mean followup time was longer in the two-stage group (7.3 years; range, 2.6-12.3 years) than in the one-stage group (6.6 years; range, 2.6-10.9 years). RESULTS: We found no differences in the latest postoperative UCLA pain, walking function, and activity scores; Harris hip scores; or SF-12 scores between the two groups. The average length of stay was shorter for the one-stage group. The early complication rates were similar between the two groups. One-stage patients had a higher revision rate than the patients in the two-stage group (14 versus four hips, respectively), but this was not true for patients with femoral components 48 mm or greater in size. CONCLUSIONS: We found a greater rate of revisions in the one-stage group, suggesting possible long-term detrimental effects of the one-stage procedure. Our data suggest selecting patients with large component sizes if the surgeries are to be performed under one anesthesia. LEVEL OF EVIDENCE: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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