Ipsilateral Varus Knee Alignment Correlates with Increased Femoral Stem Anteversion in Primary Total HIP Arthroplasty

Nam, Kwang Woo; Tsai, Tsung‐Yuan; Dimitriou, Dimitrios; Li, Guoan; Kwon, Young‐Min

doi:10.5301/hipint.5000325

Cited by 4 publications

(13 citation statements)

References 19 publications

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“…Studies also needed OA scores on a validated scale, or in unambiguous descriptive terms such as "normal cartilage" or "end-stage OA." 2,3,14,16,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]…”

Section: Literature Searchmentioning

confidence: 99%

Abnormal Femoral Anteversion Is Associated With the Development of Hip Osteoarthritis: A Systematic Review and Meta-Analysis

Parker

Meyer

Nasir

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To perform a systematic review and meta-analysis of literature and to evaluate the relationship between abnormal femoral version and the development of hip osteoarthritis (OA). Methods: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, evaluating Level I and II studies. Included studies had to provide granular femoral version (FV) information. The severity of OA was ranked on the KellgreneLawrence (KL) scale. Excel version 1808 (Microsoft, Redmond, WA) was used to perform a student t test statistical analyses. Results: Our review identified 19 qualifying studiesd5 Level I and 14 Level II with 1,756 patients. Patients with FV above normal range (>14 ) had greater KL scores than patients with normal range FV (mean AE standard deviation; 3.37 AE 1.44 vs 2.05 AE 1.72, P < .05). Analysis of KL scores in patients with FV >24 (>1 standard deviation) versus patients with FV >14 but <24 also demonstrated a positive correlation between increasing FV and KL (4.00 AE 1.96 vs 2.34 AE 0). This was significant independent of the presence or absence of developmental dysplasia of the hip. Retroverted hips (FV<10 ) in the present study showed variable OA results upon analysis. Conclusions: The present review suggests that elevated FV may be a risk factor for more severe hip OA with or without the presence of concurrent dysplasia of the hip. The relative amount of increased anteversion appears positively correlated with severity of OA. Although femoral retroversion may impact hip mechanics, in this review it does not appear to strongly correlate with the development of OA. Level of Evidence: II: systematic review of Level I and II studies.

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Section: Literature Searchmentioning

confidence: 99%

Abnormal Femoral Anteversion Is Associated With the Development of Hip Osteoarthritis: A Systematic Review and Meta-Analysis

Parker

Meyer

Nasir

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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“…On the other hand, the in uence of a prior TKA on the ipsilateral hip has also been examined. Previous studies have reported that prior TKA leads to biomechanical changes and that knee alignment caused by prior TKA affects the positioning of the ipsilateral femoral component during THA [6,[13][14][15]. However, to our knowledge, no study has yet compared the clinical outcomes and implant survivorship in patients undergoing different sequences of ipsilateral THA and TKA.…”

Section: Introductionmentioning

confidence: 99%

“…Patients with end-stage degenerative or in ammatory arthritis report excellent outcomes after THA or TKA [4]. However, there is some evidence to suggest loading redistribution and biomechanical changes in the lower limb after THA or TKA [5][6][7][8][9]. Data concerning the in uence of prior THA on the ipsilateral knee joint or ipsilateral TKA remain controversial.…”

Section: Introductionmentioning

confidence: 99%

Mid-long-term results of total knee arthroplasty followed by ipsilateral total hip arthroplasty versus total hip arthroplasty subsequent to ipsilateral total knee arthroplasty: A case-control analysis

Liu¹,

Zeng²,

Luo

et al. 2021

Preprint

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Background: The aim of the present study was to compare the outcomes of patients who underwent different sequences of ipsilateral total hip arthroplasty (THA) and total knee arthroplasty (TKA).Methods: We retrospectively identified 47 patients who underwent TKA followed by ipsilateral THA (THA-TKA) and 36 patients who received THA subsequent to ipsilateral TKA (TKA-THA) for rheumatoid arthritis or osteoarthritis between January 2008 and April 2014. Twenty-eight patients were selected for each group after case-control matching with preoperative demographics and protheses of THA. Clinical scores, radiographic results, complication rates, and survivorship were compared. The median duration of follow-up was 110 (range 80-149) months.Results: Both groups showed significant improvement in Harris Hip Scores, Knee Society Score, and Short Form-12 at the last follow-up compared to baseline (p < .001). At the last follow-up, all clinical scores were actually lower in the THA-TKA group, but those differences were not statistically significant. Otherwise, there was no significant difference in radiological alignment or complication rates. The survivorship of THA and TKA in the THA-TKA group was 88.2% and 87.4%, respectively, compared with 75.0% and 95.7% in the TKA-THA group at 10 years (log rank, p = .939 and .187).Conclusions: Patients who underwent ipsilateral THA and TKA with different sequences achieved similar favorable outcomes. Total joint arthroplasty can be performed safely with excellent outcomes in patients with a history of prior ipsilateral THA or TKA.

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“…Thereafter, manual goniometers of different kinds with the same measuring principle have been reported, with an acceptable absolute error [ 15 , 16 , 20 ]. But these goniometers also relied on the premise that the lower leg axis was vertical to the reference axis of the distal femur, and recent studies showed that knee osteoarthritis could increase the error in estimating femoral anteversion [ 16 , 21 ]. It must be acknowledged that navigation can assess femoral anteversion with high accuracy [ 7 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Measurement of operative femoral anteversion during cementless total hip arthroplasty and influencing factors for using neck-adjustable femoral stem

et al. 2021

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Background Placement of femoral stem in excessive anteversion or retroversion can cause reduced range of motion, prosthetic impingement, and dislocation. The aim of this study was to assess the operative femoral anteversion in patients treated with total hip arthroplasty (THA) and analyze the need of adjusting stem anteversion. Methods We retrospectively included 101 patients (126 hips) who underwent cementless THA with a manual goniometer to determine the femoral anteversion between October 2017 and December 2018. The operative femoral anteversion we measured was recorded during THA. We further divided those hips into three subgroups based on the range of operative femoral anteversion: group 1 (<10°), group 2 (10–30°), and group 3 (>30°) and compared the differences of their demographic data. Univariate and multivariate logistic regression were used to identify the influencing factors for the need of neck-adjustable femoral stem. The clinical and radiographic outcomes were also assessed. Perioperative complications were recorded. Results After THA, the Harris hip scores improved from 52.87 ± 15.30 preoperatively to 90.04 ± 3.31 at the last follow-up (p < 0.001). No implant loosening, stem subsidence, and radiolucent lines were observed on radiographs. No severe complications occurred and no components needed revision at the latest follow-up. The mean operative femoral anteversion was 14.21° ± 11.80° (range, −9 to 60°). Patients with femoral anteversion more than 30° were about 10 years younger than others. Femoral anteversion >30° was more common in patients with developmental dysplasia of the hip (DDH). There were totally 14 hips treated with the neck-adjustable femoral stem. From the univariate analysis, we can observe that female sex, diagnosis of DDH (compared with osteonecrosis), and higher operative femoral anteversion and its value >30° (compared with <10°) are associated with higher rates of using the neck-adjustable femoral stem. However, all these factors were no longer considered as independent influencing factors when mixed with other factors. Conclusions This study highlighted the significance of operative femoral anteversion. Identification of abnormal femoral anteversion could assist in adjusting stem anteversion and reduce the risk of dislocation after THA.

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Ipsilateral Varus Knee Alignment Correlates with Increased Femoral Stem Anteversion in Primary Total HIP Arthroplasty

Abstract: The ipsilateral knee varus deformity should be considered to optimise the femoral component position during contemporary total hip arthroplasty.

Cited by 4 publications

References 19 publications

Abnormal Femoral Anteversion Is Associated With the Development of Hip Osteoarthritis: A Systematic Review and Meta-Analysis

Abnormal Femoral Anteversion Is Associated With the Development of Hip Osteoarthritis: A Systematic Review and Meta-Analysis

Mid-long-term results of total knee arthroplasty followed by ipsilateral total hip arthroplasty versus total hip arthroplasty subsequent to ipsilateral total knee arthroplasty: A case-control analysis

Measurement of operative femoral anteversion during cementless total hip arthroplasty and influencing factors for using neck-adjustable femoral stem

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