Are leg length and hip offset comparable after hip resurfacing and cementless total hip arthroplasty?

Patel, Shelain; Thakrar, RR; Bhamra, Jagmeet; Hossain, Fahad S; Tengrootenhuysen, Mike; Haddad, FS

doi:10.1308/003588411x586731

Cited by 12 publications

(3 citation statements)

References 27 publications

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“…However, a number of authors have found the opposite [30,38,39]. In certain circumstances, this ability to vary offset and length may be desirable, for example in the case of significant pre-operative shortening or lack of soft tissue tension.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Acetabular Bone Resection, Offset, Leg Length and Post Operative Function Between Hip Resurfacing Arthroplasty and Total Hip Arthroplasty

Parry

Povey

Blom

et al. 2015

The Journal of Arthroplasty

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Section: Discussionmentioning

confidence: 99%

Comparison of Acetabular Bone Resection, Offset, Leg Length and Post Operative Function Between Hip Resurfacing Arthroplasty and Total Hip Arthroplasty

Parry

Povey

Blom

et al. 2015

The Journal of Arthroplasty

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“…Femoral offset was defined as the distance from the centre of rotation of the femoral head to the anatomical femoral axis, and total offset was defined as the distance between the teardrop along the trans-teardrop line and the central femoral axis [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

Abductor Muscle Force after Straight-Stem Compared to Short-Stem Total Hip Arthroplasty through a Modified Direct Lateral Approach: Functional Assessment of 70 Consecutive Patients of a Randomized Controlled Clinical Trial

Fuchs

Hein

Faschingbauer

et al. 2021

JCM

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Because of preservation of proximal femoral bone stock and minimized soft tissue trauma, short-stem implants are becoming increasingly important in total hip arthroplasty (THA). The postulated advantage regarding the functional outcome has not been verified. We hypothesized an increased abductor muscle strength by the use of a short-stem design. Seventy consecutive patients of a randomized clinical trial were included. Of these, 67 patients met the inclusion criteria after 12 months. Thirty-five patients received a standard straight stem and 32 patients a short-stem femoral component. All surgeries were performed by a modified direct lateral approach. Isometric muscle strength of the hip abductors was evaluated preoperatively 3 and 12 months after surgery. Harris hip score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated. After three months, there were no differences between the two groups; the abductor force was comparable to the preoperative initial values. After 12 months, a significant increase in muscle strength for the short stem patient group compared to preoperative baseline values was measured (straight-stem THA, 0.09 Nm/kg ± 0.4, p = 0.32; short-stem THA, 0.2 Nm/kg ± 0.3, p = 0.004). Comparison of the 12-month postoperative total HHS and WOMAC revealed no significant differences between both groups. A significant increase in hip abductor muscle strength 12 months after short-stem THA compared to conventional-stem THA was observed.

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“…Hip offset and leg length are regarded as the most important biomechanical characteristics and can be evaluated on plain radiographs (3). Reconstructing offset correlates with improved abductor muscle function and stability (4,5). Leg length discrepancy (LLD) after THA most commonly involves over-lengthening (6) and may cause low back pain, discomfort, instability, limping and nerve palsies (3), especially when magnitudes exceed 1.5cm (7).…”

Section: Introductionmentioning

confidence: 99%

The association of leg length and offset reconstruction after total hip arthroplasty with clinical outcomes

Bolink

Lenguerrand

Brunton

et al. 2019

Clinical Biomechanics

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Background: Restoring native hip anatomy and biomechanics is important to create a well-functioning hip arthroplasty. This study investigated the association of hip offset and leg length after hip arthroplasty with clinical outcomes, including patient reported outcome measures, the Trendelenburg Test and gait analysis. Methods: In 77 patients undergoing primary hip arthroplasty for osteoarthritis (age mean=65 SD=11 years; BMI mean=27 SD=5 kg/m 2), hip offset and leg length discrepancy were measured on anteroposterior radiographs. The Western Ontario & McMaster Universities Osteoarthritis Index, the Trendelenburg Test and gait were assessed preoperatively, and at 3 and 12 months postoperatively. An inertial measurement unit was used to derive biomechanical parameters, including spatiotemporal gait parameters and tilt angles of the pelvis. Relationships between radiographic and functional outcomes were investigated, and subgroups of patients with >15% decreased and increased femoral offset were analysed separately. Findings: patient-reported function scores and clinical tests demonstrated a few significant, weak correlations with radiographic outcomes (Spearman's ρ range =0.26-0.32; p<0.05). Undercorrection of femoral offset was associated with lower patient-reported function scores and with more step irregularity as well as step asymmetry during gait. Postoperative leg length inequality was associated with increased frontal plane tilt angle of the pelvis during the Trendelenburg Test and increased sagittal plane motion of the pelvis during gait. Femoral offset subgroups demonstrated no significant differences for patient-reported function scores and outcomes of the Trendelenburg Test and gait analysis. Interpretation: Reduced hip offset and leg length dicrepancy following hip arthroplasty seem to be marginally associated with worse clinical outcomes.

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Are leg length and hip offset comparable after hip resurfacing and cementless total hip arthroplasty?

Abstract: Leg length is restored by HRA and THA. A difference remains in offset after HRA although we attribute this to intentional medialisation of the acetabular cup.

Cited by 12 publications

References 27 publications

Comparison of Acetabular Bone Resection, Offset, Leg Length and Post Operative Function Between Hip Resurfacing Arthroplasty and Total Hip Arthroplasty

Comparison of Acetabular Bone Resection, Offset, Leg Length and Post Operative Function Between Hip Resurfacing Arthroplasty and Total Hip Arthroplasty

Abductor Muscle Force after Straight-Stem Compared to Short-Stem Total Hip Arthroplasty through a Modified Direct Lateral Approach: Functional Assessment of 70 Consecutive Patients of a Randomized Controlled Clinical Trial

The association of leg length and offset reconstruction after total hip arthroplasty with clinical outcomes

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