Effect of Anesthesia Type on Limb Length Discrepancy After Total Hip Arthroplasty

Sathappan, Sathappan S; Ginat, Daniel Thomas; Patel, Vipul P.; Walsh, Michael J.; Jaffe, William L.; Cesare, Paul E. Di

doi:10.1016/j.arth.2007.01.022

Cited by 50 publications

(37 citation statements)

References 32 publications

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“…Most revisions within the first decade are due to cup failure (migration, wear, and osteolysis) [1,44,47], dislocation, and infection. Equally encouraging are reports of stem performance in the second decade for both cemented and uncemented designs [9,25,38,40,41]. However, there are relatively few reports with more than 15 years of followup.…”

Section: Introductionmentioning

confidence: 80%

Survival of the Cementless Spotorno® Stem in the Second Decade

Aldinger

Jung

Breusch

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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High survival rates have been reported for the uncemented CLS Spotorno stem up to 10 years. To confirm survival at longer followup we report the minimum 15-year (mean, 17 years; range, 15-20 years) for 257 hips using this stem. We retrospectively evaluated the clinical and radiographic results of all 326 patients (354 THAs) operated between 1985 and 1989. The patients had a mean age of 57 years using an uncemented grit-blasted, tapered titanium femoral stem. Eighty-six patients (89 hips) died and eight patients (eight hips) were lost to followup, leaving 240 patients (257 hips) for evaluation. The femoral component was revised in 35 hips: eight for infection, nine for periprosthetic fracture, one for traumatic loosening, and 17 for aseptic loosening. Survival of the stem was 88% at 17 years (95% confidence interval, 84%-92%), and survival with femoral revision for aseptic loosening as an end point was 94% (95% confidence interval, 91%-97%). The median Harris hip score at followup was 80 points. No thigh pain was reported. Small osteolytic lesions (< 1 cm(2)) were found in the proximal Gruen zones (1 or/and 7) in 28 hips (15%). No distal femoral osteolysis was found. The long-term survival with this type of femoral component remains high in the second decade.

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Section: Introductionmentioning

confidence: 80%

Survival of the Cementless Spotorno® Stem in the Second Decade

Aldinger

Jung

Breusch

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…For example, preoperative templating is mentioned as a common method for many surgeons which is an indirect method, its result is affected by radiographic magnification and position of patients when they had X-ray, templating overlays enlarged by a uniform factor may not be perfectly accurate. The shuck test and the dropkick test both rely on soft tissue tension as a surrogate indicator of limb length, motor blockade from spinal or epidural anesthesia may cause them to be less reliable than standard general anesthesia [22]. Surgeons also should not rely solely on the intraoperative leg-to-leg comparison because it is limited by greater adduction on the operative side and inaccuracy of palpation of landmarks through surgical drapes.…”

Section: Discussionmentioning

confidence: 99%

An intraoperative device to restore femoral offset in total hip arthroplasty

et al. 2014

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BackgroundLeg length discrepancy (LLD) after total hip arthroplasty (THA) can lead to unsatisfactory outcome. Our objective was to design and evaluate a simple and reliable intraoperative device (Length-offset Lever) to minimize leg length discrepancy.MethodsThis device was used in 51 patients undergoing primary total hip replacements. The leg length discrepancy was measured pre- and postoperatively based on plain radiographs.ResultsPreoperative radiographic leg length discrepancy averaged 13.5 ± 6.2 mm. Leg length discrepancy showed significant improvement, with a postoperative average of 4.1 ± 2.3 mm (p < 0.0001). There were no complications associated with this device.ConclusionsThe ‘Length-offset Lever’ is a useful intraoperative tool to restore anatomic femoral offset and height of femoral head.

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“…Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. The New Mexico Center for Joint Replacement Surgery, New Mexico Orthopaedics, 201 Cedar SE, Suite 6600, Albuquerque, NM 87106, USA e-mail: archibeckmj@nmortho.net regional) also contributes to the inaccuracy of intraoperative subjective tests [9]. While templating preoperatively is currently the only reasonably accurate method by which to predict component sizes and placement, there are limitations.…”

Section: Introductionmentioning

confidence: 96%

“…One must assume the surgeon will try to duplicate these technique guidelines intraoperatively as accurately as possible. The most accurate restoration occurs when the surgeon adheres meticulously to preoperative templating guidelines and does not rely on intraoperative subjective tests of leg lengths and offset such as the ''shuck'' tests [9]. The type of anesthesia (general or One or more of the authors (MJA, REW) have received personal payments from Zimmer, Inc (Warsaw, IN) for serving on a speakers' bureau and royalties related to one or both of these implants.…”

Section: Introductionmentioning

confidence: 99%