Effects of the Femoral Offset and the Head Size on the Safe Range of Motion in Total Hip Arthroplasty

Matsushita, Akira; Nakashima, Yasuharu; Jingushi, Seiya; Yamamoto, Takuya; Kuraoka, Akio; Iwamoto, Yukihide

doi:10.1016/j.arth.2008.02.008

Cited by 140 publications

(87 citation statements)

References 21 publications

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“…Femoral offset is an important design feature that should be optimized since it profoundly affects mechanical function of the replaced hip 19) . Reduced femoral offset reduces the range of motion and detrimentally affect polyethylene wear and acetabular loosening rates 20) . Third, to improve range of motion and minimize prosthetic impingement, the headto-neck ratio was increased by using a 36 mm femoral head and a decreased neck diameter.…”

Section: Discussionmentioning

confidence: 99%

Minimum Seven-year Follow-up of Cementless Total Hip Arthroplasty with the COREN Hip System

et al. 2013

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� Purpose:We previously reported results of a mean 3.2-year follow-up of the COREN hip system, which is the first total hip prosthesis developed in Korea. The aim of this prospective study was to update the previous report with regard to the hip function and radiographic implant performance. Materials and Methods: Between 2003 and 2004, a consecutive series of 68 primary, cementless, total hip prostheses (COREN) were implanted in 57 patients(68 hips) and followed up for a minimum of 7 years. Sixtythree of the 68 hips were available for clinical scoring and radiographic analysis. Results: The mean Harris hip and WOMAC scores were improved from 48.1 and 54.7, preoperatively, to 96.4 and 22.1 at the final follow-up. The mean patient activity increased from 3.1, preoperatively, to 8.2 at the final follow-up. All hips showed stable bony ingrowth on the radiographs. No hips showed evidence of osteolysis or prosthesis loosening, and no revision was required during the follow-up. A Periprosthetic fracture (Vancouver type B1) was encountered in one hip 4.7 years after surgery, which was treated by reoperation. Conclusion: This study shows that the COREN hip system produces excellent mid-term results in cementless hip arthroplasty.

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Section: Discussionmentioning

confidence: 99%

Minimum Seven-year Follow-up of Cementless Total Hip Arthroplasty with the COREN Hip System

et al. 2013

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“…Because the increased risk of postoperative implant dislocation in patients who were overweight and obese may also reflect only a more difficult surgical procedure (as a result of excessive mass of adipose and muscle tissues) resulting in suboptimal orientation of the prosthetic components, the abduction angle and anteversion of the cup [38], the femoral anteversion of the stem [23], and the restoration of offset [26] were measured for each patient ( Table 1).…”

Section: Methodsmentioning

confidence: 99%

Dual-mobility or Constrained Liners Are More Effective Than Preoperative Bariatric Surgery in Prevention of THA Dislocation

Hernigou

Trousselier

Roubineau

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Obesity is associated with an increased risk of dislocation after total hip arthroplasty (THA). However, in patients with obesity, it is not known whether the risk is only in the early postoperative period or whether it persists several years after surgery, and whether having bariatric surgery before undergoing THA and/or receiving a specific device (such as a dual-mobility or constrained acetabular liner) is more effective in terms of decreasing the risk of dislocation. Question/purposes (1) What is the cumulative risk of dislocation in patients with obesity after THA in the absence of a dual-mobility or constrained liner, and is this related to component positioning? (2) Does bariatric surgery before undergoing THA decrease dislocation risk in patients with obesity? (3) Are dual-mobility and constrained liners efficient in preventing dislocation in patients with obesity? Methods At our university-based practice, all surgeons adhered to the following treatment approaches: Before 2000 no dual-mobility implants or constrained liners were used for primary THAs. 2 ) who received standard cups, 85 hips in patients with bariatric surgery before THA using standard cups (with reduction to a BMI \ 30 kg/m 2 ), and 155 hips in patients with obesity who received dual-mobility (when younger than 70 years) or constrained liners (when older than 70 years). All patients received the same implants except for different femoral head diameters (32-mm head with standard cups and 28-mm head with dual-mobility or constrained liners). The patients were followed at routine intervals and were specifically queried about dislocation. All the 670 hips had a minimum followup of 5 years with a mean followup of 14 years (range 5-25 years). At the most recent followup, 101 (15%) hips were lost to followup (respectively, 36 of 215, 34 of 215, five of 85, 24 of 155), which is the same ratio as observed among the underlying populations from which the patients were drawn.Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

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“…For a long time the offset recovery has been neglected in comparison to the restoration of leg length. However, studies have indicated that a reduced offset can have severe consequences [4], like instability of the hip joint. By causing low soft tissue tension it leads to a restricted range of motion and an increased risk of dislocation [5].…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of femoro-acetabular offsets using a short-stem

Kutzner

Kovacevic

Roeder

et al. 2014

International Orthopaedics (SICOT)

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Purpose Despite the fact that new and modern short-stems allow bone sparing and saving of soft-tissue and muscles, we still face the challenge of anatomically reconstructing the femoro-acetabular offset and leg length. Therefore a radiological and clinical analysis of a short-stem reconstruction of the femoro-acetabular offset and leg length was performed. Methods Using an antero-lateral approach, the optimys shortstem (Mathys Ltd, Bettlach, Switzerland) was implanted in 114 consecutive patients in combination with a cementless cup (Fitmore, Zimmer, Indiana, USA; vitamys RM Pressfit, Mathys Ltd, Bettlach, Switzerland). Pre-and postoperative Xrays were done in a standardized technique. In order to better analyse and compare X-ray data a special double coordinate system was developed for measuring femoral-and acetabular offset. Harris hip score was assessed before and six weeks after surgery. Visual analogue scale (VAS) satisfaction, leg length difference and the existence of gluteal muscle insufficiency were also examined. Results Postoperative femoral offset was significantly increased by a mean of 5.8 mm. At the same time cup implantation significantly decreased the acetabular offset by a mean of 3.7 mm, which resulted in an increased combined femoroacetabular offset of 2.1 mm. Postoperatively, 81.7 % of patients presented with equal leg length. The maximum discrepancy was 10 mm. Clinically, there were no signs of gluteal insufficiency. No luxation occurred during hospitalization. The Harris hip score improved from 47.3 before to 90.1 points already at six weeks after surgery while the mean VAS satisfaction was 9.1. Conclusion The analysis showed that loss of femoroacetabular offset can be reduced with an appropriate stem design. Consequently, a good reconstruction of anatomy and leg length can be achieved. In the early postoperative stage the clinical results are excellent.

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Effects of the Femoral Offset and the Head Size on the Safe Range of Motion in Total Hip Arthroplasty

Cited by 140 publications

References 21 publications

Minimum Seven-year Follow-up of Cementless Total Hip Arthroplasty with the COREN Hip System

Minimum Seven-year Follow-up of Cementless Total Hip Arthroplasty with the COREN Hip System

Dual-mobility or Constrained Liners Are More Effective Than Preoperative Bariatric Surgery in Prevention of THA Dislocation

Reconstruction of femoro-acetabular offsets using a short-stem

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