Femoral Offset (3D) in Patients without Osteoarthritis – Index Values from 200 Hip Joints

Preininger, Bernd; Schmorl, Kathrin; Roth, Philipp von; Winkler, Tobias; Matziolis, Georg; Perka, Carsten; Tohtz, Stephan

doi:10.2174/1874325001206010578

Cited by 11 publications

(6 citation statements)

References 16 publications

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“…Esposito et al [13] also noted that 57% of their cups were within both safe zones for those who dislocated. The mean cup inclination (44°) and anteversion (15°) of dislocated hips reported in the current study reflect the standard values noted for the native hip [35]. In addition, the mean values of both inclination and anteversion were nearly identical to the recommended targets by Lewinnek et al [20].…”

Section: Discussionsupporting

confidence: 85%

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What Safe Zone? The Vast Majority of Dislocated THAs Are Within the Lewinnek Safe Zone for Acetabular Component Position

Abdel

Roth

Jennings

et al. 2016

Clinical Orthopaedics &Amp; Related Research

485

301

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Background Numerous factors influence total hip arthroplasty (THA) stability including surgical approach and soft tissue tension, patient compliance, and component position. One long-held tenet regarding component position is that cup inclination and anteversion of 40°± 10°a nd 15°± 10°, respectively, represent a ''safe zone'' as defined by Lewinnek that minimizes dislocation after primary THA; however, it is clear that components positioned in this zone can and do dislocate. Questions/purposes We sought to determine if these classic radiographic targets for cup inclination and anteversion accurately predicted a safe zone limiting dislocation in a contemporary THA practice.Methods From a cohort of 9784 primary THAs performed between 2003 and 2012 at one institution, we retrospectively identified 206 THAs (2%) that subsequently dislocated. Radiographic parameters including inclination, anteversion, center of rotation, and limb length discrepancy were analyzed. Mean followup was 27 months (range, 0-133 months). Results The majority (58% [120 of 206]) of dislocated THAs had a socket within the Lewinnek safe zone. Mean cup inclination was 44°± 8°with 84% within the safe zone for inclination. Mean anteversion was 15°± 9°with 69% within the safe zone for anteversion. Sixty-five percent of dislocated THAs that were performed through a posterior approach had an acetabular component within the combined acetabular safe zones, whereas this was true for only 33% performed through an anterolateral approach. An acetabular component performed through a posterior approach was three times as likely to be within the combined acetabular safe zones (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.1-1.6) than after an anterolateral approach (OR, 0.4; 95% CI, 0.2-0.7; p \ 0.0001). In contrast, acetabular components performed through a posterior approach (OR, 1.6; 95% CI, 1.2-1.9) had an increased risk of dislocation compared with those performed through an anterolateral approach (OR, 0.8; 95% CI, 0.7-0.

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Section: Discussionsupporting

confidence: 85%

“…The femoral offset in the current study was 38 mm. According to Preininger et al [35], the offset of the native hip ranges from 39 to 43 mm. Therefore, the offset in our study cohort was reconstructed accurately.…”

Section: Discussionmentioning

confidence: 99%

What Safe Zone? The Vast Majority of Dislocated THAs Are Within the Lewinnek Safe Zone for Acetabular Component Position

Abdel

Roth

Jennings

et al. 2016

Clinical Orthopaedics &Amp; Related Research

485

301

View full text Add to dashboard Cite

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“…Also, thinner slices at the femoral neck region will be needed for improving the accuracy of measurements which will increase the radiation dose. In addition, another possible limitation is the difficulty to determine the true axis of the femoral shaft by scanning the proximal femur only if we want to reduce the radiation dose [32]. Measurement units: for offset, centimeters (cm); for anteversion, degrees The full-body, 3D EOS system has less radiation compared with regular and digital X-ray and CT scan [33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Offset and anteversion reconstruction after cemented and uncemented total hip arthroplasty: an evaluation with the low-dose EOS system comparing two- and three-dimensional imaging

Lazennec

Brusson

Folinais³

et al. 2014

International Orthopaedics (SICOT)

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“…Previous studies have shown the non-existence of side-specific differences in relation to the femoral offset. 11 Leg length showed an average shortening of 0.4 mm (SD 3.0) in the DAA group and an average lengthening of 1.28 mm (SD 4.4) in the ALMI group (p=0.001) (Table 4, Figure 1C).…”

Section: Resultsmentioning

confidence: 96%

Compared learning curves of the direct anterior and anterolateral approach for minimally invasive hip replacement

et al. 2022

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Minimally invasive hip arthroplasty becomes increasingly popular. It is technically challenging and the approaches used are associated with a considerable learning curve. This nurtures concerns regarding patient safety, surgical training, and cost effectiveness. Consequently, we initiated a study comparing the learning curves of a supervised trainee surgeon utilizing both the anterolateral and direct anterior approach (DAA) when introduced to minimally invasive hip replacement surgery. Outcome measurements included the Harris hip score (HHS), cup inclination and anteversion, offset and leg length, stem placement, surgical time and complications. Time from incision to suture decreased significantly over time but did not differ between both groups. The functional outcomes (HHS) after six weeks and three months were comparable (p=0.069 and 0.557) and within the expected range equalling 90.3 (anterior) and 89.2 (anterolateral) points. With both approaches safe component placement was readily achieved. Both offset and leg length, however, were reconstructed more reliably with the DAA (p=0.02 and 0.001). A higher rate of dislocations was seen with the anterior, more perioperative infections with the anterolateral approach. We suggest that supervision by an experienced surgeon favourably influences the learning curves for both the minimally invasive DAA and anterolateral approach and conclude that the greatest improvement is seen within the first 60 cases.

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Femoral Offset (3D) in Patients without Osteoarthritis – Index Values from 200 Hip Joints

Cited by 11 publications

References 16 publications

What Safe Zone? The Vast Majority of Dislocated THAs Are Within the Lewinnek Safe Zone for Acetabular Component Position

What Safe Zone? The Vast Majority of Dislocated THAs Are Within the Lewinnek Safe Zone for Acetabular Component Position

Offset and anteversion reconstruction after cemented and uncemented total hip arthroplasty: an evaluation with the low-dose EOS system comparing two- and three-dimensional imaging

Compared learning curves of the direct anterior and anterolateral approach for minimally invasive hip replacement

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