Implant positioning in total hip arthroplasty: influence of horizontal and vertical offset on functionality of prosthetic hip joint

Vaishy, Arun; Arif, Mohammad; Aanand, Rahul; Singh, Kamaldeep; Rulaniya, Hitesh Kumar; Kumawat, Naveen; Choudhary, Ramakishan; Choudhary, Paras

doi:10.1007/s00264-022-05364-7

Cited by 5 publications

(3 citation statements)

References 38 publications

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“…Another important factor in preventing dislocation is the restoration of the hip's offset. The study conducted by Vaishy et al highlights the significance of concurrent reconstruction of both horizontal and vertical offset to minimize dislocation risk and improve the hip range of motion ( 43 ). In our study, successful reconstruction of the rotational center of the operated hip was achieved, thereby restoring the offset and soft tissue tension to a satisfactory extent and reducing the dislocation rate.…”

Section: Discussionmentioning

confidence: 99%

A prospective and consecutive study assessing short-term clinical and radiographic outcomes of Chinese domestically manufactured 3D printing trabecular titanium acetabular cup for primary total hip arthroplasty: evaluation of 236 cases

Chen,

Wang,

et al. 2024

Front. Surg.

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PurposeWe prospectively evaluate the short-term clinical and radiographic outcomes of the only Chinese domestically produced trabecular titanium acetabular cup(3D ACT™ cup) in primary total hip arthroplasty (THA), aiming to provide evidence-based support for its clinical application.MethodsA total of 236 patients, who underwent primary THA using 3D ACT™ cup in the Department of Joint Surgery at our hospital between January 2017 and June 2019, were included in this study. General patient data, imaging information, functional scores, and complications were collected to evaluate the early clinical efficacy.ResultsAll patients were followed up for 33–52 months, with an average of (42.2 ± 9.2) months. At the last follow-up, the preoperative HHS score increased significantly from 43.7 ± 6.8 to 85.6 ± 9.3 points (P < 0.01). Similarly, the preoperative WOMAC scores showed significant improvement from 59.2 ± 5.8 to 13.1 ± 3.5 points (P < 0.01). 92.3% of the patients expressed satisfaction or high satisfaction with the clinical outcome. Furthermore, 87.7% of the acetabular cups were positioned within the Lewinnek safe zone, achieving successful reconstruction of the acetabular rotation center. The cup survival rate at the last follow-up was 100%.ConclusionsThe utilization of the only Chinese domestically manufactured 3D printing trabecular titanium acetabular cup in primary THA demonstrated favorable short-term clinical and radiographic outcomes. The acetabular cup exhibits excellent initial stability, high survival rate, and favorable osseointegration, leading to a significant enhancement in pain relief and functional improvement. In the future, larger sample sizes and multicenter prospective randomized controlled trials will be required to validate the long-term safety and effectiveness of this 3D ACT™ cup.

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Section: Discussionmentioning

confidence: 99%

A prospective and consecutive study assessing short-term clinical and radiographic outcomes of Chinese domestically manufactured 3D printing trabecular titanium acetabular cup for primary total hip arthroplasty: evaluation of 236 cases

Chen,

Wang,

et al. 2024

Front. Surg.

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“…An increased offset femoral component may also lead to increased bending moments and torsional forces in the proximal femur and potentially leads to premature failure of the femoral component by aseptic loosening. [9][10][11][12] Commonly total hip prostheses have had a relatively high neck-shaft angle and therefore a tendency to reduce the femoral offset. A decreased offset of the reconstructed hip compared to the preoperative state can result from using a femoral component that has less offset than the anatomy of the patient, from using a more valgus femoral stem or from using a short-necked femoral component.…”

Section: Introductionmentioning

confidence: 99%

Comparison of clinical and functional outcomes in patients operated with standard offset stem versus high offset stem in total hip replacement: a retrospective study

Avhad,

Gunay,

Naik

et al. 2024

Int J Res Orthop

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Background: Femoral offset restoration in total hip replacement is crucial for normal anatomy and reduced joint forces, with potential implications for implant longevity and complications. This study compares standard and high offset stem total hip replacement outcomes for better restoration of native offset, also to improve understanding of clinical and functional outcomes particularly regarding implant selection in total hip replacements. Methods: The study will include 40 patients who underwent THR, divided into standard offset and high offset stem groups. Preoperative data, including history and clinical examination, was collected. Post-operative recovery, satisfaction, and pain levels will be assessed through serial follow-ups at 6, 12, and 18 weeks, along with clinical improvement measured by Harris hip score. Analysis at 18 weeks will evaluate the outcomes of standard vs. high offset stem surgeries. Results: Group A exhibited significantly higher proportions of patients with a Harris hip score >90 (excellent) compared to Group B (70% vs. 25%) and significantly lower proportions with scores indicating poor, fair, and good outcomes (<70: 0% vs. 10%, 70-79: 5% vs. 15%, 80-89: 25% vs. 50%, respectively; p=0.02). Conclusions: This study confirms that increasing femoral offset with high-offset stems improves functional outcomes and biomechanics in total hip arthroplasty, emphasizing the need for patient-specific anatomical consideration.

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“…In fact, suboptimal restoration of femoral offset results in increased joint reaction forces caused by a reduction in abductor moment arm, which may eventually lead to limping and potential instability [4][5][6][7]. Furthermore, decreased femoral offset has been related to poorer functional outcomes [8,9].…”

Section: Introductionmentioning

confidence: 99%

Contribution of the BioballTM head–neck adapter to the restoration of femoral offset in hip revision arthroplasty with retention of a well-fixed cup and stem

Chimeno

Fernández-Valencia

Alias

et al. 2023

International Orthopaedics (SICOT)

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Purpose Failure to restore the femoral offset of the native hip is a potential cause of dysfunctional hip arthroplasty. The aim of this study was to report our experience of using a modular head–neck adapter in revision THA, specifically analyzing its usefulness as a tool to correct a slightly diminished femoral offset. Materials and methods This was a retrospective single-center study including all hip revisions performed at our institution from January 2017 to March 2022 where the BioBallTM head–neck metal adapter was used. The preoperative and one year follow-up modified Merle d’Aubigné hip score was used to evaluate functional outcomes. Results Of a total of 34 cases included for revision, the head–neck adapter system was used specifically in six patients (17.6%) to increase femoral offset, retaining both the acetabular and femoral components. In this subgroup of patients, mean offset decrease after primary THA was 6.6 mm (4.0–9.1), equivalent to a mean 16.3% femoral offset reduction. The median modified Merle d’Aubigné score went from 13.3 preoperatively to 16.2 at one year follow-up. Conclusion The use of a head–neck adapter is a safe and reliable procedure that may allow the surgeon to easily correct a slightly diminished femoral offset in a dysfunctional THA without the need to revise well-fixed prosthetic components.

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Implant positioning in total hip arthroplasty: influence of horizontal and vertical offset on functionality of prosthetic hip joint

Cited by 5 publications

References 38 publications

A prospective and consecutive study assessing short-term clinical and radiographic outcomes of Chinese domestically manufactured 3D printing trabecular titanium acetabular cup for primary total hip arthroplasty: evaluation of 236 cases

A prospective and consecutive study assessing short-term clinical and radiographic outcomes of Chinese domestically manufactured 3D printing trabecular titanium acetabular cup for primary total hip arthroplasty: evaluation of 236 cases

Comparison of clinical and functional outcomes in patients operated with standard offset stem versus high offset stem in total hip replacement: a retrospective study

Contribution of the BioballTM head–neck adapter to the restoration of femoral offset in hip revision arthroplasty with retention of a well-fixed cup and stem

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