Inducible displacements of the cup and the femoral head during active range of motion: Dynamic <scp>RSA</scp> studies of cemented total hip replacements

Digas, Georgios; Johansson, Per-Erik; Kärrholm, Johan

doi:10.1002/jor.22428

Cited by 5 publications

(6 citation statements)

References 15 publications

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“…In other instances, too many bone markers were hidden behind the stem of the prostheses. Despite these drawbacks, we think that the data available can provide interesting information about the resolution of an OTS related to true skeletal motions performed by RSA …”

Section: Discussionmentioning

confidence: 99%

“…These authors used dynamic radiostereometric examination at two exposures/s. In contrast to our examination technique, active abduction was studied only weight‐bearing on the opposite leg to evaluate femoral head translations and cup displacements …”

Section: Discussionmentioning

confidence: 99%

“…This method can also be used to measure joint motions, either by repeated static examinations or by the use of dynamic techniques based on film‐exchangers or high‐speed digital screens. RSA can be considered as “golden standard” in investigation of joint motions because of its high accuracy, high resolution, and detailed documentation …”

mentioning

confidence: 99%

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Validation of gait analysis with dynamic radiostereometric analysis (RSA) in patients operated with total hip arthroplasty

et al. 2016

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We simultaneously examined 14 patients with OTS and dynamic radiostereometric analysis (RSA) to evaluate the accuracy of both skin- and a cluster-marker models. The mean differences between the OTS and RSA system in hip flexion, abduction, and rotation varied up to 9.5° for the skin-marker and up to 11.3° for the cluster-marker models, respectively. Both models tended to underestimate the amount of flexion and abduction, but a significant systematic difference between the marker and RSA evaluations could only be established for recordings of hip abduction using cluster markers (p = 0.04). The intra-class correlation coefficient (ICC) was 0.7 or higher during flexion for both models and during abduction using skin markers, but decreased to 0.5-0.6 when abduction motion was studied with cluster markers. During active hip rotation, the two marker models tended to deviate from the RSA recordings in different ways with poor correlations at the end of the motion (ICC ≤0.4). During active hip motions soft tissue displacements occasionally induced considerable differences when compared to skeletal motions. The best correlation between RSA recordings and the skin- and cluster-marker model was found for studies of hip flexion and abduction with the skin-marker model. Studies of hip abduction with use of cluster markers were associated with a constant underestimation of the motion. Recordings of skeletal motions with use of skin or cluster markers during hip rotation were associated with high mean errors amounting up to about 10° at certain positions. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1515-1522, 2017.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Validation of gait analysis with dynamic radiostereometric analysis (RSA) in patients operated with total hip arthroplasty

et al. 2016

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“…In THA patients, femoral head medio‐lateral translation has been observed during gait and non‐weight bearing activities . Komistek et al found an average 2.0 mm femoral head medio‐lateral translation during the swing phase of gait while Dennis et al found an average 3.3 mm femoral head medio‐lateral translation during active hip abduction.…”

Section: Discussionmentioning

confidence: 99%

“…This implies that THA limits femoral head translations. However, this is a desirable effect of THA design in an attempt to decrease polyethylene wear and components loosening …”

Section: Discussionmentioning

confidence: 99%

In vivo kinematic evaluation of total hip arthroplasty during stair climbing

Dimitriou

Tsai

et al. 2015

J. Orthop. Res.

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Stair climbing is a physically demanding task and a painful limitation for patients suffering from severe hip osteoarthritis. Although total hip arthroplasty (THA) is the definitive treatment for end-stage osteoarthritis, it is not well understood whether THA restores hip kinematics during strenuous activities. The purpose of this study was to compare the 3D kinematics of THA and native hip during physically demanding tasks and correlate potential differences with THA components orientations/positions in patients with unilateral THA. In vivo hip kinematics were determined during step-up and leg stance activities using a validated combination of 3D CT-based computer modeling and dual fluoroscopic imaging system (DFIS). The THA side demonstrated an average 3.4˚(AE6.5˚, range: À5.9˚to 15.2˚) greater internal rotation than the contralateral native hip, during the step-up activity but not during leg stance. The difference in internal rotation was highly correlated to the difference in femoral anteversion and anterior translation of hip joint center between implanted and native hip (R 2 ¼ 0.71, p < 0.01). The results suggest the importance of accurate THA component placement in restoring normal hip kinematics during functional activities. ß

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Load-induced deformation of the tibia and its effect on implant loosening detection

ter Wee,

Dobbe,

Buijs

et al. 2023

Sci Rep

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CT imaging under external valgus and varus loading conditions and consecutive image analysis can be used to detect tibial implant loosening after total knee arthroplasty. However, the applied load causes the tibia to deform, which could result in an overestimation of implant displacement. This research evaluates the extent of tibia deformation and its effect on measuring implant displacement. Ten cadaver specimen with TKA were CT-scanned under valgus/varus loading (20 Nm), first implanted without bone cement fixation (mimicking a loose implant) and subsequently with bone cement fixation (mimicking a fixed implant). By means of image analysis, three relative displacements were assessed: (1) between the proximal and distal tibia (measure of deformation), (2) between the implant and the whole tibia (including potential deformation effect) and (3) between the implant and the proximal tibia (reduced deformation effect). Relative displacements were quantified in terms of translations along, and rotations about the axes of a local coordinate system. As a measure of deformation, the proximal tibia moved relative to the distal tibia by, on average 1.27 mm (± 0.50 mm) and 0.64° (± 0.25°). Deformation caused an overestimation of implant displacement in the cemented implant. The implant displaced with respect to the whole tibia by 0.45 mm (± 0.22 mm) and 0.79° (± 0.38°). Relative to the proximal tibia, the implant moved by 0.23 mm (± 0.10 mm) and 0.62° (± 0.34°). The differentiation between loose and fixed implants improved when tibia deformation was compensated for by using the proximal tibia rather than the whole tibia.

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Inducible displacements of the cup and the femoral head during active range of motion: Dynamic RSA studies of cemented total hip replacements

Cited by 5 publications

References 15 publications

Validation of gait analysis with dynamic radiostereometric analysis (RSA) in patients operated with total hip arthroplasty

Validation of gait analysis with dynamic radiostereometric analysis (RSA) in patients operated with total hip arthroplasty

In vivo kinematic evaluation of total hip arthroplasty during stair climbing

Load-induced deformation of the tibia and its effect on implant loosening detection

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