Influence of Total Hip Design on Dislocation

Padgett, Douglas E.; Lipman, Joseph; Robie, Bruce; Nestor, Bryan J.

doi:10.1097/01.blo.0000218748.30236.40

Cited by 52 publications

(10 citation statements)

References 10 publications

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“…The results of this study show that the contralateral side is the most accurate template for the reconstruction of the femoral offset for both men and women. Where the contralateral side cannot serve as a template, the FO values measured and the correlation found in our study might help to identify possible reasons for symptoms that occur postoperatively, as FO has been shown to be closely linked to the incidence of a variety of alterations [1, 3, 4, 17]. …”

Section: Limitationsmentioning

confidence: 92%

See 1 more Smart Citation

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

Preininger

Schmorl²,

Roth³

et al. 2012

TOORTHJ

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Introduction:Femoral offset (FO) is a crucial parameter for hip joint biomechanics. Reference values for FO are particularly important when joint geometry has to be reconstructed during surgical interventions. Such reference values are scarce in literature and have mainly been obtained from osteoarthritis (OA) patients. The aim of this study was to conduct a patient-specific study of FO without osteoarthritis and to create a dataset of FO index values.Materials and Methodology:One hundred (49 female, 51 male; mean age: 59 (18 - 83) years) pelvic computed tomography (CT) scans were analyzed to determine FO in each patient. Bilateral symmetry and correlation between demographic data and FO were analyzed.Results:The mean FO ± SD was different for male (4.36 ± 0.56 cm) and female patients (3.95 ± 0.35 cm) (p <.0001). No Side differences of FO were observed in male and female patients. Significant correlation between height and FO was only observed in male patients.Conclusion:The values obtained in this study can be used as index values for the restoration and evaluation of hip geometry. For men, FO can be approximated using the correlation between FO and height.

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Section: Limitationsmentioning

confidence: 92%

“…These values also make it possible to quantify the changes in hip geometry. Finally, index joint geometry values for FO are needed as well for a correct diagnostic evaluation of postoperative complications such as early hip joint dislocation [3, 4]. …”

Section: Introductionmentioning

confidence: 99%

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

Preininger

Schmorl²,

Roth³

et al. 2012

TOORTHJ

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“…In a recent report on a consecutive series of 254 primary hip arthroplasties performed by a single surgeon Padgett et al , reported a 4.8% rate of dislocation at a minimum followup of 2 year. Stratified by head size, the dislocation rates were 3.6% for 28-mm, 4.8% for 26-mm, and 18.8% for 22-mm bearings 52. Patients who are at higher risk for dislocation will have a less likely chance of complications with a larger head.…”

Section: Risk Factorsmentioning

confidence: 93%

The unstable total hip replacement

D’Angelo¹,

Murena²,

Zatti³

et al. 2008

Indian J Orthop

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Background:Dislocation is one of the most common complications of total hip arthroplasty with a reported dislocation rate of 3.2%. Despite increased experience with hip replacement, the overall rate has not yet changed. The aim of this paper is to review the most recent literature published on this topic and indexed in Medline, in order to clarify the main risk factors, and to standardize a treatment protocol of such an important complication of prosthetic surgery.Materials and Methods:Medline database was searched using key words: “hip dislocation”, “hip instability” from 1980-2007. Studies were eligible for review and included if they met the following criteria: (1) publication in English, (2) clinical trials (3) review papers.Results:The risk of first-time dislocation as a function of time after the surgery is not well understood. Most, but not all, series have demonstrated that the risk of dislocation is highest during the first few months after hip arthroplasty; however, first-time late dislocation can also occur many years after the procedure. Several risk factors were described, including the surgical approach, the diameter of the head, impingement, component malposition, insufficient abductor musculature. In addition, there are also many treatment options, such as long-term bracing after closed reduction, component reorientation, capsulorraphy, trochanteric advancement, increasing offset, exchange of the modular head and the polyethylene liner, insertion of constrained liner.Conclusion:Preventing hip dislocation is obviously the best strategy. Surgeons must take into account patient and surgical risk factors. For patients at high risk for dislocation the surgeon should accurately restore leg length and femoral offset; the use of larger femoral heads, posterior transosseous repair of the capsulotendinous envelope if posterior approach is chosen or the use of a lateral approach should be considered. Proper patient education and postoperative care are very important.

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“…The reduced risk of dislocations (Beaule et al 2002, Burroughs et al 2005, Padgett et al 2006) allows patients with large articulations unrestricted movement postoperatively. It causes the patient less anxiety (Nissen et al 2011) and permits more intensive training, which has led to faster recovery when using the anterolateral approach (Kuijer et al 2009, Sharma et al 2009).…”

mentioning

confidence: 99%

Similar range of motion and function after resurfacing large–head or standard total hip arthroplasty

Penny¹,

Ovesen²,

Varmarken³

et al. 2013

Acta Orthopaedica

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Background and purpose Large–size hip articulations may improve range of motion (ROM) and function compared to a 28–mm THA, and the low risk of dislocation allows the patients more activity postoperatively. On the other hand, the greater extent of surgery for resurfacing hip arthroplasty (RHA) could impair rehabilitation. We investigated the effect of head size and surgical procedure on postoperative rehabilitation in a randomized clinical trial (RCT).Methods We followed randomized groups of RHAs, large–head THAs and standard THAs at 2 months, 6 months, 1 and 2 years postoperatively, recording clinical rehabilitation parameters.Results Large articulations increased the mean total range of motion by 13° during the first 6 postoperative months. The increase was not statistically significant and was transient. The 2–year total ROM (SD) for RHA, standard THA, and large–head THA was 221° (35), 232° (36), and 225° (30) respectively, but the differences were not statistically significant. The 3 groups were similar regarding Harris hip score, UCLA activity score, step rate, and sick leave.Interpretation Head size had no influence on range of motion. The lack of restriction allowed for large articulations did not improve the clinical and patient–perceived outcomes. The more extensive surgical procedure of RHA did not impair the rehabilitation.This project is registered at ClinicalTrials.gov under # NCT01113762.

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Influence of Total Hip Design on Dislocation

Cited by 52 publications

References 10 publications

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

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

The unstable total hip replacement

Similar range of motion and function after resurfacing large–head or standard total hip arthroplasty

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