The continuum of hip range of motion: From soft‐tissue restriction to bony impingement

Han, Shuyang; Owens, Virgenal L.; Patel, Rikin; Ismaily, Sabir; Harrington, Melvyn A.; Incavo, Stephen J.; Noble, Philip C.

doi:10.1002/jor.24594

Cited by 10 publications

(17 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[18,64], similar values were observed for flexion and internal rotation. Contrarily, the ROM for external rotation of the patients treated with THR exceeded the physiological ROM [54]. Within the ROM analysis, the different types of impingement at maximum ROM was detected depending on the movement ( Figure 5B).…”

Section: Investigation Of Rom and Predominant Impingement Type For Thmentioning

confidence: 91%

“…In this study, we introduce a new computational framework (Figure 1), which is based on non-invasive MRI data of patients, and a previously described method of CAD modeling [18,24,30,53]; this enables the estimation of the patient-specific ROM for THRs during the movements similar to ISO-21535 and clinical joint movements [54][55][56][57]. The computational framework for the preoperative calculation of the patient-specific range of motion (ROM) after subjection to virtually performed total hip arthroplasty.…”

Section: Overview Of the Deployed Frameworkmentioning

confidence: 99%

“…The hip joint angle at this specific position was then recorded as the functional ROM of the THR. Within the ROM analysis, three different movements similar to ISO-21535 and typical clinical joint movements [54][55][56][57] were considered ( Figure 3): maximum flexion from neutral (maxFlex), combined internal rotation at 90 • flexion (IR@90Flex), and combined external rotation at 90 • flexion (ER@90Flex).…”

Section: Analysis Of Range Of Motionmentioning

confidence: 99%

See 2 more Smart Citations

An MRI-Based Patient-Specific Computational Framework for the Calculation of Range of Motion of Total Hip Replacements

et al. 2021

View full text Add to dashboard Cite

The calculation of range of motion (ROM) is a key factor during preoperative planning of total hip replacements (THR), to reduce the risk of impingement and dislocation of the artificial hip joint. To support the preoperative assessment of THR, a magnetic resonance imaging (MRI)-based computational framework was generated; this enabled the estimation of patient-specific ROM and type of impingement (bone-to-bone, implant-to-bone, and implant-to-implant) postoperatively, using a three-dimensional computer-aided design (CAD) to visualize typical clinical joint movements. Hence, patient-specific CAD models from 19 patients were generated from MRI scans and a conventional total hip system (Bicontact® hip stem and Plasmacup® SC acetabular cup with a ceramic-on-ceramic bearing) was implanted virtually. As a verification of the framework, the ROM was compared between preoperatively planned and the postoperatively reconstructed situations; this was derived based on postoperative radiographs (n = 6 patients) during different clinically relevant movements. The data analysis revealed there was no significant difference between preoperatively planned and postoperatively reconstructed ROM (∆ROM) of maximum flexion (∆ROM = 0°, p = 0.854) and internal rotation (∆ROM = 1.8°, p = 0.917). Contrarily, minor differences were observed for the ROM during maximum external rotation (∆ROM = 9°, p = 0.046). Impingement, of all three types, was in good agreement with the preoperatively planned and postoperatively reconstructed scenarios during all movements. The calculated ROM reached physiological levels during flexion and internal rotation movement; however, it exceeded physiological levels during external rotation. Patients, where implant-to-implant impingement was detected, reached higher ROMs than patients with bone-to-bone impingement. The proposed framework provides the capability to predict postoperative ROM of THRs.

show abstract

Section: Investigation Of Rom and Predominant Impingement Type For Thmentioning

confidence: 91%

Section: Overview Of the Deployed Frameworkmentioning

confidence: 99%

Section: Analysis Of Range Of Motionmentioning

confidence: 99%

See 1 more Smart Citation

An MRI-Based Patient-Specific Computational Framework for the Calculation of Range of Motion of Total Hip Replacements

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Bony impingement was also shown to frequently occur prior to component impingement in flexion maneuvers as also reported by Kessler et al 8 An obvious limitation of this study and many virtual range-of-motion studies of the hip is the lack of soft-tissue simulation. While the contribution of soft-tissue tension and other soft-tissue constraints prior to impingement can vary greatly by patient and maneuver, 2,9 Turley et al stated that "in CT simulations, range of motion restriction slightly overestimates the required range of motion due to the absence of soft tissue by 5˚." 2 Given the small sample size of this study and the multitude of factors that define a successful hip replacement, it was not surprising that very little correlation was seen between range of motion and patient-reported outcomes (PROMs).…”

Section: Discussionmentioning

confidence: 99%

“…All 22 hips were performed through an anterolateral approach and utilized an enhanced femoral workflow which allowed capture of the implanted stem version (prepared and implanted through manual means) in addition to robotic-assisted cup placement to plan. Thirteen (13) of the hips were implanted with a tapered-wedge stem and nine (9) were implanted with an anatomic fit-and-fill stem. Nineteen (19) were implanted with a neutral liner and 3 were implanted with a dualmobility liner.…”

Section: Methodsmentioning

confidence: 99%

Post-operative Virtual Range of Motion in Robotic-assisted THA Patients to determine Pre-operative Simulation Needs

Thompson¹,

Guttal²,

Darcy³

et al.

EPiC Series in Health Sciences

View full text Add to dashboard Cite

For preoperative simulations of hip range of motion to be useful in predicting complications after total hip arthroplasty (THA), the factors that could affect post-operative function must be considered including, but not limited to, bony impingement, pelvic position, and implanted vs. planned differences. This study retrospectively simulates ranges of motion to prosthetic and bony impingement of THA patients with known planned and implanted component positions and pelvic tilt to determine the factors and needs to accurately simulate range of motion preoperatively.Twenty-two (22) anterolateral, cementless total hip arthroplasties were performed using robotic-arm assisted technology which allowed capture of the implanted stem version and position in addition to robotic-assisted cup placement to plan. With the known implanted positions and preoperative 3-dimentional (3D) bone models, six (6) hip maneuvers were virtually simulated in custom software. Correlations were evaluated between planned and implanted component positions, pelvic tilt, ranges of motion, and patient-reported outcomes.Average ranges of motion to impingement were similar to those of previous simulation and navigation studies. Supine tilt varied from -10 ̊ (posterior) to 15 ̊ (anterior) with an average of 3.4±6.6 ̊. Very little correlation was seen between native or planned stem version and implanted stem version. Correlations were seen between some maneuvers such as internal rotation (IR) at 90 degrees flexion (F) (IR@90F) and combined component version and pelvic tilt. Bony impingement occurred during IR@90F in 9 of the 22cases. Pelvic tilt assessment, bony impingement detection, better prediction of implanted component position or the ability to execute a plan, such as robotically, would all provide a more accurate pre-operative simulation of the post-operative patient’s function.

show abstract

Do hip resurfacing and short hip stem arthroplasties differ from conventional hip stem replacement regarding impingement‐free range of motion?

Kebbach

Schulze

Meyenburg

et al. 2023

Journal Orthopaedic Research

View full text Add to dashboard Cite

Total hip joint replacement (THR) is clinically well‐established. In this context, the resulting range of motion (ROM) is crucial for patient satisfaction when performing joint movements. However, the ROM for THR with different bone preserving strategies (short hip stem and hip resurfacing) raises the question of whether the ROM is comparable with conventional hip stems. Therefore, this computer‐based study aimed to investigate the ROM and type of impingement for different implant systems. An established framework with computer‐aided design 3D models based on magnetic resonance imaging data of 19 patients with hip osteoarthritis was used to analyse the ROM for three different implant systems (conventional hip stem vs. short hip stem vs. hip resurfacing) during typical joint movements. Our results revealed that all three designs led to mean maximum flexion higher than 110°. However, hip resurfacing showed less ROM (−5% against conventional and −6% against short hip stem). No significant differences were observed between the conventional and short hip stem during maximum flexion and internal rotation. Contrarily, a significant difference was detected between the conventional hip stem and hip resurfacing during internal rotation (p = 0.003). The ROM of the hip resurfacing was lower than the conventional and short hip stem during all three movements. Furthermore, hip resurfacing shifted the impingement type to implant‐to‐bone impingement compared with the other implant designs. The calculated ROMs of the implant systems achieved physiological levels during maximum flexion and internal rotation. However, bone impingement was more likely during internal rotation with increasing bone preservation. Despite the larger head diameter of hip resurfacing, the ROM examined was substantially lower than that of conventional and short hip stem.

show abstract

The continuum of hip range of motion: From soft‐tissue restriction to bony impingement

Cited by 10 publications

References 30 publications

An MRI-Based Patient-Specific Computational Framework for the Calculation of Range of Motion of Total Hip Replacements

An MRI-Based Patient-Specific Computational Framework for the Calculation of Range of Motion of Total Hip Replacements

Post-operative Virtual Range of Motion in Robotic-assisted THA Patients to determine Pre-operative Simulation Needs

Do hip resurfacing and short hip stem arthroplasties differ from conventional hip stem replacement regarding impingement‐free range of motion?

Contact Info

Product

Resources

About