Bony impingement affects range of motion after total hip arthroplasty: A subject-specific approach

Background: Dislocation continues to be a common complication following total hip arthroplasty (THA). Although previous studies of computed simulation analysis investigated the range of motion (ROM), it is unclear whether the ROM before impingement simulated using computed tomography-based 3-dimensional simulation analysis (simulated ROM) is related to dislocation after THA. It is also unclear what angles are required in computed simulation analyses for stable hips after THA. In this study, we compared the simulated ROM in patients with and without dislocation. Methods: 16 patients with posterior dislocation were compared with 48 matched patients without dislocation. Risk factors including preoperative bone morphology of the hip, implant position, change of femoral offset, change of leg length, anterior aspect of the greater trochanter (GTa) length, and anterior inferior iliac spine length were also compared. Results: The mean flexion angle, internal-rotation at 90° flexion (IR) angle, cup anteversion based on the anterior pelvic plane (APP), tilt-adjusted cup anteversion and GTa length were significantly different between patients with dislocation and patients without dislocation ( p = 0.033, 0.002, 0.010, 0.047, 0.046). A receiver-operating characteristic curve analysis suggested cutoff points for flexion angle, IR angle, cup anteversion based on the APP, tilt-adjusted cup anteversion and GTa length, of 114.5°, 45.5°, 19.5°, 12.0° and 15.3 mm. Conclusions: This study suggests that preoperative planning to achieve a larger simulated ROM, flexion angle and IR angle, may reduce the risk of posterior dislocation. This study also suggests that fine-tuning of cup anteversion and/or trimming of the overhanging GTa during preoperative planning may reduce the risk of posterior dislocation.

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Excessive femoral offset does not affect the range of motion after total hip arthroplasty

International Orthopaedics ◽

10.1007/s00264-013-1881-x ◽

2013 ◽

Vol 37 (7) ◽

pp. 1233-1237 ◽

Cited By ~ 8

Author(s):

Shinya Hayashi ◽

Takayuki Nishiyama ◽

Takaaki Fujishiro ◽

Shingo Hashimoto ◽

Noriyuki Kanzaki ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Range Of Motion ◽

Hip Arthroplasty ◽

Femoral Offset ◽

Total Hip

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Visual intraoperative estimation of range of motion is misleading in minimally invasive total hip arthroplasty

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-016-2478-9 ◽

2016 ◽

Vol 136 (7) ◽

pp. 1015-1020 ◽

Cited By ~ 1

Author(s):

Michael Woerner ◽

Markus Weber ◽

Ernst Sendtner ◽

Robert Springorum ◽

Michael Worlicek ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Minimally Invasive ◽

Range Of Motion ◽

Hip Arthroplasty ◽

Total Hip

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Activity and Quality of Life after Total Hip Arthroplasty

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0010.5823 ◽

2017 ◽

Vol 19 (5) ◽

pp. 0-0 ◽

Cited By ~ 2

Author(s):

Anna Świtoń ◽

Ewa Wodka-Natkaniec ◽

Łukasz Niedźwiedzki ◽

Tadeusz Gaździk ◽

Tadeusz Niedźwiedzki

Keyword(s):

Quality Of Life ◽

Total Hip Arthroplasty ◽

Range Of Motion ◽

Hip Joint ◽

Hip Arthroplasty ◽

External Rotation ◽

Harris Hip Score ◽

Joint Analysis ◽

Total Hip

Background. Coxarthrosis is a chronic musculoskeletal condition that causes severe pain and considerable limitation of the patient’s motor performance. Total hip arthroplasty is one of the most common and effective methods used in the treatment of advanced degenerative changes. The aim of the present study was to evaluate the activity and quality of life of patients after unilateral total hip arthroplasty. Material and methods. The study was conducted in a group of 189 patients who had undergone unilateral total hip arthroplasty. Goniometry was used to determine the range of motion of both hip joints. Patients’ physical ability and pain severity were assessed based on the Harris Hip Score (HHS) questionnaire. Results. The examination of the range of motion in the lower extremities revealed statistically significant differences in flexion (p<0.01), abduction (p=<0.01), adduction (p<0.01) and external rotation (p<0.01) between the operated and the healthy extremity. The greatest limitation of motion was demonstrated for external rotation (<14°). Approximately 14% of the patients were not able to perform this motion in their healthy hip joint, while 17.5% of them could not do so in the affected hip joint. Analysis of HHS results (mean = 79 pts) revealed that more than 50% of the patients described their functional ability and quality of life as good and excellent. It was demonstrated that 54% of patients did not suffer from pain, whereas minor or mild pain was noted in 35%. Conclusions: 1. A subjective clinical assessment of patients after total hip arthroplasty showed that their quality of life had improved. 2. It is necessary to perform physiotherapy after total hip arthroplasty, on both the operated and healthy side. 3. Exacerbation of pain and impaired activity in patients after total hip arthroplasty were associated with the female sex to a considerable extent.

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