Measuring stem anteversion after total hip arthroplasty: posterior condylar tangent versus transepicondylar axis

Abstract Objective In total hip arthroplasty (THA), surgeons attempt to achieve a physiological antetorsion. However, postoperative antetorsion of the femoral stem is known to show large variabilities. The purpose of this study was to assess whether postoperative antetorsion is influenced by stem design or cementation. Materials and methods This retrospective study included 227 patients with a hip prosthesis with five different stem designs (S1: short curved, S2 and S3: standard straight, S4: standard straight collared, S5: cemented straight), who had metal suppressed 1.5T-MRI of the hip between February 2015 and October 2019. Measurement of femoral antetorsion was done independently by two fellowship-trained radiologists on axial images by measuring the angle between the long axis of the femoral neck and the posterior condylar tangent of the knee. Measured angles in the different groups were compared using the t test for independent samples. Results The cementless collared stem S4 showed the highest antetorsion with 18.1° (± 10.5°; range –10°–45°), which was significantly higher than the antetorsion of the collarless S3 with 13.3° (± 8.4°; − 4°–29°) and the cemented S5 with 12.7° (± 7.7°; − 3°–27°) with p = 0.012 and p = 0.007, respectively. S1 and S2 showed an antetorsion of 14.8° (± 10.0°; 1°–37°) and 14.1° (± 12.2°; − 20°–41°). The torsional variability of the cementless stems (S1–4) was significantly higher compared with that of the cemented S5 with a combined standard deviation of 10.5° and 7.7° (p = 0.019). Conclusion Prosthesis design impacts the postoperative femoral antetorsion, with the cementless collared stem showing the highest antetorsion. Cemented stems demonstrated significantly lower variability, suggesting the lowest rate of inadvertent malrotation.

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Selection of a Surgical Approach for Total Hip Arthroplasty According to the Depth to the Surgical Site

Hip International ◽

10.5301/hipint.5000463 ◽

2017 ◽

Vol 27 (3) ◽

pp. 273-280 ◽

Cited By ~ 4

Author(s):

Takaaki Ohmori ◽

Tamon Kabata ◽

Toru Maeda ◽

Yoshitomo Kajino ◽

Tadashi Taga ◽

...

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Coordinate System ◽

Hip Arthroplasty ◽

Correlation Coefficients ◽

Hip Joints ◽

Total Hip ◽

Posterior Condylar ◽

Low Bmi ◽

And Gender

Background The surgical depths of approaches for total hip arthroplasty (THA) have not been reported previously. In this study, we investigate the relationships between the distances to the centre of the femoral head in different approaches and body mass index (BMI). Methods The study included patients with normal hip joints who presented to our hospital. We used the pelvic coordinate system relative to the anterior pelvic plane and the femur coordinate system relative to the posterior condylar plane. We assessed the anterior, anterolateral, lateral and posterior approaches, and defined each approach line. We evaluated each distance in terms of BMI and gender. Results 164 hips were assessed. The distance to the centre of the femoral head was the longest in the posterior approach, followed by the lateral, anterolateral, and anterior approaches (p<0.05). Additionally, the distance in each approach increased as patients’ BMI increased. The approximated line tilts were almost the same. The correlation coefficients between BMI and the distance to the centre of the femoral head were high in all approaches. In the anterior and anterolateral approaches, men with low BMI had a short distance to the femoral head. The distance for each approach was measured according to the pelvic coordinate system and the femur coordinate system. The results showed no significant differences between them. Conclusions The distance to the centre of the femoral head is the shortest in the anterior approach, regardless of BMI and gender. The distance in each approach might increase with an increase in BMI. BMI has similar effects in all approaches.

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Total Hip Arthroplasty: Good News, Bad News

Rheumatology News ◽

10.1016/s1541-9800(11)70342-8 ◽

2011 ◽

Vol 10 (5) ◽

pp. 58

Author(s):

MARY ANN MOON

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Bad News ◽

Good News ◽

Total Hip

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Prevention of Readmission for Venous Thromboembolic Disease after Total Hip Arthroplasty

Yearbook of Orthopedics ◽

10.1016/s0276-1092(08)70119-6 ◽

2007 ◽

Vol 2007 ◽

pp. 116-118

Author(s):

B.F. Morrey

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Thromboembolic Disease ◽

Venous Thromboembolic Disease ◽

Total Hip ◽

Venous Thromboembolic

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Total Hip Arthroplasty – Good News, Bad News

Family Practice News ◽

10.1016/s0300-7073(11)70420-0 ◽

2011 ◽

Vol 41 (8) ◽

pp. 24

Author(s):

MARY ANN MOON

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Bad News ◽

Good News ◽

Total Hip

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MR Imaging with Metal Artifact Reduction to Differentiate between Patients with and without Infected Total Hip Arthroplasty

10.1055/s-0038-1639537 ◽

2018 ◽

Author(s):

Benedikt Schwaiger ◽

Alexandra Gersing ◽

Daniela Muenzel ◽

Julia Dangelmaier ◽

Peter Prodinger ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Mr Imaging ◽

Hip Arthroplasty ◽

Artifact Reduction ◽

Metal Artifact ◽

Metal Artifact Reduction ◽

Total Hip

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Plasma Prekallikrein Activity in Patients with Total Hip Arthroplasty

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646052 ◽

1987 ◽

Vol 58 (04) ◽

pp. 1040-1042

Author(s):

J J M L Hoffmann ◽

J H J P M Kortmann

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Hip Prosthesis ◽

Contact System ◽

Factor Xii ◽

Total Hip ◽

Activity Factor ◽

Patient Groups ◽

Kallikrein Activity

SummaryThe behaviour of the contact system was studied in 40 patients with total hip arthroplasty, by measuring plasma prekallikrein, spontaneous kallikrein activity and factor XII. In the literature it had been shown that patients with complications from this operation had decreased prekallikrein and increased kallikrein activity (M. Nakahara. Acta orthop scand 1982; 53: 591-6). In the present study, comprising patients with and without pain and proven loosening of the hip prosthesis, these findings could only partially be confirmed. Patients with a loosened prosthesis had significantly lower prekallikrein (mean 0.78 ± 0.28 U/ml; p <0.01) than patients without problems, but no detectable kallikrein activity in plasma. Patients with pain but no loosening had normal prekallikrein (1.04 ±0 0.26 U/ml) and also no demonstrable kallikrein activity. Factor XII was normal in all patient groups. It is concluded that decreased prekallikrein is limited to patients with a loosened hip prosthesis, with or without pain.

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A Comparative Analysis of Patient Satisfaction following Total Knee Arthroplasty and Total Hip Arthroplasty Using the Forgotten Joint Score

The Journal of Hip Surgery ◽

10.1055/s-0040-1712523 ◽

2020 ◽

Vol 04 (02) ◽

pp. 084-089

Author(s):

Vivek Singh ◽

Stephen Zak ◽

Ran Schwarzkopf ◽

Roy Davidovitch

Keyword(s):

Total Knee Arthroplasty ◽

Patient Satisfaction ◽

Total Hip Arthroplasty ◽

Knee Arthroplasty ◽

Hip Arthroplasty ◽

Demographic Data ◽

Demographic Differences ◽

Total Hip ◽

Forgotten Joint Score ◽

Total Knee

AbstractMeasuring patient satisfaction and surgical outcomes following total joint arthroplasty remains controversial with most tools failing to account for both surgeon and patient satisfaction in regard to outcomes. The purpose of this study was to use “The Forgotten Joint Score” questionnaire to assess clinical outcomes comparing patients who underwent a total hip arthroplasty (THA) with those who underwent a total knee arthroplasty (TKA). We conducted a retrospective review of patients who underwent primary THA or TKA between September 2016 and September 2019 and responded to the Forgotten Joint Score-12 (FJS-12) questionnaire at least at one of three time periods (3, 12, and 21 months), postoperatively. An electronic patient rehabilitation application was used to administer the questionnaire. Collected variables included demographic data (age, gender, race, body mass index [BMI], and smoking status), length of stay (LOS), and FJS-12 scores. t-test and chi-square were used to determine significance. Linear regression was used to account for demographic differences. A p-value of less than 0.05 was considered statistically significant. Of the 2,359 patients included in this study, 1,469 underwent a THA and 890 underwent a TKA. Demographic differences were observed between the two groups with the TKA group being older, with higher BMI, higher American Society of Anesthesiologists scores, and longer LOS. Accounting for the differences in demographic data, THA patients consistently had higher scores at 3 months (53.72 vs. 24.96; p < 0.001), 12 months (66.00 vs. 43.57; p < 0.001), and 21 months (73.45 vs. 47.22; p < 0.001). FJS-12 scores for patients that underwent THA were significantly higher in comparison to TKA patients at 3, 12, and 21 months postoperatively. Increasing patient age led to a marginal increase in FJS-12 score in both cohorts. With higher FJS-12 scores, patients who underwent THA may experience a more positive evolution with their surgery postoperatively than those who had TKA.

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