Range of Motion and Stability in Total Hip Arthroplasty With 28-, 32-, 38-, and 44-mm Femoral Head Sizes

2005 ◽  
Vol 20 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Brian R. Burroughs ◽  
Brian Hallstrom ◽  
Gregory J. Golladay ◽  
Daniel Hoeffel ◽  
William H. Harris
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Range Of Motion ◽  
Hip Arthroplasty ◽  
Total Hip

scholarly journals Elevated Lip Liner Positions Improving Stability in Total Hip Arthroplasty – An Experimental Study

2018 ◽  
Vol 7 (4) ◽  
Author(s):  
Suleman Qurashi ◽  
William Parr ◽  
Bob Jang ◽  
William R Walsh
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Range Of Motion ◽  
Femoral Component ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Flexion Extension ◽  
Set Up ◽  
Head Component

Background: The use of elevated lip polyethylene liners with the acetabular component is relatively common in Total Hip Arthroplasty (THA). Elevated lip liners increase stability of the THA by increasing the jump distance in one direction. However, the elevated lip, conversely, also reduces the primary arc in the opposite direction and leads to early impingement of the neck on the elevated lip, potentially causing instability. The aim of the present study is to determine the total range of motion of the femoral head component within the acetabular component with the elevated lip liner in different orientations within the acetabular cup.Methods: We introduce a novel experimental (ex-vivo) framework for studying the effects lip liner orientation on the range of motion of the femoral component. For constant acetabular cup orientation, the elevated lip liner was positioned superiorly and inferiorly. The femoral component range of motion in the coronal, sagittal and axial plane was measured. To avoid any confounding influences of out of plane motion, the femoral component was constrained to move in the tested plane.Results: This experimental set up introduces a rigorous framework in which to test the effects of elevated lip liner orientations on the range of motion of the femoral head component in abduction, adduction, flexion, extension and rotation. The movements of this experimental set-up are directly informative of patient’s maximum potential post-operative range of motion. Initial results show that an inferior placement of the elevated lip increases the effective superior lateral range of motion (abduction) for the femoral component, whilst the anatomy of the patient (i.e. their other leg) prevents the point of femoral component – acetabular lip impingement being reached (in adduction).

Influence of femoral head diameter on intraoperative range of motion in total hip arthroplasty

2019 ◽  
Vol 6 (3) ◽  
pp. 175-179
Author(s):  
Nobuhiro Kaku ◽  
Hiroaki Tagomori ◽  
Hiroya Akase ◽  
Shouhei Noda ◽  
Masashi Kataoka ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Range Of Motion ◽  
Hip Arthroplasty ◽  
Head Diameter ◽  
Total Hip ◽  
Femoral Head Diameter

scholarly journals Cup-To-Neck Contact and Range of Motion after Total Hip Arthroplasty with Large Head Diameters: An Original Three-Dimensional Combined Gait and Videofluoroscopy Analysis

2020 ◽  
Vol 10 (8) ◽  
pp. 2695
Author(s):  
Claudio Belvedere ◽  
Giada Lullini ◽  
Maurizio Ortolani ◽  
Andrea Ensini ◽  
Stefano Durante ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Gait Analysis ◽  
Range Of Motion ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Motor Tasks ◽  
Large Femoral Head ◽  
Total Hip ◽  
Limited Range Of Motion

After a total hip arthroplasty, a limited range of motion and lower-limb disability continue to be observed, with these being mainly associated with the implant design and the head-to-neck ratio. Larger diameters of the head bearings were assumed to provide better stability, a larger range of motion, and smaller risks of dislocation and stem-to-liner impingement. However, these claims have never been demonstrated in real patients. The specific aim of this study was to assess, via multi-instrumental analysis, whether the range of motion of a replaced hip is limited by the stem-to-liner contact in patients with large femoral head diameters. Twenty-three patients with a total hip arthroplasty were evaluated at their one-year follow-ups using clinical and instrumental examinations. A combined three-dimensional gait analysis of the full body and videofluoroscopy analysis of the replaced hip were performed during the execution of standard, i.e., daily living, and more demanding motor tasks. The latter were meant to reach the extreme range of motion at the replaced hip site, thus revealing possible stem-to-liner contact. An original technique based on imaging and computer-aided design (CAD) models of the prosthesis components was developed to calculate the stem-to-liner distance. Excellent clinical scores were observed in the study. The gait analysis showed that the range of motion of the replaced hip in the sagittal plane, averaged over all patients, ranged from 28° to 78° in standard activities. In more demanding tasks, single peaks were as high as 110°, 39°, and 60° in the sagittal, frontal, and transverse anatomical planes, respectively. In all motor tasks, the stem-to-liner distances ranged from 8.7 to 13.0 mm on average, with one outlier minimum distance being 2.2 mm. This study shows that, even in demanding motor tasks and with an extreme range of motion, the hip joint replaced with large femoral head diameters did not experience impingement between the prosthesis components.

Epidemiological Study of Femoral Head Osteonecrosis

2017 ◽  
Vol 68 (5) ◽  
pp. 974-976
Author(s):  
Alexandru Patrascu ◽  
Liliana Savin ◽  
Dan Mihailescu ◽  
Victor Grigorescu ◽  
carmen Grierosu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Head Group ◽  
Bipolar Hemiarthroplasty ◽  
Aseptic Necrosis ◽  
Total Hip ◽  
Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

scholarly journals A Novel Measurement Using Digital Radiography to Minimize Fluoroscopy in Total Hip Arthroplasty

2021 ◽  
Author(s):  
Andrew G. Yun ◽  
Marilena Qutami ◽  
Kory B. Dylan Pasko
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Radiation Exposure ◽  
Hip Arthroplasty ◽  
Fluoroscopy Time ◽  
Lesser Trochanter ◽  
Total Hip ◽  
Preoperative Templating ◽  
The Mean ◽  
Templating Technique

AbstractPreoperative templating for total hip arthroplasty (THA) is fraught with uncertainty. Specifically, the conventional measurement of the lesser trochanter to the center (LTC) of the femoral head used in preoperative planning is easily measured on a template but not measurable intraoperatively. The purpose of this study was to examine the utility of a novel measurement that is reproducible both on templating and in surgery as a more accurate and practical guide. We retrospectively reviewed 201 patients with a history of osteoarthritis who underwent primary THA. For preoperative templating, the distance from the top of the lesser trochanter to the equator (LeTE) of the femoral head was measured on a calibrated digital radiograph with a neutral pelvis. This measurement was used intraoperatively to guide the choice of the trial neck and head. As with any templating technique, the goal was to construct a stable, impingement-free THA with equivalent leg lengths and hip offset. In evaluating this novel templating technique, the primary outcomes measured were the number of trial reductions and the amount of fluoroscopic time, exposures, and radiation required to obtain a balanced THA reconstruction. Using the LeTE measurement, the mean number of trial reductions was 1.21, the mean number of intraoperative fluoroscopy images taken was 2.63, the mean dose of radiation exposure from fluoroscopy was 0.02 mGy, and the mean fluoroscopy time per procedure was 0.6 seconds. In hips templated with the conventional LTC prior to the LeTE, the mean fluoroscopy time was 0.9 seconds. There was a statistically significant difference in fluoroscopy time (p < 0.001). The LeTE is a reproducible measurement that transfers reliably from digital templating to surgery. This novel preoperative templating metric reduces the fluoroscopy time and consequent radiation exposure to the surgical team and may minimize the number of trial reductions.

scholarly journals Outcomes of total hip arthroplasty in patients with osteonecrosis of the femoral head—a current review

2015 ◽  
Vol 8 (3) ◽  
pp. 246-251 ◽  
Author(s):  
Todd P. Pierce ◽  
Randa K. Elmallah ◽  
Julio J. Jauregui ◽  
Daniel F. Verna ◽  
Michael A. Mont
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Current Review ◽  
A Current

Comparison of Polyethylene Wear between Highly Crosslinked and Annealed UHMWPE and Conventional UHMWPE against Ceramic Heads in Total Hip Arthroplasty

2012 ◽  
Vol 529-530 ◽  
pp. 279-284 ◽  
Author(s):  
Taishi Sato ◽  
Yasuharu Nakashima ◽  
Mio Akiyama ◽  
Takuaki Yamamoto ◽  
Taro Mawatari ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Polyethylene Wear ◽  
Wear Rates ◽  
Head Penetration ◽  
Total Hip ◽  
Patient Demographics ◽  
Ceramic Femoral Head ◽  
Implantation Period

The purpose of this study was to examine the effects of ceramic femoral head material on the wear of annealed, crosslinked ultra-high molecular weight polyethylene (UHMWPE) (XLPE) in total hip arthroplasty compared to non-crosslinked conventional UHMWPE (CPE). XLPE was fabricated by crosslinking with 60 kGy irradiation and annealing. Femoral heads made from zirconia and alumina ceramics, and cobalt-chrome (CoCr) of 22 mm or 26 mm diameter were used. In this study, the femoral head penetration into the cup was measured digitally on radiographs of 70 hips with XLPE and 50 hips with CPE. The average follow-up periods were 6.1 and 12.7 years, respectively. The steady wear rate of XLPE was significantly lower than those of CPE (0.002 versus 0.08 mm/year, respectively). Zirconia displayed increased wear rates compared to alumina in CPE; however, there was no difference among head materials in XLPE (0.0028, 0.011 and 0.009 mm/year for zirconia, alumina and CoCr, respectively). Neither head size or implantation period impacted XLPE wear. In contrast to CPE, XLPE displayed low wear rates surpassing the effects of varying femoral head material, size, implantation period and patient demographics.

Radiolucent lines do not affect the longevity of highly cross-linked polyethylene cemented components in total hip arthroplasty

2021 ◽  
Vol 103-B (10) ◽  
pp. 1604-1610
Author(s):  
Yusuke Takaoka ◽  
Koji Goto ◽  
Jiro Tamura ◽  
Yaichiro Okuzu ◽  
Toshiyuki Kawai ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Long Term Outcome ◽  
Total Hip ◽  
Radiolucent Lines ◽  
Kaplan Meier ◽  
Acetabular Components

Aims We aimed to evaluate the long-term outcome of highly cross-linked polyethylene (HXLPE) cemented acetabular components and assess whether any radiolucent lines (RLLs) which arose were progressive. Methods We retrospectively reviewed 170 patients who underwent 187 total hip arthroplasties at two hospitals with a minimum follow-up of ten years. All interventions were performed using the same combination of HXLPE cemented acetabular components with femoral stems made of titanium alloy. Kaplan-Meier survival analysis was performed for the primary endpoint of acetabular component revision surgery for any reason and secondary endpoint of the appearance of RLLs. RLLs that had appeared once were observed over time. We statistically assessed potential relationships between RLLs and a number of factors, including the technique of femoral head autografting and the Japanese Orthopaedic Association score. Results The mean follow-up period was 13.0 years (10.0 to 16.3). Femoral head autografting was performed on 135 hips (72.2%). One acetabular component was retrieved because of deep infection. No revision was performed for the aseptic acetabular loosening. The Kaplan-Meier survival curve for the primary and secondary endpoints were 98.2% (95% confidence interval (CI) 88.6% to 99.8%) and 79.3% (95% CI 72.8% to 84.6%), respectively. RLLs were detected in 38 hips (21.2%), at a mean of 1.7 years (1 month to 6 years) postoperatively. None of the RLLs were progressive, and the presence of RLLs did not show a significant association with the survival and clinical score. RLLs were more frequently observed in hips without femoral head autografts than in those with autografts. Conclusion The use of HXLPE cemented acetabular components in total hip arthroplasty demonstrated excellent clinical outcomes after ten years, and no RLLs were progressive, and their presence did not affect the outcome. Femoral head autografting did not negatively impact the acetabular component survival or the appearance of RLLs. Cite this article: Bone Joint J 2021;103-B(10):1604–1610.

Sign in / Sign up

Export Citation Format

Share Document