Plain Radiographs Fail to Reflect Femoral Offset in Total Hip Arthroplasty

2014 ◽  
Vol 29 (8) ◽  
pp. 1661-1665 ◽  
Author(s):  
Markus Weber ◽  
Michael L. Woerner ◽  
Hans-Robert Springorum ◽  
Alexander Hapfelmeier ◽  
Joachim Grifka ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Offset ◽  
Plain Radiographs ◽  
Total Hip

scholarly journals Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Y. Knafo ◽  
F. Houfani ◽  
B. Zaharia ◽  
F. Egrise ◽  
I. Clerc-Urmès ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Preoperative Planning ◽  
Femoral Stem ◽  
Leg Length ◽  
Femoral Offset ◽  
Postoperative Result ◽  
Total Hip ◽  
Planning Software ◽  
Navigated Surgery

Two-dimensional (2D) planning on standard radiographs for total hip arthroplasty may not be sufficiently accurate to predict implant sizing or restore leg length and femoral offset, whereas 3D planning avoids magnification and projection errors. Furthermore, weightbearing measures are not available with computed tomography (CT) and leg length and offset are rarely checked postoperatively using any imaging modality. Navigation can usually achieve a surgical plan precisely, but the choice of that plan remains key, which is best guided by preoperative planning. The study objectives were therefore to (1) evaluate the accuracy of stem/cup size prediction using dedicated 3D planning software based on biplanar radiographic imaging under weightbearing and (2) compare the preplanned leg length and femoral offset with the postoperative result. This single-centre, single-surgeon prospective study consisted of a cohort of 33 patients operated on over 24 months. The routine clinical workflow consisted of preoperative biplanar weightbearing imaging, 3D surgical planning, navigated surgery to execute the plan, and postoperative biplanar imaging to verify the radiological outcomes in 3D weightbearing. 3D planning was performed with the dedicated hipEOS® planning software to determine stem and cup size and position, plus 3D anatomical and functional parameters, in particular variations in leg length and femoral offset. Component size planning accuracy was 94% (31/33) within one size for the femoral stem and 100% (33/33) within one size for the acetabular cup. There were no significant differences between planned versus implanted femoral stem size or planned versus measured changes in leg length or offset. Cup size did differ significantly, tending towards implanting one size larger when there was a difference. Biplanar radiographs plus hipEOS planning software showed good reliability for predicting implant size, leg length, and femoral offset and postoperatively provided a check on the navigated surgery. Compared to previous studies, the predictive results were better than 2D planning on conventional radiography and equal to 3D planning on CT images, with lower radiation dose, and in the weightbearing position.

Effects of the Femoral Offset and the Head Size on the Safe Range of Motion in Total Hip Arthroplasty

2009 ◽  
Vol 24 (4) ◽  
pp. 646-651 ◽  
Author(s):  
Akinobu Matsushita ◽  
Yasuharu Nakashima ◽  
Seiya Jingushi ◽  
Takuaki Yamamoto ◽  
Akio Kuraoka ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Range Of Motion ◽  
Hip Arthroplasty ◽  
Head Size ◽  
Femoral Offset ◽  
Total Hip

scholarly journals The effect of femoral offset modification on gait after total hip arthroplasty

2014 ◽  
Vol 85 (2) ◽  
pp. 123-127 ◽  
Author(s):  
Elhadi Sariali ◽  
Shahnaz Klouche ◽  
Alexandre Mouttet ◽  
Hugues Pascal-Moussellard
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Offset ◽  
Total Hip

scholarly journals Radiographic Determination of Hip Rotation Center and Femoral Offset in Japanese Adults: A Preliminary Investigation toward the Preoperative Implications in Total Hip Arthroplasty

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Taichiro Takamatsu ◽  
Takaaki Shishido ◽  
Yasuhito Takahashi ◽  
Toshinori Masaoka ◽  
Toshiyuki Tateiwa ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Racial Differences ◽  
Hip Arthroplasty ◽  
Strict Sense ◽  
Anatomical Landmarks ◽  
Femoral Offset ◽  
Total Hip ◽  
Rotation Center ◽  
Japanese Adults ◽  
Hip Rotation

The values of hip rotation center (HRC) and femoral offset (FO) evaluated according to Caucasian anatomical landmarks have been regarded as a useful reference also for Japanese patients in total hip arthroplasty (THA). In a strict sense, however, since there can be racial differences among their anatomical morphologies, it is clinically important to reconsider those parameters for the Japanese. In the present study, in order to investigate correlations among hip and pelvic morphometric parameters, frontal radiographs were taken from 98 Japanese adults (60 males and 38 females) without acetabular dysplasia and arthropathy in the standing position. Their mean age was 62.0 ± 16.7 years. The horizontal position of HRC was significantly correlated with the pelvic width in both genders (P=0.0026and 0.0010 for the males and the females, resp.). The vertical position of HRC was significantly correlated with the teardrop-sacroiliac distance in the malesP=0.0003and with the pelvic cavity height in the femalesP=0.0067. However, in both genders, there were no correlations among FO and the other parameters analyzed in this study. Our present findings might contribute to theoretical implications of an appropriate HRC position for Japanese OA patients in THA.

A precise method for determining acetabular component anteversion after total hip arthroplasty

2019 ◽  
Vol 101-B (9) ◽  
pp. 1042-1049
Author(s):  
Michael P. Murphy ◽  
Cameron J. Killen ◽  
Steven J. Ralles ◽  
Nicholas M. Brown ◽  
William J. Hopkinson ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
3D Reconstruction ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Statistical Difference ◽  
Plain Radiographs ◽  
Area Method ◽  
Total Hip ◽  
Orthogonal Methods ◽  
Radiological Methods

Aims Several radiological methods of measuring anteversion of the acetabular component after total hip arthroplasty (THA) have been described. These are limited by low reproducibility, are less accurate than CT 3D reconstruction, and are cumbersome to use. These methods also partly rely on the identification of obscured radiological borders of the component. We propose two novel methods, the Area and Orthogonal methods, which have been designed to maximize use of readily identifiable points while maintaining the same trigonometric principles. Patients and Methods A retrospective study of plain radiographs was conducted on 160 hips of 141 patients who had undergone primary THA. We compared the reliability and accuracy of the Area and Orthogonal methods with two of the current leading methods: those of Widmer and Lewinnek, respectively. Results The 160 anteroposterior pelvis films revealed that the proposed Area method was statistically different from those described by Widmer and Lewinnek (p < 0.001 and p = 0.004, respectively). They gave the highest inter- and intraobserver reliability (0.992 and 0.998, respectively), and took less time (27.50 seconds (sd 3.19); p < 0.001) to complete. In addition, 21 available CT 3D reconstructions revealed the Area method achieved the highest Pearson’s correlation coefficient (r = 0.956; p < 0.001) and least statistical difference (p = 0.704) from CT with a mean within 1° of CT-3D reconstruction between ranges of 1° to 30° of measured radiological anteversion. Conclusion Our results support the proposed Area method to be the most reliable, accurate, and speedy. They did not support any statistical superiority of the proposed Orthogonal method to that of the Widmer or Lewinnek method. Cite this article: Bone Joint J 2019;101-B:1042–1049.

scholarly journals Short stems reproduce femoral offset better than standard stems in total hip arthroplasty: a case-control study

2019 ◽  
Vol 44 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Roger Erivan ◽  
Anne-Sophie Muller ◽  
Guillaume Villatte ◽  
Stéphane Millerioux ◽  
Aurélien Mulliez ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Case Control Study ◽  
Case Control ◽  
Femoral Offset ◽  
Total Hip ◽  
Short Stems ◽  
Control Study ◽  
Better Than

Gender-specific difference of in-vivo kinematics in patients with unilateral total hip arthroplasty

2020 ◽  
pp. 112070002090349
Author(s):  
Yun Peng ◽  
Paul Arauz ◽  
Young-Min Kwon
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Imaging System ◽  
Femoral Stem ◽  
Frontal Plane ◽  
Femoral Offset ◽  
Total Hip ◽  
Gait Asymmetry ◽  
Bilateral Difference ◽  
Gender Specific

Purpose: Asymmetric gait patterns are known to persist in patients with unilateral total hip arthroplasty (THA). Little is known about the effect of gender on gait asymmetry. This study aimed to determine whether gait asymmetry differs between genders in unilateral THA patients and can be explained by component positioning. Methods: 23 female and 10 male unilateral THA patients were included. Asymmetric hip kinematics during gait and component positioning were quantified using a combined computed tomography-based modelling and dual fluoroscopic imaging system. Multiple regression was performed to examine the unique and mediated contribution of gender to observed gait asymmetry. Results: Female and male patients differed most significantly in frontal plane gait asymmetry ( p = 0.001) and bilateral difference of vertical femoral offset ( p = 0.048). Compared with the native hip, the implanted hip exhibited significantly increased adduction ( p = 0.007) in females but significantly increased abduction ( p = 0.001) in males. The stem head of the implanted hip was more superiorly positioned compared to the native femoral head in female but more inferiorly positioned in male. Gender accounted for 41.5% variance of frontal plane gait asymmetry and was partially mediated by the bilateral difference of vertical femoral offset. Conclusions: Female unilateral THA patients exhibited significantly increased adduction in the implanted hip compared to the native hip, which is partially attributable to a more superiorly positioned femoral stem centre of rotation. The understanding of gender-specific differences of kinematic patterns may benefit female patients through targeted preoperative planning and postoperative rehabilitation.

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

2013 ◽  
Vol 37 (7) ◽  
pp. 1233-1237 ◽  
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

The Diagnostic Value of Digital Subtraction Arthrography and Radionuclide Arthrography in Revision Total Hip Arthroplasty / Der diagnostische Wert der digitalen Subtraktionsarthrographie und der Radionuklidarthrographie in der Revisionschirurgie des Hüftgelenkersatzes

2004 ◽  
Vol 49 (12) ◽  
Author(s):  
Marius von Knoch ◽  
Bertram Barden ◽  
Guido Saxler ◽  
Franz Löer
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Predictive Accuracy ◽  
Diagnostic Value ◽  
Diagnostic Tools ◽  
Digital Subtraction ◽  
Plain Radiographs ◽  
Total Hip ◽  
The Status ◽  
Sensitivity Specificity

AbstractAn analysis of plain radiographs, digital subtraction arthrography, and radionuclide arthrography was performed in 25 revision hip arthroplasties to evaluate the efficacy and usefulness of these methods in the diagnosis of loosening. The findings by each method were compared with intraoperative assessment of the status of components and expressed in terms of sensitivity, specificity, and predictive accuracy. Overall accuracy for the acetabular component by plain radiographs was 80%; by digital subtraction arthrography, 88%; by radionuclide arthrography, 68%. Overall accuracy for the femoral component by plain radiographs was 92%; by digital subtraction arthrography, 84%; radionuclide arthrography, 76%. We consider subtraction arthrography and radionuclide arthrography to be adjuvant diagnostic tools which may be indicated in individual cases of suspected implant loosening of total hip arthroplasty. The routine use of these two methods is not warranted when compared to plain radiographs. In 25 Fällen von Revisionsoperationen von Hüftgelenksersatz wurden Röntgenbilder, digitale Subtraktionsarthrographien und Radionuklidarthrographien analysiert, um die Effizienz dieser Methoden hinsichtlich der Diagnose von Implantatlockerungen festzustellen. Die Ergebnisse der drei genannten radiologischen Untersuchungsmethoden wurden mit der intraoperativ festgestellten Implantatstabilität verglichen. Es wurde die Sensitivität, Spezifität und die Vorhersagegenauigkeit für alle drei Methoden bestimmt. Die Vorhersagegenauigkeit für die acetabulären Komponenten betrug 80% für Röntgenbilder, 88% für digitale Subtraktionsarthrographien und 68% für Radionuklidarthrographien. Die Vorhersagegenauigkeit für die femoralen Komponenten betrug 92% für Röntgenbilder, 84% für digitale Subtraktionsarthrographien und 76% für Radionuklidarthrographien.Wir sehen in der Subtraktionsarthrographie und der Radionuklidarthrographie adjuvante diagnostische Mittel, welche im Einzelfall bei fraglich gelockerten Implantaten indiziert sind. Als Routinemassnahme scheinen diese beiden Methoden im Vergleich zu einfachen Röntgenbildern aber nicht indiziert zu sein.

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