Measuring anteversion in the femoral neck from routine radiographs

Purpose: To describe a new method for measuring femoral neck anteversion (FNA) that requires only one lateral radiograph of the knee in addition to routine radiographs of the hip for evaluation of total hip replacement; and to compare the proposed method with FNA measurement by means of 3D CT. Material and Methods: In 18 femoral specimens, radiographic examinations of the hip and knee, in three different rotational positions, and one CT examination were made, and the measurements of FNA were compared. Similarly, in 38 patients with 40 total hip replacements, measurements from routine radiographic examinations of the hip and knee and from CT examinations were compared. The accuracy and reproducibility of the FNA measurements produced by this proposed method were calculated. Results: Accuracy and reproducibility were 2° and 2° for the proposed method in the femoral specimen study, and accuracy was 4° in the hip patient study. The proposed method had a minor flaw that was caused almost solely by differences in knee size at inward rotation of the femur. Conclusion: FNA measurement can be made from a routine radiographic examination of the hip and a lateral view of the knee. This method achieves an acceptable level of accuracy and reproducibility.

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Dual Mobility Acetabular - Cup Total Hip Arthroplasty after Femoral Neck Fracture in the Elderly: Prospective Study on Risks of Early Dislocation in 80 Total Hip Replacements

Orthopedic Research & Physiotherapy ◽

10.24966/orp-2052/100041 ◽

2019 ◽

Vol 5 (1) ◽

pp. 1-4

Author(s):

K Lahrach ◽

Keyword(s):

Total Hip Arthroplasty ◽

Femoral Neck ◽

Prospective Study ◽

The Elderly ◽

Acetabular Cup ◽

Dual Mobility ◽

Total Hip ◽

Total Hip Replacements ◽

Hip Replacements ◽

Neck Fracture

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Patient and implant survival following 4323 total hip replacements for acute femoral neck fracture

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.94b11.29689 ◽

2012 ◽

Vol 94-B (11) ◽

pp. 1557-1566 ◽

Cited By ~ 19

Author(s):

S. S. Jameson ◽

J. Kyle ◽

P. N. Baker ◽

J. Mason ◽

D. J. Deehan ◽

...

Keyword(s):

Femoral Neck ◽

Femoral Neck Fracture ◽

Implant Survival ◽

Total Hip ◽

Total Hip Replacements ◽

Hip Replacements ◽

Neck Fracture

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Similar Short Term Outcomes with Press-fit Bipolar Hemiarthroplasty and Cemented Total Hip Replacements in Femoral Neck Fractures

Materiale Plastice ◽

10.37358/mp.17.2.4829 ◽

2017 ◽

Vol 54 (2) ◽

pp. 262-264 ◽

Cited By ~ 1

Author(s):

Dinu Vermesan ◽

Radu Prejbeanu ◽

Horia Haragus ◽

Marius Niculescu

Keyword(s):

Femoral Neck ◽

Femoral Neck Fractures ◽

Bipolar Hemiarthroplasty ◽

Short Term ◽

Total Hip ◽

Press Fit ◽

Total Hip Replacements ◽

Displaced Femoral Neck Fractures ◽

Duration Of Surgery ◽

Hip Replacements

There is limited data of short-term outcomes comparing press-fit bipolar and cemented total hip replacements in patients with femoral neck fractures. We therefore aimed to compare the perioperative incidents and immediate outcomes between press-fit stem bipolar head hemiarthroplasty and cemented total hip replacement in elderly patients with displaced femoral neck fractures. We reviewed prospectively collected data from 115 consecutive patients over 12 months. There were 21 cemented total hip replacements and 33 bipolar head press-fit stem hemiarthroplasties, with a male to female ratio of 1:1.84 and an average follow-up of 9.9 months (range 3-15). There were no differences between the two groups with respect to age (mean 77.4 years old), cortical index (0.77/ 0.82, p=0.087), hospitalization (17.7/ 16.7 days, p=0.59), bleeding, blood transfusions (14.3/ 18.2%, p=1.00) and Barthel index preoperatively, at discharge and 3 months (5.67/ 5.48, p=0.62; 10.57/ 10.47, p=0.89; 13.81/ 13.28, p=0.47). For all 54 patients the hemoglobin dropped from 13 to 11.2 g/dL after surgery without difference between implants. The mean duration of surgery was 21minutes (p[0.01) shorter for the press-fit hemiarthroplasty group compared to cemented total hip replacements. Our findings show comparable blood loss and functional outcomes with press-fit bipolar hemiarthroplasty and cemented total hip replacements for treating displaced femoral neck fractures in the elderly. Both were safe and allowed early recovery, with the only significant difference being the longer duration of surgery for the total arthroplasty.

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Rotational Movement of Femoral Components of Total Hip Replacements in Response to an Anteriorly Applied Load

Engineering in Medicine ◽

10.1243/emed_jour_1988_017_033_02 ◽

1988 ◽

Vol 17 (3) ◽

pp. 127-129 ◽

Cited By ~ 4

Author(s):

K E Tanner ◽

W Bonfield ◽

D Nunn ◽

M A R Freeman

Keyword(s):

Femoral Neck ◽

Applied Load ◽

Total Hip ◽

Total Hip Replacements ◽

Uncemented Prosthesis ◽

Hip Replacements ◽

Improved Stability ◽

Posterior Direction ◽

The Stability ◽

Anterior Posterior

Mechanical testing has been performed on total hip replacements implanted in sections of cadaveric femora. A purpose built transducer has been used to measure the rotation of the implant in the bone under loads applied in the anterior-posterior direction. This has been used to assess the effect of cement and also of retaining more of the femoral neck. The retention of the femoral neck improved stability, as did the bone cement, and in the case of the uncemented prosthesis, longitudinal ridges increased the stability of the prosthesis.

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

Applied Sciences ◽

10.3390/app11062852 ◽

2021 ◽

Vol 11 (6) ◽

pp. 2852

Author(s):

Maeruan Kebbach ◽

Christian Schulze ◽

Christian Meyenburg ◽

Daniel Kluess ◽

Mevluet Sungu ◽

...

Keyword(s):

Range Of Motion ◽

Internal Rotation ◽

Computer Aided Design ◽

External Rotation ◽

Patient Specific ◽

Computational Framework ◽

Total Hip ◽

Total Hip Replacements ◽

Significant Difference ◽

Hip Replacements

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.

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