Accuracy of Femoral Templating in Reproducing Anatomical Femoral Offset in Total Hip Replacement

2007 ◽  
Vol 17 (3) ◽  
pp. 155-159 ◽  
Author(s):  
H. Davies ◽  
J. Foote ◽  
R.F. Spencer
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Rank Order ◽  
Computer Software ◽  
X Rays ◽  
Femoral Offset ◽  
Total Hip ◽  
Crucial Component ◽  
Best Fitting ◽  
The Uk

Restoration of hip biomechanics is a crucial component of successful total hip replacement. Preoperative templating is recommended to ensure that the size and orientation of implants is optimised. We studied how closely natural femoral offset could be reproduced using the manufacturers' templates for 10 femoral stems in common use in the UK. A series of 23 consecutive preoperative radiographs from patients who had undergone unilateral total hip replacement for unilateral osteoarthritis of the hip was employed. The change in offset between the templated position of the best-fitting template and the anatomical centre of the hip was measured. The templates were then ranked according to their ability to reproduce the normal anatomical offset. The most accurate was the CPS-Plus (Root Mean Square Error 2.0 mm) followed in rank order by: C stem (2.16), CPT (2.40), Exeter (3.23), Stanmore (3.28), Charnley (3.65), Corail (3.72), ABG II (4.30), Furlong HAC (5.08) and Furlong modular (7.14). A similar pattern of results was achieved when the standard error of variability of offset was analysed. We observed a wide variation in the ability of the femoral prosthesis templates to reproduce normal femoral offset. This variation was independent of the seniority of the observer. The templates of modern polished tapered stems with high modularity were best able to reproduce femoral offset. The current move towards digitisation of X-rays may offer manufacturers an opportunity to improve template designs in certain instances, and to develop appropriate computer software.

scholarly journals Total hip replacement: increasing femoral offset improves functional outcome

2016 ◽  
Vol 136 (9) ◽  
pp. 1317-1323 ◽  
Author(s):  
N. D. Clement ◽  
R. S. Patrick-Patel ◽  
D. MacDonald ◽  
S. J. Breusch
Keyword(s):  
Functional Outcome ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Offset ◽  
Total Hip

Modification of Pelvic Orientation after Total Hip Replacement in Primary Osteoarthritis

2009 ◽  
Vol 19 (3) ◽  
pp. 257-263 ◽  
Author(s):  
Elhadi Sariali ◽  
Jean Yves Lazennec ◽  
Frederic Khiami ◽  
Michel Gorin ◽  
Yves Catonne
Keyword(s):  
Healthy Volunteers ◽  
Range Of Motion ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Sacral Slope ◽  
X Rays ◽  
Acetabular Anteversion ◽  
Total Hip ◽  
Pelvic Inclination ◽  
Primary Osteoarthritis

The acetabular anteversion angle varies according to the position of the pelvis. The objective goal of our study was to investigate changes in pelvic orientation after total hip replacement for primary osteoarthritis. We studied 89 patients who underwent total hip replacement for primary unilateral osteoarthritis. Lateral pelvic X-rays that included the hips were performed pre-operatively and one year post-operatively. Reference values were calculated by carrying out the same analysis in 100 asymptomatic healthy volunteers. Pelvic orientation was analyzed using the sacral slope. Patients having surgery for osteoarthritis had a decreased pelvic range of motion pre-operatively and post-operatively when compared to healthy volunteers. Post-operatively, this range of motion increased by 3° but remained lower than the norm. Compared to asymptomatic healthy volunteers, patients affected by osteoarthritis had a posterior pelvic extension that decreased post-operatively but did not return to norm. This post-operative pelvic inclination generates a significant decrease in the final cup anteversion and thus may predispose to posterior dislocation. As this post-operative alteration to pelvic orientation cannot be anticipated, computer-aided surgery for cup positioning may not improve the accuracy of the acetabular anteversion in some patients.

scholarly journals Total Hip Replacement: Results of a Postal Survey of Current Practice on the Cement Fixation of the Acetabular Cup in the UK

2004 ◽  
Vol 14 (3) ◽  
pp. 155-162
Author(s):  
R. Mootanah ◽  
P. Ingle ◽  
K. Cheah ◽  
J. K. Dowell ◽  
J. C. Shelton
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Current Practice ◽  
Postal Survey ◽  
Acetabular Cup ◽  
Total Hip ◽  
The Uk

Standing or Supine X-Rays after Total Hip Replacement – When is the Safe Zone Not Safe?

2014 ◽  
Vol 24 (6) ◽  
pp. 616-623 ◽  
Author(s):  
John Au ◽  
Diana M. Perriman ◽  
Teresa M. Neeman ◽  
Paul N. Smith
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Safe Zone ◽  
X Rays ◽  
Total Hip

Accuracy of femoral templating in reproducing anatomical femoral offset in total hip replacement

2007 ◽  
Vol 17 (3) ◽  
pp. 155-159 ◽  
Author(s):  
H. Davies ◽  
J. Foote ◽  
Robert F. Spencer
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Offset ◽  
Total Hip

scholarly journals What does standard rehabilitation practice after total hip replacement in the UK entail? results of a mixed methods study

2013 ◽  
Vol 14 (1) ◽  
Author(s):  
Tosan Okoro ◽  
Ashok Ramavath ◽  
Jan Howarth ◽  
Jane Jenkinson ◽  
Peter Maddison ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Mixed Methods Study ◽  
Total Hip ◽  
The Uk

Radiographic Assessment of Biomechanical Parameters following hip Resurfacing and Cemented Total Hip Arthroplasty

2009 ◽  
Vol 19 (3) ◽  
pp. 251-256 ◽  
Author(s):  
Curtis Robb ◽  
Richard Harris ◽  
Kevin O'dwyer ◽  
Nadim Aslam
Keyword(s):  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Hip Resurfacing ◽  
Leg Length ◽  
Femoral Offset ◽  
Normal Side ◽  
Total Hip ◽  
Significant Difference ◽  
Joint Reaction Forces

Resurfacing hip arthroplasty and total hip replacement both aim to restore anatomical parameters. Leg length and offset discrepancy can result in altered joint reaction forces, and are associated with increased wear, dislocation, and decreased patient satisfaction. This study assesses the accuracy of leg length and offset restoration after either a Birmingham Hip Resurfacing (BHR) or a cemented total hip replacement (THR). Standardised antero-posterior radiography was performed on two groups of 30 patients with unilateral primary osteoarthritis undergoing either a cemented total hip or resurfacing. The normal contra-lateral hip was used as the control. Leg length and offset were measured pre-operatively with no significant difference between the two groups. Cup offset, femoral offset, total offset and leg length of the prosthesis and normal side were measured by two observers and mean measurements were analysed by a paired t test. Leg lengths in each group did not differ significantly from the normal side, THR 0.53 mm (95% CI -2.4 to 3.4 mm) but BHR implantation did result in mean leg shortening of -1.9 mm (95% CI -4.5 mm to 0.6 mm). Cup offset differed significantly from normal anatomy in both groups, as did femoral and total offset for the total hip replacement group. However, femoral offset was restored in the Birmingham resurfacing group. When the THR group was compared against the BHR group we found no difference between restoration of leg lengths (p = 0.21) and cup offset (p = 0.30) but femoral (p = 0.0063) and total offset (p = 0.03) were restored more accurately with a BHR.

scholarly journals Re-Admission Rates within 28 Days of Total Hip Replacement

2006 ◽  
Vol 88 (5) ◽  
pp. 475-478 ◽  
Author(s):  
C Cullen ◽  
DS Johnson ◽  
G Cook
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Admission Rate ◽  
Wound Complications ◽  
Superficial Infection ◽  
Total Hip ◽  
Admission Rates ◽  
Department Of Health ◽  
The Uk ◽  
Atraumatic Dislocation

INTRODUCTION The aim of the study was to identify the reasons for the higher than expected emergency re-admission to hospital within 28 days of total hip replacement (THR) for Stepping Hill Hospital, Stockport. PATIENTS AND METHODS Over a 42-month period, 65 (8.5%) of 769 patients were re-admitted within 28 days of discharge following primary THR. Case notes for 61 patients were available for retrospective review to assess premorbidity, initial postoperative complications and reason for re-admission. RESULTS The main reasons for re-admission were complications related to the procedure. These included thrombo-embolic disease 2.5%, atraumatic dislocation 1.4%, wound complications 1.2% and swollen limb 1.8%. Other causes such as admission to another department for problems not related to THR accounted for 0.8%. CONCLUSIONS Our findings are comparable with the published literature for early complications following THR. The three main reasons for re-admission were atraumatic dislocation, thrombo-embolic and wound complications such as superficial infection and haematoma are the commonest world-wide. The re-admission rate to hospital within the first 28 days following THR was a clinical indicator suggested by the UK Department of Health. It has subsequently been incorporated in a group of indicators used by the CASPE Healthcare Knowledge Systems (CHKS), a private healthcare consultancy and analysis company, for peer benchmarking. Our re-admission rates are inflated by admissions for non-THR-related reasons. The level of post-THR complications leading to re-admission were acceptable compared with the available published literature regarding 28-day re-admission. We anticipate that this study may act as a benchmark for other trusts.

scholarly journals National variation between clinical commissioning groups in referral criteria for primary total hip replacement surgery

2018 ◽  
Vol 100 (6) ◽  
pp. 443-445
Author(s):  
A Moorhouse ◽  
G Giddins
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Evidence Base ◽  
Total Hip ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Referral Criteria ◽  
The Uk

The referral criteria used by the UK clinical commissioning groups for primary total hip replacement surgery appear inconsistent; the criteria rarely follow National Institute for Health and Care Excellence criteria. With established guidelines available, it is unclear why the clinical commissioning groups have referral criteia with less evidence base, without obviously addressing particular issues in their locality.

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