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 An 18-year comparison of hybrid total hip replacement and Birmingham hip resurfacing in active young patients

2019 ◽  
Vol 29 (6) ◽  
pp. 630-637 ◽  
Author(s):  
Sam C Jonas ◽  
Michael R Whitehouse ◽  
Simon Bick ◽  
Gordon C Bannister ◽  
Richard P Baker
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Resurfacing ◽  
Lower Mortality ◽  
Total Hip ◽  
Birmingham Hip Resurfacing ◽  
Significant Difference ◽  
Active Patients

Aim: To compare the long-term clinical and radiological results of metal-on-polyethylene hybrid total hip replacement (THA) with metal-on-metal Birmingham hip resurfacing (BHR) in young, active patients. Patients and methods: From the 1st consecutive 63 hips in young, active patients who underwent BHR by the senior author, 54 (51 patients) were matched to patients who had undergone THA with regard to age, gender, body mass index and preoperative levels of activity. Radiologically, all hips were assessed for migration and osteolysis, THAs for polyethylene wear and BHRs for a pedestal sign. Patient-reported outcomes, mortality and revision rates were compared. Results: The mean follow-up of the patients with a hybrid THR was 19.9 years and for those with a BHR, 17.6 years. 13 patients with a hybrid THR and 5 with a BHR had died. 1 hybrid THR and 3 BHRs were lost to follow-up. The revision rate of the hybrid THRs was 14/54 and of the BHRs 6/54. Log rank comparison of Kaplan-Meier survival estimates demonstrated a significantly lower mortality in the BHR group ( p = 0.039; hazard ratio [HR] = 0.37 [95% CI, 0.15–0.95]) but a non-significant difference in revision rates ( p = 0.067; HR = 0.43 [95% CI, 0.18–1.06]). The BHRs recorded superior OHS ( p = 0.03), UCLA ( p = 0.0096), and EuroQol visual analogue scores ( p = 0.03). Significantly more BHRs had run, played sport and undertaken heavy manual labour in the month preceding follow-up. Conclusion: After 18 years, patients with BHRs remained more active with a lower mortality rate but demonstrated no significant difference in revision rates. Both groups demonstrated progressive radiological changes at long-term follow-up.

Leg Length Discrepancy after Total Hip Replacement

1997 ◽  
Vol 7 (3) ◽  
pp. 121-124 ◽  
Author(s):  
P. P. Sarangi ◽  
G.C. Bannister
Keyword(s):  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Total Hip ◽  
Length Discrepancy ◽  
Before And After ◽  
Subjective Sensation ◽  
Better Than

Leg length differential in 110 patients with unilateral hip arthritis was measured on supine AP radiographs before and after hip arthroplasty, and compared with subjective sensation of leg length discrepancy at that time. Eight percent of limbs were of equal length, 60% were within 0.5 cm. and 9% demonstrated a discrepancy greater than 1 cm. Shortening was tolerated better than lengthening. No patient with true shortening of less than 6 mm or lengthening of less than 4 mm perceived discrepancy. Shortening of over 10 mm and lengthening of over 6 mm was perceived universally. Shortening of between 6 mm and 10 mm was perceived by 55% of patients, and lengthening between 4 mm and 6 mm by 26%.

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.

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

Patient-Reported Outcome following Metal-On-Metal Resurfacing of the Hip and Total Hip Replacement

2009 ◽  
Vol 19 (3) ◽  
pp. 245-250 ◽  
Author(s):  
David P. Hall ◽  
Del Srikantharajah ◽  
Raimond E. Anakwe ◽  
Paul Gaston ◽  
Colin R. Howie
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Short Form ◽  
Length Of Hospital Stay ◽  
Multivariate Regression Analysis ◽  
Hip Resurfacing ◽  
Patient Reported Outcome ◽  
Additional Patient ◽  
Total Hip ◽  
Patient Reported

Patient-reported outcome and satisfaction scores have become increasingly important in evaluating successful surgery. This case-matched control study compared patient-reported outcome and satisfaction data following hip resurfacing and total hip arthroplasty. Thirty-three consecutive patients selected for hip resurfacing were compared with 99 patients undergoing cemented total hip replacement (THR), matched for age, sex and pathology. Participants completed a Short-Form 12 Health Survey (SF-12) and Oxford Hip Score questionnaire preoperatively and 6 months post operatively with an additional patient satisfaction questionnaire. There was no difference in length of hospital stay. While both groups reported improved outcome scores, multivariate regression analysis did not demonstrate any significant benefit for one group over the other. Both groups reported high levels of satisfaction, which tended to be better in patients undergoing hip resurfacing.

Hip Resurfacing Compared with 28-mm Metal-on-Metal Total Hip Replacement

2020 ◽  
Vol 102 (Suppl 2) ◽  
pp. 80-90
Author(s):  
Pascal-André Vendittoli ◽  
Maged Shahin ◽  
Charles Rivière ◽  
Alain Guy Roy ◽  
Janie Barry ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Resurfacing ◽  
Total Hip ◽  
Metal On Metal

A new method for intraoperative assessment of leg length, sizing and placement of the components in total hip replacement

2020 ◽  
Vol 30 (4) ◽  
pp. 689-694
Author(s):  
Ioannis P. Stathopoulos ◽  
Nicolaos Andrianopoulos ◽  
Dimitrios Paschaloglou ◽  
Kalliopi Lampropoulou-Adamidou ◽  
Maria Spetsaki ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
New Method ◽  
Leg Length ◽  
Total Hip ◽  
Intraoperative Assessment
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