Contact force path in total hip arthroplasty: effect of cup medialisation in a whole-body simulation

2020 ◽  
pp. 112070002091732
Author(s):  
Enrico De Pieri ◽  
Federica Atzori ◽  
Stephen J Ferguson ◽  
Sebastian Dendorfer ◽  
Michael Leunig ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Contact Force ◽  
Hip Arthroplasty ◽  
Whole Body ◽  
Anatomical Reconstruction ◽  
Femoral Offset ◽  
Total Hip ◽  
Lever Arm ◽  
Press Fit ◽  
Force Magnitude

Background: Cup medialisation down to the true acetabular floor in total hip arthroplasty with a compensatory femoral offset increase seems to be mechanically advantageous for the abductor muscles due to the relocation of the lever arms (body weight lever arm decreased, abductor lever arm increased). However, limited information is currently available about the effects of this reconstruction type at the head cup interface, compared to an anatomical reconstruction that maintains the natural lever arms. Through a whole-body simulation analysis, we compared medialised versus anatomical reconstruction in THA to analyse the effects on: (1) contact force magnitude at the head cup interface; (2) contact force path in the cup; and (3) abductor activity. Methods: Musculoskeletal simulations were performed to calculate the above-mentioned parameters using inverse dynamics analysis. The differences between the virtually implanted THAs were calculated to compare the medialised versus anatomical reconstruction. Results: Cup medialisation with compensatory femoral offset increase led to: (1) a reduction in contact force magnitude at the head cup interface up to 6.6%; (2) a similar contact force path in the cup in terms of sliding distance and aspect ratio; and (3) a reduction in abductor activity up to 17.2% (gluteus medius). Conclusions: In our opinion, these potential biomechanical gains do not generally justify a fully medialised reconstruction, especially in younger patients that are more likely to undergo revision surgery in their lifetime. Cup medialisation should be performed until sufficient press fit and bony coverage of a properly sized and oriented cup can be achieved.

Femoral anteversion, femoral offset, and abductor lever arm after total hip arthroplasty using a modular femoral neck system

2002 ◽  
Vol 7 (1) ◽  
pp. 62-67 ◽  
Author(s):  
Takashi Sakai ◽  
Nobuhiko Sugano ◽  
Kenji Ohzono ◽  
Takashi Nishii ◽  
Keiji Haraguchi ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Femoral Anteversion ◽  
Femoral Offset ◽  
Total Hip ◽  
Lever Arm ◽  
Abductor Lever Arm ◽  
Modular Femoral Neck System

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.

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

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.

scholarly journals Association of Femoral Rotation With Whole-Body Alignment in Patients Who Underwent Total Hip Arthroplasty

2020 ◽  
Vol 6 (3) ◽  
pp. 532-537
Author(s):  
Daigo Kobayashi ◽  
Hyonmin Choe ◽  
Naomi Kobayashi ◽  
Taro Tezuka ◽  
Hiroyuki Ike ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Whole Body ◽  
Femoral Rotation ◽  
Total Hip
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