Acetabular component migration in total HIP arthroplasty using CT and a semiautomated program for volume merging

2002 ◽  
Vol 43 (5) ◽  
pp. 517-527 ◽  
Author(s):  
L. Olivecrona ◽  
J. Crafoord ◽  
H. Olivecrona ◽  
M. E. Noz ◽  
G. Q. Maguire ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Plain Radiography ◽  
Acetabular Cup ◽  
Visual Evaluation ◽  
Total Hip ◽  
Non Invasive ◽  
Invasive Method ◽  
The Mean ◽  
Component Migration

Purpose: To develop a non-invasive method for detection of acetabular cup migration after total hip arthroplasty (THA) with a higher degree of accuracy than routine plain radiography. Material and Methods: Two CT examinations, 10 min apart, were obtained from each of 10 patients that had undergone THA. Using an in-house developed semiautomated program for volume merging, the pelves in the two examinations were fused and the acetabular cup was visually and numerically evaluated to test the method's accuracy in detecting migration. Results: In the visual evaluation of the best match a 1-mm translation of the cup was detectable. The numerical evaluation, comparing landmarks placed in the images of the acetabular cup and the head of the femur component in the two examinations, showed the mean difference in orientation of acetabular axes to be 2.5°, the mean distance between centre of cup face to be 2.5 mm and the mean distance between centre of the head of the prosthetic femoral component to be 1 mm. Conclusion: This method has a significantly higher accuracy than routine plain radiography in detecting acetabular cup migration and could be used in clinical practice. It gives both a visual and a numerical correlate to migration.

Model studies on acetabular component migration in total hip arthroplasty using CT and a semiautomated program for volume merging

2003 ◽  
Vol 44 (4) ◽  
pp. 419-429 ◽  
Author(s):  
L. Olivecrona ◽  
H. Olivecrona ◽  
L. Weidenhielm ◽  
M. E. Noz ◽  
G. Q. Maguire ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Absolute Error ◽  
Acetabular Cup ◽  
Total Hip ◽  
Model Studies ◽  
Non Invasive ◽  
Specificity And Sensitivity ◽  
The Mean ◽  
Accuracy And Repeatability

Purpose: Validation of a non-invasive CT method for detection of acetabular cup migration after total hip arthroplasty in a phantom study. Material and Methods: 26 CT examinations were obtained of a pelvic model while altering the position of the acetabular cup. Using a previously described program for volume merging, the pelvi in different examinations were fused and the 3D alterations of the position of the acetabular cup were evaluated visually and numerically and correlated to direct measurements on the model. Results: Visually, two independent examiners differentiated between 0, 1 and 2 to 3 mm migration with 100% specificity and sensitivity. Numerically, the mean error over all cases between model and CT measurements was 0.04 mm (SD ± 0.33). The mean absolute error between model and CT data was 0.26 mm (SD ± 0.19). Intra- and interobserver 95% accuracy and repeatability limits were below 0.5/0.7 mm, respectively. No significant interobserver difference occurred. The data were normally distributed and not dependent on observer. Conclusion: The accuracy of this non-invasive method out-performs routine plain radiography. The method gives both visual and numerical correlates to migration and can be used in clinical practice.

A follow-up study of hip arthroplasty in patients with chronic renal failure on dialysis

2020 ◽  
Author(s):  
Sang Min Lee ◽  
Kuen Tak Suh ◽  
Won Chul Shin ◽  
Young Kwang Oh ◽  
Seung Hun Woo
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Bipolar Hemiarthroplasty ◽  
Acetabular Cup ◽  
Total Hip ◽  
The Mean

Abstract Background Although hip arthroplasty has become increasingly common, its radiological and clinical outcomes in chronic renal failure patients remain unclear. This study analyzed the outcomes of hip arthroplasty in patients with chronic renal failure undergoing dialysis. Methods Of 2,364 hips undergoing total hip arthroplasty or bipolar hemiarthroplasty between January 2003 and December 2017, data pertaining of 37 hips of patients with chronic renal failure undergoing dialysis (16 men, 21 women) were retrospectively examined. We analyzed the radiological and clinical outcomes of hip arthroplasty, as well as the occurrence of local and general complications (particularly the time of their occurrence) during follow-up and their association with dialysis duration. Results The mean patient age was 60.6 ± 13.5 years, and the mean follow-up duration was 36.6 ± 27.2 months. The mean T-value indicating bone mineral density was -2.62 ± 1.15, with osteoporosis noted in 20 cases. Except for 1 case with infection-induced change in acetabular cup tilt, all cases of total hip arthroplasty with cementless acetabular cup implant exhibited excellent radiographic outcomes. The cementless proximally coated femoral stem was used in all 25 cases of total hip arthroplasty and 7 out of 12 cases of bipolar hemiarthroplasty. Changes in the alignment of femoral stems, subsidence, osteolysis, and loosening were not observed. On clinical assessment, 33 patients received an “excellent” or “good” Harris hip score. Within 1 year postoperatively, complications developed in 18 patients, and some patients exhibited more than 1 complication. More than 1 year after surgery, general complications developed in 12 patients; however, no patient experienced local complications.Conclusions Hip arthroplasty in chronic renal failure patients on dialysis showed excellent radiological and satisfactory clinical outcomes; however, it may be associated with various postoperative complications. Therefore, meticulous preoperative treatment planning and overall postoperative management are required to reduce the risk of complications.

scholarly journals Relationship Between the Accuracy of Acetabular Cup Angle and Body Mass Index in Posterolateral Total Hip Arthroplasty With CT-Based Navigation: A Retrospective Case-Control Study

2020 ◽  
Author(s):  
Hisatoshi Ishikura ◽  
Masaki Nakamura ◽  
Hanae Nishino ◽  
Shigeru Nakamura ◽  
Takeyuki Tanaka ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Total Hip Arthroplasty ◽  
Body Mass ◽  
Hip Arthroplasty ◽  
Acetabular Cup ◽  
Total Hip ◽  
Significant Difference ◽  
The Mean ◽  
Navigation Errors ◽  
The Relationship

Abstract Background: Precise acetabular cup placement is essential for successful total hip arthroplasty (THA). In obese patients, its accuracy is often difficult to achieve because of the thickness of the soft tissues. This study aimed to determine the relationship between the accuracy of acetabular cup angle and body mass index (BMI) in posterolateral THA using the computed tomography-based navigation (CT-navi) system.Methods: We retrospectively reviewed 145 consecutive primary THAs using the CT-navi system between January 2015 and January 2018. All surgeries were performed using cementless cups employing the posterolateral approach with the patient in the decubitus position. We compared the radiographic inclination and anteversion obtained from the angle displayed on the CT-navi screen with those measured by the postoperative CT using the three-dimensional templating software. We evaluated the relationship between the extent of errors and correlation with BMI. Statistical analyses were performed using the Student’s t-test and Spearman’s rank coefficient test.Results: In non-overweight patients (BMI < 25, 88 hips), the mean navigation errors for inclination were 2.8 ± 2.2° and for anteversion were 2.6 ± 2.3°. Meanwhile, in overweight patients (BMI ≥ 25, 57 hips), the mean navigation errors were 2.6 ± 2.4° for inclination and 2.4 ± 2.4° for anteversion. We found no significant difference between overweight and non-overweight patients in both inclination and anteversion. The Spearman’s rank correlation coefficients were -0.04 for inclination and -0.11 for anteversion, showing no correlation between the extent of errors and BMI.Conclusions: In posterolateral THA, CT-navi can aid the precise placement of the acetabular cup irrespective of a patient’s BMI.Trial registration: This trial was retrospectively registered and approved by the institutional ethics committee of Teikyo University. The registration number is 17-190, and the date of approval was March 1, 2018. URL of trial registry is: https://www.teikyo-u.ac.jp/application/files/7015/8432/1341/2016_all_syounin_1.pdf

scholarly journals The Difference of Acetabular Cup Orientation Between Two Surgical Sides After Primary Total Hip Arthroplasty by Right-handed Surgeons

2021 ◽  
Author(s):  
Ao Xiong ◽  
su liu ◽  
Guoqing Li ◽  
Jian Weng ◽  
Deli Wang ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Safe Zone ◽  
Dominant Hand ◽  
Acetabular Cup ◽  
Total Hip ◽  
Left And Right ◽  
The Mean ◽  
The Right ◽  
Primary Total Hip Arthroplasty

Abstract Background: We performed the retrospective cohort study to compare the acetabular cup orientation, including anteversion angle (AA) and inclination angle (IA), of dominant hand side and non-dominant hand side after primary total hip arthroplasty (THA) by right-handed orthopedic surgeons. Methods: Between January 2018 and December 2018, 290 patients who aged below 60 years and underwent primary THA were retrospective screened. Patients who had hemiarthroplasty, previous hip surgery, ankylosing spondylitis, developmental dysplasia of hip (DDH, Crowe type-Ⅲ and type-Ⅳ), severe comorbidity, missing information, inferior quality radiographs were excluded. According to the surgery side, all patients were divided into left group and right group. Postoperative plain radiographs were analyzed to compare the AA and IA between left and right side. Univariate and stepwise multivariable linear regression to control included confounding factors. Stratified analysis was performed to identify whether the operation approach can affect the result, including anterolateral (ALA) and posterolateral approach (PLA). Results: The mean AA was 17.7° (range 6.0° to 30.0°) and 21.0° (range 9.5° to 35.0°) for the left and right side respectively. The mean difference was 3.28° (95% CI: 1.92 – 4.64; P<0.001). The mean IA was 41.1° (range 24.0° to 59.0°) and 40.1° (range 20.5° to 56.0°) for the left and right side respectively (P=0.314). 113 patients' AA within the “safe zone” in the left (93.4 %), while the right was 93 patients (82.3 %) (P=0.009). 95 patients' IA within the “safe zone” in the left (78.5 %), while the right was 97 patients (85.8 %) (P=0.144). The IA of ALA group was smaller than PLA group in both sides. The mean difference was 3.98° (95% CI: 1.22 - 6.74; P=0.005). Conclusions: We concluded that AA in left side may be more accurate than right side after primary THA by right-handed surgeons. The IA was no difference between the two sides, while it was smaller in ALA than in PLA. The results are still needed to be verified in future.

scholarly journals Treatment of Crowe IV developmental dysplasia of the hip with cementless total hip arthroplasty and shortening subtrochanteric osteotomy

2019 ◽  
Vol 47 (7) ◽  
pp. 3223-3233 ◽  
Author(s):  
Tang Liu ◽  
Sisi Wang ◽  
Guoliang Huang ◽  
Wanchun Wang
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Developmental Dysplasia ◽  
Harris Hip Score ◽  
Acetabular Cup ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
The Mean ◽  
Dysplasia Of The Hip

Objective This study was performed to document the clinical and radiographic results of consecutive patients with Crowe IV developmental dysplasia of the hip (DDH) treated by cementless total hip arthroplasty (THA) using an S-ROM femoral component with shortening derotational subtrochanteric osteotomy. Methods Twenty-three hips of 21 patients with Crowe IV DDH were treated by cementless THA combined with shortening derotational subtrochanteric osteotomy from January 2005 to January 2011. The mean preoperative modified Harris hip score (mHHS) and University of California, Los Angeles (UCLA) activity score were 40.7 and 4.2, respectively. Results The mean follow-up was 105 months. The mean mHHS and UCLA score improved to 87.0 and 9.1, respectively, at the latest follow-up. Nine of the 23 hips had a negative Trendelenburg sign. One of the 23 hips was outside the Lewinnek acetabular cup inclination safe range, and 3 of the 23 hips were outside the Lewinnek acetabular cup anteversion safe range. The probability of prosthesis survival was 100% at 5 years and 91.3% at 10 years. Conclusion Patients with Crowe IV DDH can be treated by cementless THA combined with shortening derotational subtrochanteric osteotomy. This method can greatly improve hip joint function and relieve pain without significant complications.

scholarly journals The accuracy of free-hand cup positioning: a CT based measurement in a South Indian hospital

2018 ◽  
Vol 4 (6) ◽  
pp. 887
Author(s):  
Vetrivel Chezian Sengodan ◽  
S. Marimuthu ◽  
Raghupathy Ramasamy
Keyword(s):  
Total Hip Arthroplasty ◽  
Ct Scan ◽  
Hip Arthroplasty ◽  
Acetabular Reconstruction ◽  
Acetabular Cup ◽  
Acetabular Version ◽  
Total Hip ◽  
South Indian ◽  
The Mean ◽  
Free Hand Technique

<p class="abstract"><strong>Background:</strong> In total hip arthroplasty, the restoration of normal hip center in acetabular reconstruction encourages the normal bio mechanics. The impingement, dislocation, and implant wear have increased the interest in accurate component placement in arthroplasty. This study is to determine the accuracy of the free hand technique in the acetabular cup placement in relation to native acetabulam using CT scan images.</p><p class="abstract"><strong>Methods:</strong> This study was done in the Coimbatore Medical College and Hospital from June 2015 to March 2016. Twenty patients who have undergone total hip replacements were subjected to CT scan of pelvis preoperatively and postoperatively. The acetabular cup version and the inclination were measured and analyzed statistically.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean acetabular version was 17.5◦±6.5◦ and the inclination was 46.6◦±9.3◦ pre operatively. Post operatively the mean acetabular version was 26.3◦±17.3◦ and the inclination was 41.7◦±10.9◦. With reference to the component version it ranged from 12.5˚ of retroversion to 62.5˚ anteversion with a mean of 26.3◦±17.3◦. The component inclination ranged from 15.6◦ to 58.4◦ with a mean of 41.7◦±10.9◦. On combining component version and inclination, only (50%) was within the safe zone.</p><p class="abstract"><strong>Conclusions:</strong> Based on the CT finding acetabular version and inclination differs from individual to individual. During acetabular cup placement in total hip arthroplasty using free hand technique, our study shows that that inclination is better achieved and the anteversion is over targeted in most of the cases.</p>

scholarly journals Trends In Cup Position Utilizing Computer-Assisted Navigation During Total Hip Arthroplasty

10.29007/jn8x ◽  
2019 ◽  
Author(s):  
Rachel Mays ◽  
Jessica Benson ◽  
Jeffrey Muir ◽  
Peter White ◽  
Morteza Meftah
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lateral Approach ◽  
Computer Assisted ◽  
Acetabular Cup ◽  
Assisted Navigation ◽  
Total Hip ◽  
Current Mass ◽  
The Mean ◽  
Cup Position

Proper positioning of the acetabular cup deters dislocation after total hip arthroplasty (THA). The concept of a safe zone (SZ) for acetabular component placement was first characterized by Lewinnek et al. and furthered by Callanan et al. The SZ concept remains widely utilized and accepted in contemporary THA practice; however, components positioned in this SZ still dislocate. This study sought to characterize current mass trends in cup position identified across a large study sample of THA procedures completed by multiple surgeons. This retrospective, observational study reviewed acetabular cup position in 1,236 patients who underwent THA using computer-assisted navigation between July 2015 and November 2017. The overall mean cup position of all recorded cases was 21.8° (±7.7°, 95% CI = 6.7°, 36.9°) of anteversion and 40.9° (±6.5°, 95% CI = 28.1°, 53.7°) of inclination. For both anteversion and inclination, 65.5% (809/1236) of acetabular cup components were within the Lewinnek SZ and 58.4% (722/1236) were within the Callanan SZ. Acetabular cups were placed a mean of 6.8° of anteversion (posterior/lateral approach: 7.0°, anterior approach: 5.6°) higher than the Lewinnek and Callanan SZs whereas inclination was positioned 0.9° higher than the reported Lewinnek SZ and 3.4° higher than the Callanan SZ. Our data shows that while the majority of acetabular cups were placed within the traditional SZs, the mean anteversion orientation is considerably higher than those suggested by the Lewinnek and Callanan SZs. The implications of this observation warrant further investigation.

Does total hip arthroplasty with high hip centre in dysplasia compromise acetabular bone stock?

2021 ◽  
pp. 112070002110594
Author(s):  
Arun Kannan ◽  
Chameka Madurawe ◽  
Jim Pierrepont ◽  
Stephen McMahon
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Host Bone ◽  
Bone Stock ◽  
Acetabular Cup ◽  
Digital Templating ◽  
3 Dimensional ◽  
Total Hip ◽  
The Mean

Background: The placement of uncemented acetabular components during total hip arthroplasty (THA) in Crowe II and Crowe III dysplasia can be at the anatomic or high hip centre position. Purposes: Using computerised tomography data, we simulated acetabular cup placement at the anatomic hip centre and the high hip centre positions to assess whether there is a difference between the 2 in terms of bone loss from acetabular reaming and in acetabular coverage by host bone. Methods: The study population included a consecutive cohort of 19 patients (22 hips) with Crowe II or III dysplasia. 3-dimensional models of the pelvis were created for each patient and digital templating was used to determine the anatomic and high hip centre positions. The coordinates of the digitally templated cup positions were fed into an image processing software to estimate the amount of bone reamed, the cup coverage by host bone and the elevation from tear drop. Results: The mean volume of bone reamed was greater in the high hip centre position as compared to the anatomic position (27.3 ± 11. 4 cm3 vs. 19.4 ± 12.2 cm3, p  < 0.0001). The coverage of the acetabular cup by host bone was greater in the high hip centre position (87.3 ± 5.9% vs. 68.3 ± 10%). The mean elevation in the high hip centre group was 13 mm with 3 hips having a breach of the medial wall. Conclusions: In Crowe II and III dysplasia, placement of acetabular cups at the anatomic hip centre better preserves bone stock as compared to high hip centre placement and should be preferred in young patients requiring THA.

scholarly journals Outpatient Total Hip Arthroplasty: A Meta-Analysis

2021 ◽  
Vol 11 (15) ◽  
pp. 6853
Author(s):  
Filippo Migliorini ◽  
Lucio Cipollaro ◽  
Francesco Cuozzo ◽  
Francesco Oliva ◽  
Andrea Valerio Marino ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Readmission Rates ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Outpatient Group ◽  
Operative Planning ◽  
The Mean ◽  
And Gender

Introduction: Outpatient total hip arthroplasty (THA) is increasingly popular. This meta-analysis investigated the potential advantages of outpatient regimes for THA. Methods: This study followed the PRISMA guidelines. PubMed, Web of Science, Google Scholar, Embase, and Scopus databases were accessed in June 2021. All clinical studies investigating outpatient THA were considered. The outcomes of interest were pain, infection, mortality, revision, dislocation, readmission rates, and deep vein thrombosis (DVT). Results: Data from 102,839 patients were included. A total of 52% (153,168 of 102,839 patients) were women. The mean age of patients was 62.6 ± 4.6 years, the mean BMI was 29.1 ± 1.8 kg/m2. Good comparability was found in age, BMI, and gender (p > 0.1). No difference was found in pain (p = 0.4), infections (p = 0.9), mortality (p = 0.9), rate of revision (p = 0.1), dislocation (p = 0.9), and readmission (p = 0.8). The outpatient group demonstrated a greater rate of DVT (OR 3.57; 95% CI 2.47 to 5.18; p < 0.0001). Conclusions: In selected patients, outpatient THA can be performed safely with optimal outcomes comparable with inpatient THA. Clear and comprehensive pre-operative planning should involve a multi-disciplinary group composed of orthopaedic surgeons, anaesthesia and rehabilitation specialists, and physiotherapists. Each centre performing outpatient THA should implement continuous homecoming welfare activity, to supervise physiotherapy and monitor anticoagulant therapy.

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