Effect of acetabular cup orientation and femoral stem placement on the functional outcome in uncemented total hip arthroplasty

AbstractThe aim of this study was to assess a large, single-surgeon dataset of uncemented total hip arthroplasties that had been templated using software. This assessment compared preoperative templated predictions with what was implanted with regard to (1) femoral prosthesis size and (2) acetabular cup size. The operation notes for two types of uncemented total hip arthroplasty performed by a single surgeon between January 9, 2008, and March 21, 2019, were assessed. The data were refined so that only those that were fully templated on a correctly calibrated pelvic radiograph were included. This provided a total of 153 cases. The predicted software template was compared with actual implanted component sizes. With regard to the femoral stems, the templating software was exactly correct in 45.75% of cases and was accurate to within one size in 87.59% of cases. With regard to the acetabular component, the templating software was exactly correct in 52.94% of cases and was accurate to within one size (2 mm) in 86.94% of cases. Templating software offers an accurate prediction of the size of uncemented femoral and acetabular components. In addition, the benefits of templating include cognitive rehearsal, insight into potentially challenging aspects of surgery, and highlighting intraoperative issues where there is a large intraoperative deviation from what is templated. This study demonstrates the congruence and reproducibility of templating software when compared with other smaller studies performed in the literature.

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Distal femoral stem tip resection for thigh pain complicating uncemented total hip arthroplasty. Five patients followed up for 6-10 years

Hip International ◽

10.5301/hip.2008.2615 ◽

2006 ◽

Vol 16 (3) ◽

pp. 210-214

Author(s):

L. Kandel ◽

M. Kligman ◽

R. Sekel

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Femoral Stem ◽

Thigh Pain ◽

Total Hip ◽

Uncemented Total Hip Arthroplasty

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Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.1.3089 ◽

2020 ◽

Vol 37 (1) ◽

Author(s):

Engin Çarkçı ◽

Ayse Esin Polat ◽

Yusuf Öztürkmen ◽

Tolga Tüzüner

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Survival Rates ◽

Femoral Stem ◽

Long Term Results ◽

Harris Hip Score ◽

Acetabular Cup ◽

Total Hip ◽

Kaplan Meier

Objective: In this study we aimed to investigate the long-term clinical and radiological results, revision rates and causes, and the rate of implant survival in total hip arthroplasty performed using CLS® expansion cup and Spotorno® cementless femoral stem. Methods: Clinical results of total hip arthroplasty performed on 131 hips of 114 patients in Istanbul Training and Research Hospital between 1993 and 2003 were retrospectively evaluated according to the Harris Hip Score. Revision rates were determined and implant survival rates were identified using the Kaplan-Meier estimator. Results: Of the patients, 39 were males and 75 were females. The average age of the patients at surgery was 48.7±11.3 years. Patients were followed up for a mean period of 13.9±2.4 years. The mean Harris Hip Score was 34.35±6.09 preoperatively and 88.20±7.11 at the final follow-up (p<0.001). The Kaplan-Meier survivorship estimate for the cup at 13.9 years, taking revision for any reason as the end point was 95.6% (95% CI), while the 15th and 17th year survival rates were 90% and 85%, respectively. Conclusion: In total hip arthroplasty using a cementless expansive acetabular cup, a 95.6% survival rate is achieved after an average of 14 years, whereas the rate decreases to 85% after 17 years. Even if the incidence of cup breakage is reduced with proper implantation, particle disease and periacetabular osteolysis remains a problem for the long-term survival. doi: https://doi.org/10.12669/pjms.37.1.3089 How to cite this:Carkci E, Polat AE, Ozturkmen Y, Tuzuner T. Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem. Pak J Med Sci. 2021;37(1):52-58. doi: https://doi.org/10.12669/pjms.37.1.3089 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Artificial Intelligence Technology

10.21203/rs.3.rs-120578/v1 ◽

2020 ◽

Author(s):

Jiabang Huo ◽

Guangxin Huang ◽

Dong Han ◽

Xinjie Wang ◽

Yufan Bu ◽

...

Keyword(s):

Artificial Intelligence ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Acetabular Dysplasia ◽

Preoperative Planning ◽

Femoral Stem ◽

Acetabular Cup ◽

Component Size ◽

Total Hip ◽

Digital Template

Abstract Background: Accurate preoperative planning is an important step for accurate reconstruction in total hip arthroplasty (THA). Presently, preoperative planning is completed using either a two-dimensional (2D) template or three-dimensional (3D) mimics software. With the development of artificial intelligence (AI) technology, AI HIP, a planning software based on AI technology can quickly and automatically identify acetabular and femur morphology, and automatically match the optimal prosthesis size. However, the accuracy and feasibility of its clinical application still needs to be further verified. The purposes of this study were to investigate the accuracy and time efficiency of AI HIP in preoperative planning for primary THA, compared with 3D mimics software and 2D digital template; and further analyze the factors that influence the accuracy of AI HIP.Methods: A prospective study was conducted on 53 consecutive patients (59 hips) undergoing primary THA with cementless prostheses in our department. All preoperative planning was completed using AI HIP as well as 3D mimics and 2D digital template. The predicted component size and the actual implantation results were compared to determine the accuracy. The templating time was compared to determine the efficiency. Furthermore, the potential factors influencing the accuracy of AI HIP were analyzed including sex, body mass index (BMI), and hip dysplasia.Results: The accuracy in predicting the acetabular cup and femoral stem was 74.58% and 71.19%, respectively, for AI HIP; 71.19% (P = 0.743) and 76.27% (P = 0.468), respectively, for 3D mimics; 40.68% (P < 0.001) and 49.15% (P = 0.021), respectively, for 2D digital templating. The templating time using AI HIP was 3.91±0.64 min, which was equivalent to 2D digital templates (2.96±0.48 min, P < 0.001), but shorter than 3D mimics (32.07±2.41 min, P < 0.001). Acetabular dysplasia(P = 0.021), rather than sex and BMI, was an influential factor in the accuracy of AI HIP templating. Compared to patients with developmental dysplasia of the hip (DDH), the accuracy of acetabular cup in the non-DDH group was better (P = 0.021), but the difference in the accuracy of the femoral stem between the two groups was statistically insignificant (P = 0.062).Conclusion: AI HIP showed excellent reliability for component size in THA. Acetabular dysplasia may affect the accuracy of AI HIP templating.

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The accuracy of digital templating in cementless total hip arthroplasty in dysplastic hips

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04793-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Emelie Kristoffersson ◽

Volker Otten ◽

Sead Crnalic

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Femoral Stem ◽

Developmental Dysplasia ◽

Leg Length ◽

Acetabular Cup ◽

Digital Templating ◽

Total Hip ◽

Implant Size ◽

Crowe Classification

Abstract Background Total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH) is a complex procedure due to associated anatomical abnormalities. We studied the extent to which preoperative digital templating is reliable when performing cementless THA in patients with DDH. Methods We templated and compared the pre- and postoperative sizes of the acetabular and femoral components and the center of rotation (COR), and analysed the postoperative cup coverage, leg length discrepancy (LLD), and stem alignment in 50 patients (56 hips) with DDH treated with THA. Results The implant size exactly matched the template size in 42.9% of cases for the acetabular component and in 38.2% of cases for the femoral component, whereas the templated ±1 size was used in 80.4 and 81.8% of cases for the acetabular and femoral components, respectively. There were no statistically significant differences between templated and used component sizes among different DDH severity levels (acetabular cup: p = 0.30 under the Crowe classification and p = 0.94 under the Hartofilakidis classification; femoral stem: p = 0.98 and p = 0.74, respectively). There were no statistically significant differences between the planned and postoperative COR (p = 0.14 horizontally and p = 0.52 vertically). The median postoperative LLD was 7 (range 0–37) mm. Conclusion Digital preoperative templating is reliable in the planning of cementless THA in patients with DDH.

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A study of functional outcome in young arthritic hip undergoing uncemented total hip arthroplasty

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2017.v3.i3k.113 ◽

2017 ◽

Vol 3 (3k) ◽

pp. 751-756

Author(s):

Avik Sarkar ◽

Ravi i Bhanushal ◽

Vikram Chauhan ◽

Umesh Nagrale ◽

Prasannaditya Muzumdar

Keyword(s):

Total Hip Arthroplasty ◽

Functional Outcome ◽

Hip Arthroplasty ◽

Total Hip ◽

Uncemented Total Hip Arthroplasty

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Comparison of Acetabular Reamings during Hip Resurfacing versus Uncemented Total Hip Arthroplasty

Journal of Orthopaedic Surgery ◽

10.1177/230949900901700110 ◽

2009 ◽

Vol 17 (1) ◽

pp. 42-46 ◽

Cited By ~ 9

Author(s):

SA Brennan ◽

JA Harty ◽

C Gormley ◽

SK O'Rourke

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Elderly Women ◽

Hip Resurfacing ◽

Acetabular Cup ◽

Total Hip ◽

Uncemented Total Hip Arthroplasty ◽

Neck Fracture ◽

History Of ◽

Resurfacing Hip Arthroplasty

Purpose. To compare the quantity of bone removed from the acetabulum during resurfacing hip arthroplasty versus uncemented total hip arthroplasty (THA). Methods. 62 consecutive patients with osteoarthritis of the hip were prospectively studied. 24 men and 7 women aged 40 to 86 (mean, 59) years underwent Birmingham hip resurfacing. 13 men and 18 women aged 34 to 88 (mean, 61) years underwent uncemented THA using the trident acetabular cup. Obese elderly women at risk of femoral neck fracture and patients with large subchondral pseudocysts or a history of avascular necrosis of the femoral head were assigned to uncemented THA. Acetabular reamings were collected; marginal osteophytes were not included. The reamings were dehydrated, defatted, and weighed. Results. The mean weight of acetabular reamings was not significantly different between patients undergoing hip resurfacing and uncemented THA (p=0.57). Conclusion. In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and removal of excessive bone stock.

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Definition and validation of a system for classifying the undersized Corail femoral stem in total hip arthroplasty

Hip International ◽

10.1177/1120700021996001 ◽

2021 ◽

pp. 112070002199600

Author(s):

Jamie S McConnell ◽

Farhan A Syed ◽

Paul Saunders ◽

Raviprasad Kattimani ◽

Anthony Ugwuoke ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Classification System ◽

Femoral Stem ◽

Observer Agreement ◽

Stem Size ◽

Total Hip ◽

Initial Fixation ◽

Uncemented Total Hip Arthroplasty ◽

Hip Arthroplasties

Introduction: The uncemented total hip arthroplasty relies on a secure initial fixation of the femoral stem to achieve osseointegration. Undersizing of the femoral implant compromises this. Surgeons routinely review postoperative radiographs to assess appropriate sizing, but existing methods of assessment lack standardisation. We present a system of accurately and reliably classifying radiological undersizing, which will help us better understand the factors that might have led to undersizing. Aim: To describe and evaluate a classification system for assessing radiological undersizing of the uncemented stem in hip arthroplasty. Method: We conducted a retrospective review of 1,337 consecutive hip arthroplasties using the Corail stem. Two independent investigators reviewed post-operative radiographs and classified them as either appropriately sized or undersized. Undersized stems were sub-categorised into four subtypes: uniformly undersized, varus undersized, valgus undersized or ‘cocktail-glass’ undersized. Inter- and intra-observer agreement was determined. The accuracy of our classification system was validated by comparison with digital re-templating. We further assessed patient demographics and stem size in relation to sizing. Results: 1 in 5 cases (19.75%) were deemed radiologically undersized. The commonest subtypes of undersizing were uniformly (47%) and varus (39%) undersized. When assessing sizing and subtype categorisation, inter-observer agreement was 89–92% and intra-observer agreement 86%. Classification decisions showed 92% and 97% accuracy for uniformly undersizing and varus undersizing respectively when validated against digital re-templating. Age, gender and smaller stem size were significantly associated with radiological undersizing. The Corail KLA model (125° neck) was found to have a higher incidence of stems undersized in varus. Conclusions: This study describes and validates a classification system for the analysis of radiological undersizing.

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Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Artificial Intelligence Technology

10.21203/rs.3.rs-120578/v2 ◽

2021 ◽

Author(s):

Jiabang Huo ◽

Guangxin Huang ◽

Dong Han ◽

Xinjie Wang ◽

Yufan Bu ◽

...

Keyword(s):

Artificial Intelligence ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Acetabular Dysplasia ◽

Preoperative Planning ◽

Femoral Stem ◽

Acetabular Cup ◽

Component Size ◽

Total Hip ◽

Digital Template

Abstract Background: Accurate preoperative planning is an important step for accurate reconstruction in total hip arthroplasty (THA). Presently, preoperative planning is completed using either a two-dimensional (2D) template or three-dimensional (3D) mimics software. With the development of artificial intelligence (AI) technology, AI HIP, a planning software based on AI technology can quickly and automatically identify acetabular and femur morphology, and automatically match the optimal prosthesis size. However, the accuracy and feasibility of its clinical application still needs to be further verified. The purposes of this study were to investigate the accuracy and time efficiency of AI HIP in preoperative planning for primary THA, compared with 3D mimics software and 2D digital template; and further analyze the factors that influence the accuracy of AI HIP.Methods: A prospective study was conducted on 53 consecutive patients (59 hips) undergoing primary THA with cementless prostheses in our department. All preoperative planning was completed using AI HIP as well as 3D mimics and 2D digital template. The predicted component size and the actual implantation results were compared to determine the accuracy. The templating time was compared to determine the efficiency. Furthermore, the potential factors influencing the accuracy of AI HIP were analyzed including sex, body mass index (BMI), and hip dysplasia.Results: The accuracy of predicting the size of acetabular cup and femoral stem was 74.58% and 71.19%, respectively, for AI HIP; 71.19% (P = 0.743) and 76.27% (P = 0.468), respectively, for 3D mimics; 40.68% (P < 0.001) and 49.15% (P = 0.021), respectively, for 2D digital templating. The templating time using AI HIP was 3.91±0.64 min, which was equivalent to 2D digital templates (2.96±0.48 min, P < 0.001), but shorter than 3D mimics (32.07±2.41 min, P < 0.001). Acetabular dysplasia(P = 0.021), rather than sex and BMI, was an influential factor in the accuracy of AI HIP templating. Compared to patients with developmental dysplasia of the hip (DDH), the accuracy of acetabular cup in the non-DDH group was better (P = 0.021), but the difference in the accuracy of the femoral stem between the two groups was statistically insignificant (P = 0.062).Conclusion: AI HIP showed excellent reliability for component size in THA. Acetabular dysplasia may affect the accuracy of AI HIP templating.

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A prospective study on functional outcome of uncemented total hip arthroplasty in patients with inflammatory arthropathies

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20201520 ◽

2020 ◽

Vol 6 (3) ◽

pp. 622

Author(s):

Girish Marappa ◽

Vishwanath Muttagaduru Shivalingappa ◽

Nuthan Jagadeesh ◽

Arjun Mandri

Keyword(s):

Total Hip Arthroplasty ◽

Prospective Study ◽

Functional Outcome ◽

Hip Arthroplasty ◽

Inflammatory Arthritis ◽

Posterolateral Approach ◽

Harris Hip Score ◽

Total Hip ◽

Uncemented Total Hip Arthroplasty ◽

A Prospective Study

Background: Although medical management has improved the outcome and may have reduced the need for surgery, total hip arthroplasty (THA) is often required to manage pain and restore function and mobility. The successful functional outcome of THA in patients with inflammatory arthropathies is essential in understanding the need for THA, and its benefits in those undergoing it. Objective of the study is to evaluate the functional outcome of total hip arthroplasty in patients suffering from inflammatory arthritis using Harris hip score (HHS) and to assess the post operative complication in these patients.Methods: In a prospective study conducted on patients with inflammatory arthritis treated with THA between a study period of January 2018 to January 2020. All the patients after assessing them clinically and radiologically were operated with uncemented THA through posterolateral approach. Functional outcomes of hip were evaluated using HHS at various intervals.Results: In this study, patients were followed up to 24 months. About 46.7% of patients were diagnosed with rheumatoid arthritis, 33.3% of patients were diagnosed with ankylosing spondylitis, 20% of patients were diagnosed with sero negative arthritis. 90% of patients had no limb length discrepancy, no other post-operative complications were noted. The final functional outcome of hip according to HHS were 13.3% of excellent, 56.7% good results and 30% of fair results.Conclusions: This study concludes that THA in patients with inflammatory arthritis with restricted activities of life had improved in short term follow up and ease of rehabilitation and return to function.

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