Peculiarities of Preoperative Planning of Total Hip Arthroplasty in Patients with Hip-Lumbar Syndrome

Summary. At present, no scheme of approach to surgical treatment of patients with hip-lumbar syndrome (HLS) depending on the type of vertical posture and the type of bone formation and progression of coxarthrosis is developed. The decision of these questions, interesting from the scientific and practical point of view, is an actual task of modern orthopedics and defines features of preoperative planning of total hip arthroplasty (THA) in patients with HLS. Objective: to determine the features of preoperative planning of total hip arthroplasty in patients with hip-lumbar syndrome. Materials and Methods. The basis for the development of recommendations for preoperative planning of THA in patients with HLS was the data of retrospective analysis of medical histories of 138 patients who underwent hip arthroplasty in the Department of Orthopedics and Traumatology of Adults of SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine”. The data of the clinical study of 506 patients with idiopathic, dysplastic and post-traumatic coxarthrosis conducted earlier were also taken into account, and the tactics of treatment in cementless hip arthroplasty was developed. Results. It was determined that the vertical posture affects the progression of coxarthrosis and the nature of the lesion of the lumbar spine in patients with HLS. Patients with a certain hypolordotic posture and a rapid course of coxarthrosis are recommended to undergo primary decompression of the spinal roots and THA at the second stage. In other cases, the initial implementation of THA is recommended. Recommendations for the use of the type and method of fixation and coverage of the leg of the endoprosthesis depending on the type of bone formation in the HLS of the examined patients are developed. Conclusions. Taking into account the features of preoperative planning of THA in patients with HLS will reduce the number of negative results and complications of this category of orthopedic patients.

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Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs

BioMed Research International ◽

10.1155/2019/1932191 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 6

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.

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Computer-Assisted Two-Dimensional Preoperative Planning for Total Hip Arthroplasty: Clinical Evaluation

Orthopedics ◽

10.3928/0147-7447-20051101-15 ◽

2005 ◽

Vol 28 (11) ◽

pp. 1356-1359

Author(s):

B M Jolles ◽

P-F Leyvraz

Keyword(s):

Total Hip Arthroplasty ◽

Clinical Evaluation ◽

Hip Arthroplasty ◽

Preoperative Planning ◽

Computer Assisted ◽

Two Dimensional ◽

Total Hip

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Serum Alkaline Phosphatase as an Indicator of Heterotopic Bone Formation Following Total Hip Arthroplasty

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-198809000-00019 ◽

1988 ◽

Vol &NA; (234) ◽

pp. 102???109 ◽

Cited By ~ 1

Author(s):

PER KJ??RSGAARD-ANDERSEN ◽

POUL PEDERSEN ◽

S??REN SKYDT KRISTENSEN ◽

STEEN ASMUS SCHMIDT ◽

NIELS WISBECH PEDERSEN

Keyword(s):

Alkaline Phosphatase ◽

Total Hip Arthroplasty ◽

Bone Formation ◽

Hip Arthroplasty ◽

Serum Alkaline Phosphatase ◽

Heterotopic Bone ◽

Heterotopic Bone Formation ◽

Total Hip

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Is analog preoperative planning still applicable?—comparison of accuracy of analog and computer preoperative planning methods in total hip arthroplasty

Annals of Translational Medicine ◽

10.21037/atm-20-7489 ◽

2021 ◽

Vol 9 (9) ◽

pp. 749-749

Author(s):

Julian Dutka ◽

Slawomir Kiepura ◽

Mateusz Bukowczan

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Preoperative Planning ◽

Total Hip ◽

Planning Methods

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The effect of range of motion simulated with a patient-specific three-dimensional simulation analysis on dislocation after total hip arthroplasty

Hip International ◽

10.1177/11207000211044807 ◽

2021 ◽

pp. 112070002110448

Author(s):

Ryo Mitsutake ◽

Hiromasa Tanino ◽

Hiroshi Ito

Keyword(s):

Total Hip Arthroplasty ◽

Range Of Motion ◽

Hip Arthroplasty ◽

Preoperative Planning ◽

Simulation Analysis ◽

Fine Tuning ◽

Posterior Dislocation ◽

Flexion Angle ◽

Total Hip ◽

Dimensional Simulation

Background: Dislocation continues to be a common complication following total hip arthroplasty (THA). Although previous studies of computed simulation analysis investigated the range of motion (ROM), it is unclear whether the ROM before impingement simulated using computed tomography-based 3-dimensional simulation analysis (simulated ROM) is related to dislocation after THA. It is also unclear what angles are required in computed simulation analyses for stable hips after THA. In this study, we compared the simulated ROM in patients with and without dislocation. Methods: 16 patients with posterior dislocation were compared with 48 matched patients without dislocation. Risk factors including preoperative bone morphology of the hip, implant position, change of femoral offset, change of leg length, anterior aspect of the greater trochanter (GTa) length, and anterior inferior iliac spine length were also compared. Results: The mean flexion angle, internal-rotation at 90° flexion (IR) angle, cup anteversion based on the anterior pelvic plane (APP), tilt-adjusted cup anteversion and GTa length were significantly different between patients with dislocation and patients without dislocation ( p = 0.033, 0.002, 0.010, 0.047, 0.046). A receiver-operating characteristic curve analysis suggested cutoff points for flexion angle, IR angle, cup anteversion based on the APP, tilt-adjusted cup anteversion and GTa length, of 114.5°, 45.5°, 19.5°, 12.0° and 15.3 mm. Conclusions: This study suggests that preoperative planning to achieve a larger simulated ROM, flexion angle and IR angle, may reduce the risk of posterior dislocation. This study also suggests that fine-tuning of cup anteversion and/or trimming of the overhanging GTa during preoperative planning may reduce the risk of posterior dislocation.

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