Leg Length Equality in Total Hip Replacement

The purpose of this study was to analyse a new concept of using the the minimally invasive direct anterior approach (DAA) in total hip replacement (THR) in combination with the leg positioner (Rotex- Table) and a modified retractor system (Condor). We evaluated retrospectively the first 100 primary THR operated with the new concept between 2009 and 2010, regarding operation data, radiological and clinical outcome (HOOS). All surgeries were perfomed in a standardized operation technique including navigation. The average age of the patients was 68 years (37 to 92 years), with a mean BMI of 26.5 (17 to 43). The mean time of surgery was 80 min. (55 to 130 min). The blood loss showed an average of 511.5 mL (200 to 1000 mL). No intra-operative complications occurred. The postoperative complication rate was 6%. The HOOS increased from 43 points pre-operatively to 90 (max 100 points) 3 months after surgery. The radiological analysis showed an average cup inclination of 43° and a leg length discrepancy in a range of +/- 5 mm in 99%. The presented technique led to excellent clinic results, showed low complication rates and allowed correct implant positions although manpower was saved.

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Assessing Reproducibility for Radiographic Measurement of Leg Length Inequality after Total Hip Replacement

Hip International ◽

10.5301/hip.2012.9751 ◽

2012 ◽

Vol 22 (5) ◽

pp. 539-544 ◽

Cited By ~ 9

Author(s):

Anthony B. McWilliams ◽

Andrew J. Grainger ◽

Philip J. O'Connor ◽

Anthony C. Redmond ◽

Todd D. Stewart ◽

...

Keyword(s):

Total Hip Replacement ◽

Hip Replacement ◽

Radiographic Measurement ◽

Leg Length ◽

Leg Length Inequality ◽

Total Hip

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Radiographic Assessment of Biomechanical Parameters following hip Resurfacing and Cemented Total Hip Arthroplasty

Hip International ◽

10.1177/112070000901900311 ◽

2009 ◽

Vol 19 (3) ◽

pp. 251-256 ◽

Cited By ~ 16

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.

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Secondary Hip Osteoarthritis due to Neurofibroma Treated with Total Hip Replacement

Case Reports in Orthopedics ◽

10.1155/2012/173921 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Suksan Tangsataporn ◽

Alireza Shakib ◽

Paul R. Kuzyk ◽

David J. Backstein ◽

Allan E. Gross ◽

...

Keyword(s):

Total Hip Replacement ◽

Hip Replacement ◽

Plexiform Neurofibroma ◽

Hip Osteoarthritis ◽

Valgus Deformity ◽

Coxa Vara ◽

Leg Length ◽

Secondary Osteoarthritis ◽

Total Hip ◽

Trochanteric Slide

Background. Local plexiform neurofibroma can lead to deformity of the pelvis, valgus deformity of femoral neck, and joint capsule laxity. We report a case of secondary hip osteoarthritis with subluxation and coxa vara deformity resulting from an extra-articular neurofibroma treated with total hip replacement.Case Description. A 39-year-old man had a large benign plexiform neurofibroma at buttock which induced secondary osteoarthritis of the hip. Conservative treatment of tumor was selected because the patient had low chance of malignant transformation due to absence of other neurofibromatosis features. However, due to secondary osteoarthritis he underwent total hip arthroplasty. Anterior capsulotomy was selected to avoid large posterior hip tumor mass. In order to avoid the difficulties associated with setting tension of the abductor muscle, modified trochanteric slide osteotomy with trochanteric advancement, lateralized cup placement, and extended neck offset were used. One year after the surgery, the patient had excellent clinical function, hip stability, leg length equality and was satisfied with the outcome.Clinical Relevance. We concluded that the modified trochanteric slide osteotomy with trochanteric advancement represents a valuable approach for THR in patients with extremely elongation of the hip abductor and secondary hip osteoarthritis resulting from extra-articular neurofibroma.

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