Gait Analysis before and after Total Hip Arthroplasty in Hip Dysplasia and Osteonecrosis of the Femoral Head

After a total hip arthroplasty, a limited range of motion and lower-limb disability continue to be observed, with these being mainly associated with the implant design and the head-to-neck ratio. Larger diameters of the head bearings were assumed to provide better stability, a larger range of motion, and smaller risks of dislocation and stem-to-liner impingement. However, these claims have never been demonstrated in real patients. The specific aim of this study was to assess, via multi-instrumental analysis, whether the range of motion of a replaced hip is limited by the stem-to-liner contact in patients with large femoral head diameters. Twenty-three patients with a total hip arthroplasty were evaluated at their one-year follow-ups using clinical and instrumental examinations. A combined three-dimensional gait analysis of the full body and videofluoroscopy analysis of the replaced hip were performed during the execution of standard, i.e., daily living, and more demanding motor tasks. The latter were meant to reach the extreme range of motion at the replaced hip site, thus revealing possible stem-to-liner contact. An original technique based on imaging and computer-aided design (CAD) models of the prosthesis components was developed to calculate the stem-to-liner distance. Excellent clinical scores were observed in the study. The gait analysis showed that the range of motion of the replaced hip in the sagittal plane, averaged over all patients, ranged from 28° to 78° in standard activities. In more demanding tasks, single peaks were as high as 110°, 39°, and 60° in the sagittal, frontal, and transverse anatomical planes, respectively. In all motor tasks, the stem-to-liner distances ranged from 8.7 to 13.0 mm on average, with one outlier minimum distance being 2.2 mm. This study shows that, even in demanding motor tasks and with an extreme range of motion, the hip joint replaced with large femoral head diameters did not experience impingement between the prosthesis components.

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Gait Analysis before and after Total Hip Arthroplasty

Orthopedics & Traumatology ◽

10.5035/nishiseisai.55.61 ◽

2006 ◽

Vol 55 (1) ◽

pp. 61-64

Author(s):

Riki Ueki ◽

Masamori Shigematsu ◽

Takao Hotokebuchi ◽

Tsutomu Motooka

Keyword(s):

Total Hip Arthroplasty ◽

Gait Analysis ◽

Hip Arthroplasty ◽

Total Hip ◽

Before And After

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Long-term retrospective study on the placement of the cementless acetabular cup and clinical outcomes in patients undergoing femoral head autografting for hip dysplasia and total hip arthroplasty

Journal of Orthopaedic Science ◽

10.1016/j.jos.2018.02.009 ◽

2018 ◽

Vol 23 (3) ◽

pp. 525-531 ◽

Cited By ~ 1

Author(s):

Vahit Emre Ozden ◽

Goksel Dikmen ◽

Burak Beksac ◽

Ismail Remzi Tozun

Keyword(s):

Retrospective Study ◽

Femoral Head ◽

Total Hip Arthroplasty ◽

Clinical Outcomes ◽

Hip Arthroplasty ◽

Hip Dysplasia ◽

Acetabular Cup ◽

Total Hip

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Epidemiological Study of Femoral Head Osteonecrosis

Revista de Chimie ◽

10.37358/rc.17.5.5593 ◽

2017 ◽

Vol 68 (5) ◽

pp. 974-976

Author(s):

Alexandru Patrascu ◽

Liliana Savin ◽

Dan Mihailescu ◽

Victor Grigorescu ◽

carmen Grierosu ◽

...

Keyword(s):

Risk Factors ◽

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Young Patients ◽

Head Group ◽

Bipolar Hemiarthroplasty ◽

Aseptic Necrosis ◽

Total Hip ◽

Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

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A Novel Measurement Using Digital Radiography to Minimize Fluoroscopy in Total Hip Arthroplasty

The Journal of Hip Surgery ◽

10.1055/s-0041-1728760 ◽

2021 ◽

Author(s):

Andrew G. Yun ◽

Marilena Qutami ◽

Kory B. Dylan Pasko

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Radiation Exposure ◽

Hip Arthroplasty ◽

Fluoroscopy Time ◽

Lesser Trochanter ◽

Total Hip ◽

Preoperative Templating ◽

The Mean ◽

Templating Technique

AbstractPreoperative templating for total hip arthroplasty (THA) is fraught with uncertainty. Specifically, the conventional measurement of the lesser trochanter to the center (LTC) of the femoral head used in preoperative planning is easily measured on a template but not measurable intraoperatively. The purpose of this study was to examine the utility of a novel measurement that is reproducible both on templating and in surgery as a more accurate and practical guide. We retrospectively reviewed 201 patients with a history of osteoarthritis who underwent primary THA. For preoperative templating, the distance from the top of the lesser trochanter to the equator (LeTE) of the femoral head was measured on a calibrated digital radiograph with a neutral pelvis. This measurement was used intraoperatively to guide the choice of the trial neck and head. As with any templating technique, the goal was to construct a stable, impingement-free THA with equivalent leg lengths and hip offset. In evaluating this novel templating technique, the primary outcomes measured were the number of trial reductions and the amount of fluoroscopic time, exposures, and radiation required to obtain a balanced THA reconstruction. Using the LeTE measurement, the mean number of trial reductions was 1.21, the mean number of intraoperative fluoroscopy images taken was 2.63, the mean dose of radiation exposure from fluoroscopy was 0.02 mGy, and the mean fluoroscopy time per procedure was 0.6 seconds. In hips templated with the conventional LTC prior to the LeTE, the mean fluoroscopy time was 0.9 seconds. There was a statistically significant difference in fluoroscopy time (p < 0.001). The LeTE is a reproducible measurement that transfers reliably from digital templating to surgery. This novel preoperative templating metric reduces the fluoroscopy time and consequent radiation exposure to the surgical team and may minimize the number of trial reductions.

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The impact of reducing the femoral stem length in total hip arthroplasty during gait

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03852-w ◽

2021 ◽

Author(s):

Anatole Vilhelm Wiik ◽

Adeel Aqil ◽

Bilal Al-Obaidi ◽

Mads Brevadt ◽

Justin Peter Cobb

Keyword(s):

Total Hip Arthroplasty ◽

Gait Analysis ◽

Hip Arthroplasty ◽

Femoral Stem ◽

Short Stem ◽

Stem Length ◽

Practical Consideration ◽

Total Hip ◽

Long Stem ◽

The Impact

Abstract Aim The length of the femoral stem in total hip arthroplasty (THA) is a practical consideration to prevent gait impairment. The aim of this study was to determine if reducing the femoral stem length in THA would lead to impaired gait biomechanics. Methods Patients uniformly with the same brand implant of differing lengths (100 mm vs 140–166 mm) were taken retrospectively from a prospective trial introducing a new short stem. Twelve patients without any other disorder to alter gait besides contralateral differing length stem THA were tested at differing gradients and speed on a validated instrumented treadmill measuring ground reaction forces. An anthropometrically similar group of healthy controls were analysed to compare. Results With the same posterior surgical approach, the offset and length of both hips were reconstructed within 5 mm of each other with an identical mean head size of 36 mm. The short stem was the last procedure for all the hips with gait analysis occurring at a mean of 31 and 79 months postoperatively for the short and long stem THA, respectively. Gait analysis between limbs of both stem lengths demonstrated no statistical difference during any walking condition. In the 90 gait assessments with three loading variables, the short stem was the favoured side 51% of the time compared 49% for the long stem. Conclusion By testing a range of practical walking activities, no lower limb loading differences can be observed by reducing the femoral stem length. A shorter stem demonstrates equivalence in preference during gait when compared to a reputable conventional stem in total hip arthroplasty.

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