Assessment of restoration of leg length and femoral offset after total hip arthroplasty

2021 ◽  
Vol 56 (3) ◽  
pp. 148
Author(s):  
Hatem Bakr ◽  
Mohamed Mahran
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Leg Length ◽  
Femoral Offset ◽  
Total Hip

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

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
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.

scholarly journals Restoring femoral offset and leg length; the potential of a short curved stem in total hip arthroplasty

2019 ◽  
Vol 16 (5) ◽  
pp. 396-399 ◽  
Author(s):  
Thom E. Snijders ◽  
Joost H.J. van Erp ◽  
Arthur de Gast
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Leg Length ◽  
Femoral Offset ◽  
Total Hip

scholarly journals Greater increase in femoral offset with use of collum femoris-preserving stem than Tri-Lock stem in primary total hip arthroplasty

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052092599
Author(s):  
Mengxuan Yao ◽  
Yuchuan Wang ◽  
Congcong Wei ◽  
Yongtai Han ◽  
Huijie Li
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Leg Length ◽  
Femoral Offset ◽  
Unaffected Side ◽  
Neck Shaft Angle ◽  
Total Hip ◽  
Stem Group

Objective This study was performed to compare the clinical outcomes and performance of the collum femoris-preserving (CFP) stem (Waldemar Link GmbH & Co., Hamburg, Germany) and the Tri-Lock stem (DePuy Orthopaedics, Warsaw, IN, USA) in terms of femoral offset (FO) and leg length reconstruction. Methods Clinical and radiographic data of patients who underwent total hip arthroplasty with either a CFP stem or Tri-Lock stem from January 2016 to March 2017 were compared (65 and 57 patients, respectively). The Harris hip score and Western Ontario and McMaster Universities Osteoarthritis Index were recorded. The FO, femoral vertical offset, and neck–shaft angle were measured at the last follow-up. The occurrence of dislocation and periprosthetic fracture during the follow-up period was recorded. Results The CFP stem induced significantly more FO than did the Tri-Lock stem on the operated side than contralateral side (3.63 ± 4.28 vs. 0.83 ± 5.46 mm). Significantly fewer patients had a >5-mm decrease in FO on the unaffected side in the CFP stem group ( n = 1) than Tri-Lock stem group ( n = 10). Conclusion Both stems similarly improved hip function and reconstructed the leg length, but the CFP stem was superior to the Tri-Lock stem in reconstructing FO.

scholarly journals Severe Pelvic Obliquity Affects Femoral Offset in Patients with Total Hip Arthroplasty but Not Leg-Length Inequality

PLoS ONE ◽  
2015 ◽  
Vol 10 (12) ◽  
pp. e0144863 ◽  
Author(s):  
Xiaoxiao Zhou ◽  
Qi Wang ◽  
Xianlong Zhang ◽  
Yunsu Chen ◽  
Xiaochun Peng ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Obliquity ◽  
Leg Length ◽  
Femoral Offset ◽  
Leg Length Inequality ◽  
Total Hip

Accuracy of leg length and femoral offset restoration after total hip arthroplasty with the utilisation of an intraoperative calibration gauge

2019 ◽  
Vol 30 (3) ◽  
pp. 296-302 ◽  
Author(s):  
Oliver Enke ◽  
Yadin D Levy ◽  
Warwick JM Bruce
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
Leg Length ◽  
Femoral Offset ◽  
Measuring Device ◽  
X Ray ◽  
Total Hip ◽  
Hip Function ◽  
The Mean

Background: Offset and leg length (LL) restoration are critical for the achievement of a stable, well-functioning hip following total hip arthroplasty (THA). Several techniques are described in the literature, including a hip calibration gauge. We question whether meticulous preoperative planning of a specific surgical technique in combination with the utilisation of a calibration gauge can provide an accurate offset and LL restoration. Methods: Retrospective review of 101 unilateral THAs via a posterior approach by a single surgeon. Preoperative radiographic LL and offset were radiographically calculated. Intraoperatively prior to hip dislocation a calibration gauge was used to measure LL and offset with a pin inserted into the iliac crest acting as a static referencing point. All had pelvis x-ray performed 6 weeks postoperatively. A literature review was conducted to establish average postoperative LL/offset values for statistical comparison. Results: The average absolute postoperative leg-length discrepancy (LLD) was 2.51 mm compared to preoperatively 3.54 mm ( p = 0.018). A total of 93.1% and 100% had LLD of ⩽5 mm and ⩽10 mm, respectively. The mean postoperative offset difference was 2.39 mm. The investigated LLD and offset results were comparable with literature data of studies utilising an intraoperative measuring device. LLD was significantly decreased when compared to a free-hand technique (LLD 4.42 mm, p < 0.001). Conclusion: The technique utilising preoperative templating, intraoperative offset verification together with the use of hip calibration gauge yielded accurate LLD and offset restoration as in the literature. Precise offset restoration, which often is a neglected issue, can lead to better abductor vector restoration, hip function and less pain.

scholarly journals Staged reconstruction of unilateral neglected hip dislocation through total hip arthroplasty and subsequent intramedullary femoral lengthening

2021 ◽  
Author(s):  
Bjoern Vogt ◽  
Christoph Theil ◽  
Georg Gosheger ◽  
Adrien Frommer ◽  
Burkhard Moellenbeck ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Plate Fixation ◽  
Hip Dislocation ◽  
Leg Length ◽  
Total Hip ◽  
Femoral Lengthening ◽  
Shortening Osteotomy ◽  
Successful Approach ◽  
Staged Reconstruction

Abstract Background and purpose Total hip arthroplasty (THA) is a successful approach to treat unilateral symptomatic neglected hip dislocation (NHD). However, the extensive leg length discrepancy (LLD) can hereby only be partially corrected. In case of residual LLD of more than 2 cm, subsequent femoral lengthening can be considered. Patients/material/methods Retrospective analysis of clinical data and radiographs of five patients (age 38.1 (28–51) years) with unilateral NHD who underwent THA with (n  = 3) or without (n = 2) subtrochanteric shortening osteotomy (SSO) and secondary intramedullary femoral lengthening through a retrograde magnetically-driven lengthening nail (follow-up 18.4 (15–27) months). Results LLD was 51.0 (45–60) mm before and 37.0 (30–45) mm after THA. Delayed bone union at one SSO site healed after revision with autologous bone grafting and plate fixation. Subsequent lengthening led to leg length equalisation in all patients. Complete consolidation was documented in all lengthened segments. Conclusion Staged reconstruction via THA and secondary femoral lengthening can successfully be used to reconstruct the hip joint and equalise LLD. The specific anatomical conditions have to be taken into consideration when planning treatment, and patients ought to be closely monitored.

Changes in patient-perceived leg length discrepancy following total hip arthroplasty

2021 ◽  
Author(s):  
Kentaro Iwakiri ◽  
Yoichi Ohta ◽  
Takashi Fujii ◽  
Yukihide Minoda ◽  
Akio Kobayashi ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Total Hip ◽  
Length Discrepancy

Measuring leg length and offset with an imageless navigation system during total hip arthroplasty: is it really accurate?

2009 ◽  
Vol 5 (2) ◽  
pp. 192-197 ◽  
Author(s):  
Tobias Renkawitz ◽  
Tibor Schuster ◽  
Thomas Herold ◽  
Holger Goessmann ◽  
Ernst Sendtner ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Navigation System ◽  
Leg Length ◽  
Total Hip ◽  
Imageless Navigation
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