Accuracy of femoral templating in reproducing anatomical femoral offset in total hip replacement

2007 ◽  
Vol 17 (3) ◽  
pp. 155-159 ◽  
Author(s):  
H. Davies ◽  
J. Foote ◽  
Robert F. Spencer
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Offset ◽  
Total Hip

scholarly journals Total hip replacement: increasing femoral offset improves functional outcome

2016 ◽  
Vol 136 (9) ◽  
pp. 1317-1323 ◽  
Author(s):  
N. D. Clement ◽  
R. S. Patrick-Patel ◽  
D. MacDonald ◽  
S. J. Breusch
Keyword(s):  
Functional Outcome ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Offset ◽  
Total Hip

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

2009 ◽  
Vol 19 (3) ◽  
pp. 251-256 ◽  
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.

Accuracy of Femoral Templating in Reproducing Anatomical Femoral Offset in Total Hip Replacement

2007 ◽  
Vol 17 (3) ◽  
pp. 155-159 ◽  
Author(s):  
H. Davies ◽  
J. Foote ◽  
R.F. Spencer
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Rank Order ◽  
Computer Software ◽  
X Rays ◽  
Femoral Offset ◽  
Total Hip ◽  
Crucial Component ◽  
Best Fitting ◽  
The Uk

Restoration of hip biomechanics is a crucial component of successful total hip replacement. Preoperative templating is recommended to ensure that the size and orientation of implants is optimised. We studied how closely natural femoral offset could be reproduced using the manufacturers' templates for 10 femoral stems in common use in the UK. A series of 23 consecutive preoperative radiographs from patients who had undergone unilateral total hip replacement for unilateral osteoarthritis of the hip was employed. The change in offset between the templated position of the best-fitting template and the anatomical centre of the hip was measured. The templates were then ranked according to their ability to reproduce the normal anatomical offset. The most accurate was the CPS-Plus (Root Mean Square Error 2.0 mm) followed in rank order by: C stem (2.16), CPT (2.40), Exeter (3.23), Stanmore (3.28), Charnley (3.65), Corail (3.72), ABG II (4.30), Furlong HAC (5.08) and Furlong modular (7.14). A similar pattern of results was achieved when the standard error of variability of offset was analysed. We observed a wide variation in the ability of the femoral prosthesis templates to reproduce normal femoral offset. This variation was independent of the seniority of the observer. The templates of modern polished tapered stems with high modularity were best able to reproduce femoral offset. The current move towards digitisation of X-rays may offer manufacturers an opportunity to improve template designs in certain instances, and to develop appropriate computer software.

The influence of femoral offset on health-related quality of life after total hip replacement

2014 ◽  
Vol 96-B (1) ◽  
pp. 36-42 ◽  
Author(s):  
T. R.  Liebs ◽  
L. Nasser ◽  
W. Herzberg ◽  
W. Rüther ◽  
J. Hassenpflug
Keyword(s):  
Quality Of Life ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Health Related Quality ◽  
Femoral Offset ◽  
Total Hip ◽  
Related Quality ◽  
Health Related

The Hemodynamic and Fibrinolytic Response to Low Dose Epinephrine and Phenylephrine Infusions During Total Hip Replacement Under Epidural Anesthesia

1992 ◽  
Vol 68 (04) ◽  
pp. 436-441 ◽  
Author(s):  
Nigel E Sharrock ◽  
George Go ◽  
Robert Mineo ◽  
Peter C Harpel
Keyword(s):  
Heart Rate ◽  
Deep Vein Thrombosis ◽  
Cardiac Index ◽  
Total Hip Replacement ◽  
Epidural Anesthesia ◽  
Hip Replacement ◽  
Low Dose ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryLower rates of deep vein thrombosis have been noted following total hip replacement under epidural anesthesia in patients receiving exogenous epinephrine throughout surgery. To determine whether this is due to enhanced fibrinolysis or to circulatory effects of epinephrine, 30 patients scheduled for primary total hip replacement under epidural anesthesia were randomly assigned to receive intravenous infusions of either low dose epinephrine or phenylephrine intraoperatively. All patients received lumbar epidural anesthesia with induced hypotension and were monitored with radial artery and pulmonary artery catheters.Patients receiving low dose epinephrine infusion had maintenance of heart rate and cardiac index whereas both heart rate and cardiac index declined significantly throughout surgery in patients receiving phenylephrine (p = 0.0001 and p = 0.0001, respectively). Tissue plasminogen activator (t-PA) activity increased significantly during surgery (p <0.0005) and declined below baseline postoperatively (p <0.005) in both groups. Low dose epinephrine was not associated with any additional augmentation of fibrinolytic activity perioperatively. There were no significant differences in changes in D-Dimer, t-PA antigen, α2-plasmin inhibitor-plasmin complexes or thrombin-antithrombin III complexes perioperatively between groups receiving low dose epinephrine or phenylephrine. The reduction in deep vein thrombosis rate with low dose epinephrine is more likely mediated by a circulatory mechanism than by augmentation of fibrinolysis.

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