Restoring global offset and lower limb length with a 3 offset option double-tapered stem.
Global offset
Hip parameters
Leg length
Offset
Total hip Arthroplasty
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
02 Oct 2020
02 Oct 2020
Historique:
received:
19
06
2020
accepted:
24
09
2020
entrez:
3
10
2020
pubmed:
4
10
2020
medline:
15
5
2021
Statut:
epublish
Résumé
A proper restoration of hip biomechanics is fundamental to achieve satisfactory outcomes after total hip arthroplasty (THA). A global hip offset (GO) postoperatively reduction of more than 5 mm was known to impair hip functionality after THA. This study aimed to verify the restoration of the GO radiographic parameter after primary THA by the use of a cementless femoral stem available in three different offset options without length changing. From a consecutive series of 201 patients (201 hips) underwent primary cementless THA in our center with a minimum 3-year follow up, 80 patients (80 hips) were available for complete radiographic evaluation for GO and limb length (LL) and clinical evaluation with Harris hip score (HHS). All patients received the same femoral stem with three different offset options (option A with - 5 mm offset, option B and option C with + 5 mm offset, constant for each sizes) without changing stem length. Mean GO significantly increased by + 3 mm (P < 0.05) and mean LL significantly decreased by + 5 mm (P < 0.05) after surgery, meaning that postoperatively the limb length of the operated side increased by + 5 mm. HHS significantly improved from 56.3 points preoperatively to 95.8 postoperatively (P < 0.001). Offset option A was used in 1 hip (1%), B in 59 hips (74%) and C in 20 hips (25%). The femur is lateralized with a mean of + 5 mm after surgery than, the native anatomy, whatever type of stem was used. Thus, the use of this 3-offset options femoral stem is effective in restoring the native biomechanical hip parameters as GO, even if 2 offset options were considered sufficient to restore GO.
Sections du résumé
BACKGROUND
BACKGROUND
A proper restoration of hip biomechanics is fundamental to achieve satisfactory outcomes after total hip arthroplasty (THA). A global hip offset (GO) postoperatively reduction of more than 5 mm was known to impair hip functionality after THA. This study aimed to verify the restoration of the GO radiographic parameter after primary THA by the use of a cementless femoral stem available in three different offset options without length changing.
METHODS
METHODS
From a consecutive series of 201 patients (201 hips) underwent primary cementless THA in our center with a minimum 3-year follow up, 80 patients (80 hips) were available for complete radiographic evaluation for GO and limb length (LL) and clinical evaluation with Harris hip score (HHS). All patients received the same femoral stem with three different offset options (option A with - 5 mm offset, option B and option C with + 5 mm offset, constant for each sizes) without changing stem length.
RESULTS
RESULTS
Mean GO significantly increased by + 3 mm (P < 0.05) and mean LL significantly decreased by + 5 mm (P < 0.05) after surgery, meaning that postoperatively the limb length of the operated side increased by + 5 mm. HHS significantly improved from 56.3 points preoperatively to 95.8 postoperatively (P < 0.001). Offset option A was used in 1 hip (1%), B in 59 hips (74%) and C in 20 hips (25%).
CONCLUSIONS
CONCLUSIONS
The femur is lateralized with a mean of + 5 mm after surgery than, the native anatomy, whatever type of stem was used. Thus, the use of this 3-offset options femoral stem is effective in restoring the native biomechanical hip parameters as GO, even if 2 offset options were considered sufficient to restore GO.
Identifiants
pubmed: 33008343
doi: 10.1186/s12891-020-03674-8
pii: 10.1186/s12891-020-03674-8
pmc: PMC7532558
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
646Références
Bone. 1993 May-Jun;14(3):231-42
pubmed: 8363862
Orthopedics. 2014 Jul;37(7):e678-84
pubmed: 24992068
Int Orthop. 2012 Jun;36(6):1129-36
pubmed: 22113735
Ir J Med Sci. 2018 Aug;187(3):663-668
pubmed: 29335832
Acta Radiol. 2017 Sep;58(9):1125-1131
pubmed: 28068823
Acta Orthop Scand. 1995 Dec;66(6):487-93
pubmed: 8553813
Clin Orthop Relat Res. 2011 Feb;469(2):429-36
pubmed: 20844997
Hip Int. 2011 Jul-Aug;21(4):428-35
pubmed: 21818743
Orthopedics. 2010 Sep 07;33(9):631
pubmed: 20839699
J Arthroplasty. 2018 Apr;33(4):1126-1132
pubmed: 29246717
J Bone Joint Surg Am. 1969 Jun;51(4):737-55
pubmed: 5783851
J Orthop. 2019 May 28;16(6):483-488
pubmed: 31680736
Gait Posture. 2016 Sep;49:196-201
pubmed: 27450670
Bone Joint J. 2016 Mar;98-B(3):349-58
pubmed: 26920960
J Bone Joint Surg Br. 2006 Jul;88(7):883-6
pubmed: 16798989
J Bone Joint Surg Br. 1987 Jan;69(1):45-55
pubmed: 3818732
Acta Orthop. 2016 Feb;87(1):36-41
pubmed: 26471772
J Arthroplasty. 2010 Jun;25(4):624-34.e1-2
pubmed: 19559561
J Bone Joint Surg Br. 1950 May;32-B(2):183-6
pubmed: 15422015
Int Orthop. 2009 Aug;33(4):905-9
pubmed: 18437379
Clin Orthop Relat Res. 1979 Jun;(141):17-27
pubmed: 477100
Orthop Traumatol Surg Res. 2016 Feb;102(1 Suppl):S9-20
pubmed: 26797005
J Bone Joint Surg Br. 2003 Mar;85(2):209-14
pubmed: 12678354
J Bone Joint Surg Br. 1992 Jan;74(1):28-32
pubmed: 1732260
Arch Orthop Trauma Surg. 2016 Sep;136(9):1317-1323
pubmed: 27484875
J Arthroplasty. 2011 Apr;26(3):386-90
pubmed: 20299184
J Arthroplasty. 2019 Dec;34(12):3106-3113
pubmed: 31427132
Eur J Orthop Surg Traumatol. 2018 Oct;28(7):1291-1296
pubmed: 29736726