Skip to main content
Erschienen in: Clinical Orthopaedics and Related Research® 2/2011

01.02.2011 | Symposium: Papers Presented at the Hip Society Meetings 2010

Hip Offset in Total Hip Arthroplasty: Quantitative Measurement with Navigation

verfasst von: Manish Dastane, MD, Lawrence D. Dorr, MD, Rupesh Tarwala, MD, Zhinian Wan, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 2/2011

Einloggen, um Zugang zu erhalten

Abstract

Background

Offset in THA correlates to abductor muscle function, wear, and impingement. Femoral offset after THA is not independent of the cup center of rotation (COR) so hip offset, a combination of femoral offset and change in hip COR, becomes the important measurement.

Questions/purposes

We therefore asked whether hip offset in arthritic hips would correlate with cup COR; whether offset could always be balanced within 6 mm of contralateral normal hips; and whether hip length could also be kept within 6 mm.

Methods

We compared hip offset of arthritic and contralateral normal hips on radiographs in 82 patients (82 hips) who had THA. We used computer navigation in all patients with the aim of reconstructing the hip offset and to compare hip offset change to the quantitative change of the hip COR.

Results

The preoperative radiographic change to equalize the offset ranged from −12 to +21 mm (mean, 1.5); postoperatively the change was 1.4 ± 6.4 mm and was within ± 6 mm in 78 of 82 hips. As COR displaced superiorly from 3 to 6+ mm the offset had to be substantially increased. Only with COR 0–3 mm superior and 0–5 mm medial was offset always within 5 mm.

Conclusions

Hip offset reconstruction was directly related to the position of the hip COR, and navigation allowed quantitative control of offset and hip length.
Literatur
1.
Zurück zum Zitat Asayama I, Chamnongkich S, Simpson KJ, Kinsey TL, Mahoney OM. Reconstructed hip joint position and abductor muscle strength after total hip arthroplasty. J Arthroplasty. 2005;20:414–420.CrossRefPubMed Asayama I, Chamnongkich S, Simpson KJ, Kinsey TL, Mahoney OM. Reconstructed hip joint position and abductor muscle strength after total hip arthroplasty. J Arthroplasty. 2005;20:414–420.CrossRefPubMed
2.
Zurück zum Zitat Bourne RB, Rorabeck CH. Soft tissue balancing: The hip. J Arthroplasty. 2002; 17(Suppl 1):17–22.CrossRefPubMed Bourne RB, Rorabeck CH. Soft tissue balancing: The hip. J Arthroplasty. 2002; 17(Suppl 1):17–22.CrossRefPubMed
3.
Zurück zum Zitat Charles MN, Bourne RB, Davey JR, Greenwald AS, Morrey BF, Rorabeck CH. Soft-tissue balancing of the hip: the role of femoral offset restoration. J Bone Joint Surg Am. 2004;86:1078–1088. Charles MN, Bourne RB, Davey JR, Greenwald AS, Morrey BF, Rorabeck CH. Soft-tissue balancing of the hip: the role of femoral offset restoration. J Bone Joint Surg Am. 2004;86:1078–1088.
4.
Zurück zum Zitat Dolhain P, Tsigaras H, Bourne RB, Rorabeck CH, Mac Donald S, Mc Calden R. The effectiveness of dual offset stems in restoring offset during total hip replacement. Acta Orthop Belg, 2002;68:490–499.PubMed Dolhain P, Tsigaras H, Bourne RB, Rorabeck CH, Mac Donald S, Mc Calden R. The effectiveness of dual offset stems in restoring offset during total hip replacement. Acta Orthop Belg, 2002;68:490–499.PubMed
5.
Zurück zum Zitat Dorr LD. Hip Arthroplasty: Minimally Invasive Techniques and Computer Navigation. 1st ed. Philadelphia, PA: WB Saunders; 2005. Dorr LD. Hip Arthroplasty: Minimally Invasive Techniques and Computer Navigation. 1st ed. Philadelphia, PA: WB Saunders; 2005.
6.
Zurück zum Zitat Flecher X, Parratte S, Brassart N, Aubaniac JM, Argenson JN. Evaluation of the hip center in total hip arthroplasty for old development dysplasia. J Arthroplasty. 2008;23:1189–1196.CrossRefPubMed Flecher X, Parratte S, Brassart N, Aubaniac JM, Argenson JN. Evaluation of the hip center in total hip arthroplasty for old development dysplasia. J Arthroplasty. 2008;23:1189–1196.CrossRefPubMed
7.
Zurück zum Zitat Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.PubMed Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.PubMed
8.
Zurück zum Zitat Heaton K, Dorr LD. Surgical release of iliopsoas tendon for groin pain after total hip arthroplasty. J Arthroplasty. 2002;17:779–781.CrossRefPubMed Heaton K, Dorr LD. Surgical release of iliopsoas tendon for groin pain after total hip arthroplasty. J Arthroplasty. 2002;17:779–781.CrossRefPubMed
9.
Zurück zum Zitat Johnston RC, Brand RA, Crownenshield RD. Reconstruction of the hip. A mathematical approach to determine optimum geometric relationships. J Bone Joint Surg Am. 1979;61:639–652.PubMed Johnston RC, Brand RA, Crownenshield RD. Reconstruction of the hip. A mathematical approach to determine optimum geometric relationships. J Bone Joint Surg Am. 1979;61:639–652.PubMed
10.
Zurück zum Zitat Karachalios T, Hartofilakidis G, Zacharakis N, Tsekoura M. A 12- to 18-year radiographic follow-up study of Charnley low-friction arthroplasty. The role of the center of rotation. Clin Orthop Relat Res. 1993;296:140–147.PubMed Karachalios T, Hartofilakidis G, Zacharakis N, Tsekoura M. A 12- to 18-year radiographic follow-up study of Charnley low-friction arthroplasty. The role of the center of rotation. Clin Orthop Relat Res. 1993;296:140–147.PubMed
11.
Zurück zum Zitat Krishnan SP, Carrington RW, Mohiyaddin S, Garlick N. Common misconceptions of normal hip joint relations on pelvic radiographs. J Arthroplasty. 2006;21:409–412.CrossRefPubMed Krishnan SP, Carrington RW, Mohiyaddin S, Garlick N. Common misconceptions of normal hip joint relations on pelvic radiographs. J Arthroplasty. 2006;21:409–412.CrossRefPubMed
12.
Zurück zum Zitat Kurtz WB, Ecker TM, Reichmann WM, Murphy SB. Factors affecting bony impingement in hip arthroplasty. J Arthroplasty. 2010;25:624–634.CrossRefPubMed Kurtz WB, Ecker TM, Reichmann WM, Murphy SB. Factors affecting bony impingement in hip arthroplasty. J Arthroplasty. 2010;25:624–634.CrossRefPubMed
13.
Zurück zum Zitat Little NJ, Busch CA, Gallagher JA, Rorabeck CH, Bourne RB. Acetabular polyethylene wear and acetabular inclination and femoral offset. Clin Orthop Relat Res. 2009;467:2895–2900.CrossRefPubMed Little NJ, Busch CA, Gallagher JA, Rorabeck CH, Bourne RB. Acetabular polyethylene wear and acetabular inclination and femoral offset. Clin Orthop Relat Res. 2009;467:2895–2900.CrossRefPubMed
14.
Zurück zum Zitat Long WT, Dastane M, Harris MJ, Wan Z, Dorr LD. Failure of the Durom Metasul acetabular component. Clin Orthop Relat Res. 2010;468:400–405.CrossRefPubMed Long WT, Dastane M, Harris MJ, Wan Z, Dorr LD. Failure of the Durom Metasul acetabular component. Clin Orthop Relat Res. 2010;468:400–405.CrossRefPubMed
15.
Zurück zum Zitat Loughead JM, Chesney D, Holland JP, McCaskie AW. Comparison of offset in Birmingham hip resurfacing and hybrid total hip arthroplasty. J Bone Joint Surg Br. 2005;87:163–166.CrossRefPubMed Loughead JM, Chesney D, Holland JP, McCaskie AW. Comparison of offset in Birmingham hip resurfacing and hybrid total hip arthroplasty. J Bone Joint Surg Br. 2005;87:163–166.CrossRefPubMed
16.
Zurück zum Zitat Malik A, Maheshwari A, Dorr LD. Impingement with total hip replacement. J Bone Joint Surg Am. 2007;89:1832–1842.CrossRefPubMed Malik A, Maheshwari A, Dorr LD. Impingement with total hip replacement. J Bone Joint Surg Am. 2007;89:1832–1842.CrossRefPubMed
17.
Zurück zum Zitat McGrory BJ, Morrey BJ, Cahalan TD, An KN, Cabanela ME. Effect of femoral offset on range of motion and abductor muscle strength after total hip arthroplasty. J Bone Joint Surg Br. 1995;77:865–869.PubMed McGrory BJ, Morrey BJ, Cahalan TD, An KN, Cabanela ME. Effect of femoral offset on range of motion and abductor muscle strength after total hip arthroplasty. J Bone Joint Surg Br. 1995;77:865–869.PubMed
18.
Zurück zum Zitat Pagnano MW, Hanssen AD, Lewallen DG, Shaughnessy WJ. Effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg Am. 1996;78:1004–1014.PubMed Pagnano MW, Hanssen AD, Lewallen DG, Shaughnessy WJ. Effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg Am. 1996;78:1004–1014.PubMed
19.
Zurück zum Zitat Ranawat CS, Dorr LD, Inglis AE. Total hip arthroplasty in protusio acetabuli of rheumatoid arthritis. J Bone Joint Surg Am. 1980;62:1059–1065.PubMed Ranawat CS, Dorr LD, Inglis AE. Total hip arthroplasty in protusio acetabuli of rheumatoid arthritis. J Bone Joint Surg Am. 1980;62:1059–1065.PubMed
20.
Zurück zum Zitat Ranawat CS, Rao RR, Rodriguez JA, Bhende HS. Correction of limb-length inequality during total hip arthroplasty. J Arthroplasty. 2001;16:715–720.CrossRefPubMed Ranawat CS, Rao RR, Rodriguez JA, Bhende HS. Correction of limb-length inequality during total hip arthroplasty. J Arthroplasty. 2001;16:715–720.CrossRefPubMed
21.
Zurück zum Zitat Ranawat CS, Rodriguez JA. Functional leg-length inequality following total hip arthroplasty. J Arthroplasty. 1997;12:359–364.CrossRefPubMed Ranawat CS, Rodriguez JA. Functional leg-length inequality following total hip arthroplasty. J Arthroplasty. 1997;12:359–364.CrossRefPubMed
22.
Zurück zum Zitat Renkawitz T, Schuster T, Herold T, Goessmann H, Sendtner E, Grifka J, Kalteis T. Measuring leg length and offset with an imageless navigation system during total hip arthroplasty: is it really accurate? Int J Med Robot. 2009;5:192–197.PubMed Renkawitz T, Schuster T, Herold T, Goessmann H, Sendtner E, Grifka J, Kalteis T. Measuring leg length and offset with an imageless navigation system during total hip arthroplasty: is it really accurate? Int J Med Robot. 2009;5:192–197.PubMed
23.
Zurück zum Zitat Resnick D. Bone and Joint Imaging. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2005. Resnick D. Bone and Joint Imaging. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2005.
24.
Zurück zum Zitat Sakalkale DP, Sharkey PF, Eng K, Hozack WJ, Rothman RH. Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res. 2001;388:125–134.CrossRefPubMed Sakalkale DP, Sharkey PF, Eng K, Hozack WJ, Rothman RH. Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res. 2001;388:125–134.CrossRefPubMed
25.
Zurück zum Zitat Silva, M, Lee KH, Heisel C, Dela Rosa MS, Schmalzried TP. The biomechanical results of total hip resurfacing arthroplasty. J Bone Joint Surg Am. 2004;86-A:40–60. Silva, M, Lee KH, Heisel C, Dela Rosa MS, Schmalzried TP. The biomechanical results of total hip resurfacing arthroplasty. J Bone Joint Surg Am. 2004;86-A:40–60.
26.
Zurück zum Zitat Stans AA, Pagnano MW, Shaughnessy WJ, Hanssen AD. Results of total hip arthroplasty for Crowe type III developmental hip dysplasia. Clin Orthop Relat Res. 1998;348:149–157.CrossRefPubMed Stans AA, Pagnano MW, Shaughnessy WJ, Hanssen AD. Results of total hip arthroplasty for Crowe type III developmental hip dysplasia. Clin Orthop Relat Res. 1998;348:149–157.CrossRefPubMed
27.
Zurück zum Zitat Sugano N, Noble PC, Kamaric E. Predicting the position of the femoral head center. J Arthroplasty. 1999;14:102–107.CrossRefPubMed Sugano N, Noble PC, Kamaric E. Predicting the position of the femoral head center. J Arthroplasty. 1999;14:102–107.CrossRefPubMed
28.
Zurück zum Zitat Yoder SA, Brand RA, Pedersen DR, O’Gorman TW. Total hip acetabular component position affects component loosening rates. Clin Orthop Relat Res. 1988;228:79–87.PubMed Yoder SA, Brand RA, Pedersen DR, O’Gorman TW. Total hip acetabular component position affects component loosening rates. Clin Orthop Relat Res. 1988;228:79–87.PubMed
Metadaten
Titel
Hip Offset in Total Hip Arthroplasty: Quantitative Measurement with Navigation
verfasst von
Manish Dastane, MD
Lawrence D. Dorr, MD
Rupesh Tarwala, MD
Zhinian Wan, MD
Publikationsdatum
01.02.2011
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 2/2011
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1554-7

Weitere Artikel der Ausgabe 2/2011

Clinical Orthopaedics and Related Research® 2/2011 Zur Ausgabe

Symposium: Papers Presented at the Hip Society Meetings 2010

Wear versus Thickness and Other Features of 5-Mrad Crosslinked UHMWPE Acetabular Liners

Symposium: Papers Presented at the Hip Society Meetings 2010

Improving Cup Positioning Using a Mechanical Navigation Instrument

Symposium: Papers Presented at the Hip Society Meetings 2010

A Monoblock Porous Tantalum Acetabular Cup Has No Osteolysis on CT at 10 Years

Symposium: Papers Presented at the Hip Society Meetings 2010

THA After Acetabular Fracture Fixation: Is Frozen Section Necessary?

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.