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Erschienen in: International Orthopaedics 1/2014

01.01.2014 | Original Paper

Combined anteversion technique reduced the dislocation in cementless total hip arthroplasty

verfasst von: Yasuharu Nakashima, Masanobu Hirata, Mio Akiyama, Takashi Itokawa, Takuaki Yamamoto, Goro Motomura, Masanobu Ohishi, Satoshi Hamai, Yukihide Iwamoto

Erschienen in: International Orthopaedics | Ausgabe 1/2014

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Abstract

Purpose

The combined anteversion (CA) technique is a method in which the cup is placed according to the stem anteversion in total hip arthroplasty (THA). We examined whether the CA technique reduced the dislocation rate, and the distribution of CA with the manual placement of the cup.

Methods

We retrospectively reviewed 634 hips in 579 patients with primary cementless THA. In 230 hips using the CA technique [CA(+)], a CA of 50 ± 10° was the aim. In the remaining 404 hips [CA(−)], the cup was first placed targeting 20° of anteversion. The post-operative CA was measured using the computed tomography (CT) images in 111 hips.

Results

One hip (0.4 %) had a dislocation in the CA(+) group, whereas ten hips (2.5 %) had a dislocation in the CA(−) group. A multivariate analysis showed that primary diagnosis, head size and CA technique significantly influenced the dislocation rate. Patients in the CA(−) group were 5.8 times more likely to have a dislocation compared to the CA(+) group. In the 111 hips with CT images, 81 hips (73.0 %) achieved the intended CA.

Conclusions

Although the manual placement of the cup resulted in 27 % of outliers from the intended CA, the CA technique significantly reduced the dislocation after primary THA.
Literatur
1.
Zurück zum Zitat Malik A, Maheshwari A, Dorr LD (2007) Impingement with total hip replacement. J Bone Joint Surg Am 89:1832–1842PubMedCrossRef Malik A, Maheshwari A, Dorr LD (2007) Impingement with total hip replacement. J Bone Joint Surg Am 89:1832–1842PubMedCrossRef
2.
Zurück zum Zitat Sato T, Nakashima Y, Akiyama M et al (2012) Wear resistant performance of highly cross-linked and annealed ultra-high molecular weight polyethylene against ceramic femoral heads in total hip arthroplasty. J Orthop Res 30:2031–2037PubMedCrossRef Sato T, Nakashima Y, Akiyama M et al (2012) Wear resistant performance of highly cross-linked and annealed ultra-high molecular weight polyethylene against ceramic femoral heads in total hip arthroplasty. J Orthop Res 30:2031–2037PubMedCrossRef
3.
Zurück zum Zitat Wan Z, Boutary M, Dorr LD (2008) The influence of acetabular component position on wear in total hip arthroplasty. J Arthroplasty 23:51–56PubMedCrossRef Wan Z, Boutary M, Dorr LD (2008) The influence of acetabular component position on wear in total hip arthroplasty. J Arthroplasty 23:51–56PubMedCrossRef
4.
Zurück zum Zitat Hernigou P, Ratte L, Roubineau F et al (2013) The risk of dislocation after total hip arthroplasty for fractures is decreased with retentive cups. Int Orthop 37(7):1219–1223PubMedCrossRef Hernigou P, Ratte L, Roubineau F et al (2013) The risk of dislocation after total hip arthroplasty for fractures is decreased with retentive cups. Int Orthop 37(7):1219–1223PubMedCrossRef
5.
Zurück zum Zitat Philippot R, Camilleri JP, Boyer B, Adam P, Farizon F (2009) The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty: analysis of 384 cases at a mean follow-up of 15 years. Int Orthop 33(4):927–932PubMedCentralPubMedCrossRef Philippot R, Camilleri JP, Boyer B, Adam P, Farizon F (2009) The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty: analysis of 384 cases at a mean follow-up of 15 years. Int Orthop 33(4):927–932PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Bosker BH, Ettema HB, Verheyen CC, Castelein RM (2009) Acetabular augmentation ring for recurrent dislocation of total hip arthroplasty: 60% stability rate after an average follow-up of 74 months. Int Orthop 33(1):49–52PubMedCentralPubMedCrossRef Bosker BH, Ettema HB, Verheyen CC, Castelein RM (2009) Acetabular augmentation ring for recurrent dislocation of total hip arthroplasty: 60% stability rate after an average follow-up of 74 months. Int Orthop 33(1):49–52PubMedCentralPubMedCrossRef
7.
Zurück zum Zitat Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR (1978) Dislocations after total hip replacement arthroplasties. J Bone Joint Surg Am 60:217–220PubMed Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR (1978) Dislocations after total hip replacement arthroplasties. J Bone Joint Surg Am 60:217–220PubMed
8.
Zurück zum Zitat Akiyama M, Nakashima Y, Fujii M et al (2012) Femoral anteversion is correlated with acetabular version and coverage in Asian woman with anterior and global deficient subgroups of hip dysplasia: a CT study. Skeletal Radiol 41:1411–1418PubMedCrossRef Akiyama M, Nakashima Y, Fujii M et al (2012) Femoral anteversion is correlated with acetabular version and coverage in Asian woman with anterior and global deficient subgroups of hip dysplasia: a CT study. Skeletal Radiol 41:1411–1418PubMedCrossRef
9.
Zurück zum Zitat Maruyama M, Feinberg JR, Capello WN, D’Antonio JA (2001) The Frank Stinchfield Award: Morphologic features of the acetabulum and femur: anteversion angle and implant positioning. Clin Orthop Relat Res 393:52–65PubMedCrossRef Maruyama M, Feinberg JR, Capello WN, D’Antonio JA (2001) The Frank Stinchfield Award: Morphologic features of the acetabulum and femur: anteversion angle and implant positioning. Clin Orthop Relat Res 393:52–65PubMedCrossRef
10.
Zurück zum Zitat Matsushita A, Nakashima Y, Fujii M, Sato T, Iwamoto Y (2010) Modular necks improve the range of hip motion in cases with excessively anteverted or retroverted femurs in THA. Clin Orthop Relat Res 468:3342–3347PubMedCrossRef Matsushita A, Nakashima Y, Fujii M, Sato T, Iwamoto Y (2010) Modular necks improve the range of hip motion in cases with excessively anteverted or retroverted femurs in THA. Clin Orthop Relat Res 468:3342–3347PubMedCrossRef
11.
Zurück zum Zitat Ranawat CS, Maynard MJ (1991) Modern techniques of cemented total hip arthroplasty. Tech Orthop 6:17–25CrossRef Ranawat CS, Maynard MJ (1991) Modern techniques of cemented total hip arthroplasty. Tech Orthop 6:17–25CrossRef
12.
Zurück zum Zitat Widmer KH, Zurfluh B (2004) Compliant positioning of total hip components for optimal range of motion. J Orthop Res 22:815–821PubMedCrossRef Widmer KH, Zurfluh B (2004) Compliant positioning of total hip components for optimal range of motion. J Orthop Res 22:815–821PubMedCrossRef
13.
Zurück zum Zitat Masaoka T, Yamamoto K, Shishido T, Katori Y, Mizoue T, Shirasu H, Nunoda D (2006) Study of hip joint dislocation after total hip arthroplasty. Int Orthop 30(1):26–30PubMedCentralPubMedCrossRef Masaoka T, Yamamoto K, Shishido T, Katori Y, Mizoue T, Shirasu H, Nunoda D (2006) Study of hip joint dislocation after total hip arthroplasty. Int Orthop 30(1):26–30PubMedCentralPubMedCrossRef
14.
Zurück zum Zitat Dorr LD, Malik A, Dastane M, Wan Z (2009) Combined anteversion technique for total hip arthroplasty. Clin Orthop Relat Res 467:119–127PubMedCrossRef Dorr LD, Malik A, Dastane M, Wan Z (2009) Combined anteversion technique for total hip arthroplasty. Clin Orthop Relat Res 467:119–127PubMedCrossRef
15.
Zurück zum Zitat Jolles BM, Zangger P, Leyvraz PF (2002) Factors predisposing to dislocation after primary total hip arthroplasty: a multivariate analysis. J Arthroplasty 17:282–288PubMedCrossRef Jolles BM, Zangger P, Leyvraz PF (2002) Factors predisposing to dislocation after primary total hip arthroplasty: a multivariate analysis. J Arthroplasty 17:282–288PubMedCrossRef
16.
Zurück zum Zitat Emerson RH Jr (2012) Increased anteversion of press-fit femoral stems compared with anatomic femur. Clin Orthop Relat Res 470:477–481PubMedCrossRef Emerson RH Jr (2012) Increased anteversion of press-fit femoral stems compared with anatomic femur. Clin Orthop Relat Res 470:477–481PubMedCrossRef
17.
Zurück zum Zitat Renkawitz T, Hamerl M, Dohmen L et al (2011) Minimally invasive computer-navigated total hip arthroplasty, following the concept of femur first and combined anteversion: design of a blinded randomized controlled trial. BMC Musculoskelet Disord 12:192PubMedCentralPubMedCrossRef Renkawitz T, Hamerl M, Dohmen L et al (2011) Minimally invasive computer-navigated total hip arthroplasty, following the concept of femur first and combined anteversion: design of a blinded randomized controlled trial. BMC Musculoskelet Disord 12:192PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat Wiberg G (1939) Studies on dysplastic acetabula and congenital subluxation of the hip joint with special reference to the complication of osteoarthritis. Acta Chir Scand 83(Suppl 58):5–135 Wiberg G (1939) Studies on dysplastic acetabula and congenital subluxation of the hip joint with special reference to the complication of osteoarthritis. Acta Chir Scand 83(Suppl 58):5–135
19.
Zurück zum Zitat Nakashima Y, Hayashi K, Inadome T, Uenoyama K, Hara T, Kanemaru T, Sugioka Y, Noda I (1997) Hydroxyapatite-coating on titanium arc sprayed titanium implants. J Biomed Mater Res 35:287–298PubMedCrossRef Nakashima Y, Hayashi K, Inadome T, Uenoyama K, Hara T, Kanemaru T, Sugioka Y, Noda I (1997) Hydroxyapatite-coating on titanium arc sprayed titanium implants. J Biomed Mater Res 35:287–298PubMedCrossRef
20.
Zurück zum Zitat Inaba Y, Dorr LD, Wan Z, Sirianni L, Boutary M (2005) Operative and patient care techniques for posterior mini-incision total hip arthroplasty. Clin Orthop Relat Res 441:104–114PubMedCrossRef Inaba Y, Dorr LD, Wan Z, Sirianni L, Boutary M (2005) Operative and patient care techniques for posterior mini-incision total hip arthroplasty. Clin Orthop Relat Res 441:104–114PubMedCrossRef
21.
Zurück zum Zitat Murray DW (1993) The definition and measurement of acetabular orientation. J Bone Joint Surg Br 75:228–232PubMed Murray DW (1993) The definition and measurement of acetabular orientation. J Bone Joint Surg Br 75:228–232PubMed
22.
Zurück zum Zitat Zhang Y, Tang Y, Zhang C, Zhao X, Xie Y, Xu S (2013) Modified posterior soft tissue repair for the prevention of early postoperative dislocation in total hip arthroplasty. Int Orthop 37(6):1039–1044PubMedCrossRef Zhang Y, Tang Y, Zhang C, Zhao X, Xie Y, Xu S (2013) Modified posterior soft tissue repair for the prevention of early postoperative dislocation in total hip arthroplasty. Int Orthop 37(6):1039–1044PubMedCrossRef
23.
Zurück zum Zitat Sugano N, Noble PC, Kamaric E (1998) A comparison of alternative methods of measuring femoral anteversion. J Comput Assist Tomogr 22:610–614PubMedCrossRef Sugano N, Noble PC, Kamaric E (1998) A comparison of alternative methods of measuring femoral anteversion. J Comput Assist Tomogr 22:610–614PubMedCrossRef
24.
Zurück zum Zitat Pierchon F, Pasquier G, Cotten A, Fontaine C, Clarisse J, Duquennoy A (1994) Causes of dislocation of total hip arthroplasty. CT study of component alignment. J Bone Joint Surg Br 76:45–48PubMed Pierchon F, Pasquier G, Cotten A, Fontaine C, Clarisse J, Duquennoy A (1994) Causes of dislocation of total hip arthroplasty. CT study of component alignment. J Bone Joint Surg Br 76:45–48PubMed
25.
Zurück zum Zitat Wines AP, McNicol D (2006) Computed tomography measurement of the accuracy of component version in total hip arthroplasty. J Arthroplasty 21:696–701PubMedCrossRef Wines AP, McNicol D (2006) Computed tomography measurement of the accuracy of component version in total hip arthroplasty. J Arthroplasty 21:696–701PubMedCrossRef
26.
Zurück zum Zitat Ji HM, Kim KC, Lee YK, Ha YC, Koo KH (2012) Dislocation after total hip arthroplasty: a randomized clinical trial of a posterior approach and a modified lateral approach. J Arthroplasty 27:378–385PubMedCrossRef Ji HM, Kim KC, Lee YK, Ha YC, Koo KH (2012) Dislocation after total hip arthroplasty: a randomized clinical trial of a posterior approach and a modified lateral approach. J Arthroplasty 27:378–385PubMedCrossRef
27.
Zurück zum Zitat Berry DJ, von Knoch M, Schleck CD, Harmsen WS (2005) Effect of femoral head diameter and operative approach on risk of dislocation after primary total hip arthroplasty. J Bone Joint Surg Am 87:2456–2463PubMedCrossRef Berry DJ, von Knoch M, Schleck CD, Harmsen WS (2005) Effect of femoral head diameter and operative approach on risk of dislocation after primary total hip arthroplasty. J Bone Joint Surg Am 87:2456–2463PubMedCrossRef
28.
Zurück zum Zitat Matsushita A, Nakashima Y, Jingushi S, Yamamoto T, Kuraoka A, Iwamoto Y (2009) Effects of the femoral offset and the head size on the safe range of motion in total hip arthroplasty. J Arthroplasty 24:646–651PubMedCrossRef Matsushita A, Nakashima Y, Jingushi S, Yamamoto T, Kuraoka A, Iwamoto Y (2009) Effects of the femoral offset and the head size on the safe range of motion in total hip arthroplasty. J Arthroplasty 24:646–651PubMedCrossRef
29.
Zurück zum Zitat Boyer B, Philippot R, Geringer J, Farizon F (2012) Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips. Int Orthop 36(3):511–518PubMedCentralPubMedCrossRef Boyer B, Philippot R, Geringer J, Farizon F (2012) Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips. Int Orthop 36(3):511–518PubMedCentralPubMedCrossRef
30.
Zurück zum Zitat DiGioia AM 3rd, Jaramaz B, Plakseychuk AY et al (2002) Comparison of a mechanical acetabular alignment guide with computer placement of the socket. J Arthroplasty 17:359–364PubMedCrossRef DiGioia AM 3rd, Jaramaz B, Plakseychuk AY et al (2002) Comparison of a mechanical acetabular alignment guide with computer placement of the socket. J Arthroplasty 17:359–364PubMedCrossRef
31.
Zurück zum Zitat Müller M, Crucius D, Perka C, Tohtz S (2011) The association between the sagittal femoral stem alignment and the resulting femoral head centre in total hip arthroplasty. Int Orthop 35:981–987PubMedCentralPubMedCrossRef Müller M, Crucius D, Perka C, Tohtz S (2011) The association between the sagittal femoral stem alignment and the resulting femoral head centre in total hip arthroplasty. Int Orthop 35:981–987PubMedCentralPubMedCrossRef
32.
Zurück zum Zitat Jolles BM, Genoud P, Hoffmeyer P (2004) Computer-assisted cup placement techniques in total hip arthroplasty improve accuracy of placement. Clin Orthop Relat Res 426:174–179PubMedCrossRef Jolles BM, Genoud P, Hoffmeyer P (2004) Computer-assisted cup placement techniques in total hip arthroplasty improve accuracy of placement. Clin Orthop Relat Res 426:174–179PubMedCrossRef
Metadaten
Titel
Combined anteversion technique reduced the dislocation in cementless total hip arthroplasty
verfasst von
Yasuharu Nakashima
Masanobu Hirata
Mio Akiyama
Takashi Itokawa
Takuaki Yamamoto
Goro Motomura
Masanobu Ohishi
Satoshi Hamai
Yukihide Iwamoto
Publikationsdatum
01.01.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 1/2014
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-2091-2

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