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Optimal anterior femoral offset for functional range of motion in total hip arthroplasty—a computer simulation study

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Abstract

Purpose

Compared to medial femoral offset (MFO), the role of anterior femoral offset (AFO) on range of motion (ROM) in total hip arthroplasty (THA) has not been fully examined. We therefore defined AFO as the anterior distance from the centre of the femoral head to the proximal femoral axis in the sagittal plane and determined the optimal AFO required for ROM needed for activities of daily living using a computer-simulated THA model.

Methods

Various AFOs were obtained by changing stem anteversion (stem-AV) and stem tilt in the sagittal plane (stem-tilt) using a CT-based simulation software. The required ROM was defined as: flexion ≥ 110°, internal rotation at 90° flexion (IR) ≥ 30°, external rotation (ER) ≥ 30°, and extension ≥ 30°, and we determined AFO and MFO to satisfy required ROM.

Results

AFO was positively correlated with stem-AV and anterior stem-tilt. MFO was negatively correlated with stem-AV and not influenced by stem-tilt. Flexion and IR increased with both increased AFO and MFO, whereas extension and ER decreased with increased AFO. A smoothing spline curve showed the optimal AFO and MFO for required ROM to be from 15 mm to 25 mm on average and more than 32.1 mm, respectively.

Conclusions

This is the first study to show that AFO directly influenced ROM in THA. Optimal AFO as well as MFO should be reconstructed to achieve sufficient ROM.

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Acknowledgments

This work was supported by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (No. 24592268). We thank Junji Kishimoto, a statistician from the Digital Medicine Initiative, Kyushu University, for his valuable comments and suggestions in regards to the statistical analysis.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Masanobu Hirata, Yasuharu Nakashima, Daisuke Hara, Masayuki Kanazawa, Yusuke Kohno, Kensei Yoshimoto & Yukihide Iwamoto

Authors
  1. Masanobu Hirata
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  2. Yasuharu Nakashima
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  3. Daisuke Hara
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  4. Masayuki Kanazawa
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  5. Yusuke Kohno
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  6. Kensei Yoshimoto
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  7. Yukihide Iwamoto
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Corresponding author

Correspondence to Yasuharu Nakashima.

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Hirata, M., Nakashima, Y., Hara, D. et al. Optimal anterior femoral offset for functional range of motion in total hip arthroplasty—a computer simulation study. International Orthopaedics (SICOT) 39, 645–651 (2015). https://doi.org/10.1007/s00264-014-2538-0

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  • DOI: https://doi.org/10.1007/s00264-014-2538-0

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