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Archives of Orthopaedic and Trauma Surgery

, Volume 137, Issue 11, pp 1579–1585 | Cite as

Effect of changes of femoral offset on abductor and joint reaction forces in total hip arthroplasty

  • Hannes A. Rüdiger
  • Maïka Guillemin
  • Adeliya Latypova
  • Alexandre Terrier
Hip Arthroplasty

Abstract

Background

Anatomical reconstruction in total hip arthroplasty (THA) allows for physiological muscle function, good functional outcome and implant longevity. Quantitative data on the effect of a loss or gain of femoral offset (FO) are scarce. The aim of this study was to quantitatively describe the effect of FO changes on abductor moment arms, muscle and joint reactions forces.

Methods

THA was virtually performed on 3D models built from preoperative CT scans of 15 patients undergoing THA. Virtual THA was performed with a perfectly anatomical reconstruction, a loss of 20% of FO (−FO), and a gain of 20% of FO (+FO). These models were combined with a generic musculoskeletal model (OpenSim) to predict moment arms, muscle and joint reaction forces during normal gait cycles.

Results

In average, with −FO reconstructions, muscle moment arms decreased, while muscle and hip forces increased significantly (p < 0.001). We observed the opposite with +FO reconstructions. Gluteus medius was more affected than gluteus minimus. −FO had more effect than +FO. A change of 20% of FO induced an average change 8% of abductor moment arms, 16% of their forces, and 6% of the joint reaction force.

Conclusions

To our knowledge, this is the first report providing quantitative data on the effect of FO changes on muscle and joint forces during normal gait. A decrease of FO necessitates an increase of abductor muscle force to maintain normal gait, which in turn increases the joint reaction force. This effect underscores the importance of an accurate reconstruction of the femoral offset.

Keywords

Hip Arthroplasty Femoral offset Patient-specific musculoskeletal modeling Muscle Moment arm Joint force 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study is based on previously published finite element models, which are derived from CT scans of 15 of our patients. The use of this numeric model has been approved by our IRB.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Hannes A. Rüdiger
    • 1
    • 2
  • Maïka Guillemin
    • 3
  • Adeliya Latypova
    • 3
  • Alexandre Terrier
    • 3
  1. 1.Department of Orthopaedics and TraumatologyCentre Hospitalier Universitaire Vaudois CHUVLausanneSwitzerland
  2. 2.Department of Orthopaedic SurgerySchulthess ClinicZurichSwitzerland
  3. 3.Laboratory of Biomechanical OrthopedicsEcole Polytechnique Fédérale de LausanneLausanneSwitzerland

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