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The influence of the centre of rotation on implant survival using a modular stem hip prosthesis

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Abstract

The restoration of the hip centre of rotation in an anatomical position is considered to be relevant for total hip prosthesis survival. When the cup is implanted with a high centre of rotation, the lever arm of the abductor muscles is decreased, causing higher joint-reaction forces. Modular stems with varying lengths and geometries can be used to balance soft tissues, and ceramic bearing surfaces can be used to reduce the wear rate. Forty-four hip replacements performed with a high hip centre of rotation were matched with 44 performed with an anatomical centre of rotation. In all cases the preoperative diagnosis was dysplasia of the hip (DDH) and cementless modular neck prostheses with ceramic bearing surfaces were used. At nine years follow-up the mean Harris hip and WOMAC scores were not statistically different. All stems and cups were stable; the femoral offset was no different between the two groups (p = 0.4) as leg-length discrepancy (p = 0.25).

Résumé

On considère important pour la survie de la prothèse totale de la hanche que le centre de rotation soit rétabli en position anatomique. Quand le cotyle est implanté avec un centre de rotation haut, le bras de levier des muscles abducteurs se raccourcit et cause des majeures forces de réaction de l’articulation. Les tiges modulaires à longueurs et géométries variables peuvent être utilisés pour balancer les tissus mous, et les couples de frottement en céramique peuvent être utilisés pour réduire l’usure. Quarante-quatre prothèses totales de hanche réalisées avec un centre de rotation haut ont été confrontées avec 44 prothèses réalisées avec un centre de rotation anatomique. Tous les patients souffraient de dysplasie développementale de la hanche et on a utilisé une prothèse sans ciment avec un cou modulaire et avec les couples de frottement en céramique. Les résultats à 9 ans des scores Harris et WOMAC n’étaient pas statistiquement différents. Tous les cotyles et les tiges étaient stables; l’offset fémoral (p = 0,4) et la différence de longueur des membres inférieurs (p = 0,25) n’était pas différents dans les deux groupes.

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Authors and Affiliations

  1. 1st Department of Orthopaedic Surgery and Laboratory of Medical Technology (LTM), Istituti Ortopedici Rizzoli, Via Pupilli 1, Bologna, Italy, 40136

    Francesco Traina & Aldo Toni

  2. 1st Department of Orthopaedic Surgery, Istituti Ortopedici Rizzoli, Via Pupilli 1, Bologna, Italy, 40136

    Marcello De Fine, Federico Biondi, Enrico Tassinari & Andrea Galvani

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  1. Francesco Traina
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  2. Marcello De Fine
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  3. Federico Biondi
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  4. Enrico Tassinari
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  5. Andrea Galvani
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  6. Aldo Toni
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Correspondence to Francesco Traina.

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Traina, F., De Fine, M., Biondi, F. et al. The influence of the centre of rotation on implant survival using a modular stem hip prosthesis. International Orthopaedics (SICOT) 33, 1513–1518 (2009). https://doi.org/10.1007/s00264-008-0710-0

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  • DOI: https://doi.org/10.1007/s00264-008-0710-0

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