Skip to main content
SpringerLink
Log in

Functional implications of femoral offset following hemiarthroplasty for displaced femoral neck fracture

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

Inadequate reconstruction of femoral offset after total hip arthroplasty (THA) is associated with unfavourable outcomes, but its importance following hemiarthroplasty for displaced femoral neck fracture is unknown.

Methods

Our study examined the correlation between reconstructed femoral offset and functional outcome 12 months after post traumatic hemiarthroplasty in 126 prospectively enrolled elderly patients. Rotation-corrected femoral offset (FORC), relative femoral offset (FORL) and contralateral femoral offset (FOC) were measured on anteroposterior radiographs. The Harris Hip Score (HHS) was the primary outcome measure; the timed up and go (TUG) test and Lawton instrumental activities of daily living (IADL) score were secondary outcomes. Correlations were sought using the Spearman correlation coefficient (r). Sample size was calculated using an Altman nomogram, with the power set at 80 %, the significance level of 0.05 and a standardised difference of 0.75.

Results

The mean reconstructed FORC was 41 mm (17–67 mm) and showed a linear relationship and excellent correlation with the FOC. At 12 months, we found a significant positive correlation between FORC and HHS (r = 0.303, p = 0.025) and IADL (r = 0.325, p = 0.013), but not TUG (r = −0.026, p = 0.863). These findings were confirmed by bivariate and multivariate correlation between FORL and functional outcome parameters.

Conclusions

We found a clinically relevant relationship between femoral offset and functional outcome after hemiarthroplasty in elderly patients, comparable with that of THA, for treating osteoarthritis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Khan MA, Hossain FS, Ahmed I, Muthukumar N, Mohsen A (2013) Predictors of early mortality after hip fracture surgery. Int Orthop 37(11):2119–2124

    Article  PubMed  PubMed Central  Google Scholar 

  2. Buecking B, Eschbach D, Koutras C, Kratz T, Balzer-Geldsetzer M, Dodel R, Ruchholtz S (2013) Re-admission to Level 2 unit after hip-fracture surgery - Risk factors, reasons and outcome. Injury 44:1919–1925

    Article  PubMed  Google Scholar 

  3. Hedbeck CJ, Blomfeldt R, Lapidus G, Törnkvist H, Ponzer S, Tidermark J (2011) Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in the most elderly patients with displaced femoral neck fractures: a randomised, controlled trial. Int Orthop 35(11):1703–1711

    Article  PubMed  PubMed Central  Google Scholar 

  4. Hartel M, Arndt M, Eulenburg CZ, Petersen JP, Rueger JM, Hoffmann M (2014) Restoration of hip architecture with bipolar hemiarthroplasty in the elderly: does it affect early functional outcome? Arch Orthop Trauma Surg 134:31–38

    Article  PubMed  Google Scholar 

  5. Bourne RB, Rorabeck CH (2002) Soft tissue balancing: the hip. J Arthroplasty 17:17–22

    Article  PubMed  Google Scholar 

  6. Lechler P, Frink M, Gulati A, Murray D, Renkawitz T, Bücking B, Ruchholtz S, Boese CK (2014) The influence of hip rotation on femoral offset in plain radiographs. Acta Orthop 85:389–395

    Article  PubMed  PubMed Central  Google Scholar 

  7. Weber M, Lechler P, von Kunow F, Völlner F, Keshmiri A, Hapfelmeier A, Grifka J, Renkawitz T (2015) Validity of a novel radiographic method for measuring femoral stem torsion on anteroposterior hip radiographs after total hip arthroplasty. Bone Joint J 97-B:306–311

    Article  CAS  PubMed  Google Scholar 

  8. Gore SM, Altman DG (1982) Statistics in practice. British Medical Association, London

    Google Scholar 

  9. Talsnes O, Hjelmstedt F, Dahl OE, Pripp AH, Reikerås O (2011) Clinical and biochemical prediction of early fatal outcome following hip fracture in the elderly. Int Orthop 35(6):903–907

    Article  PubMed  Google Scholar 

  10. Laflamme GY, Rouleau DM, Leduc S, Roy L, Beaumont E (2012) The Timed Up and Go test is an early predictor of functional outcome after hemiarthroplasty for femoral neck fracture. J Bone Joint Surg Am 94:1175–1179

    Article  PubMed  Google Scholar 

  11. Lecerf G, Fessy MH, Philippot R, Massin P, Giraud F, Flecher X, Girard J, Mertl P, Marchetti E, Stindel E (2009) Femoral offset: anatomical concept, definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol Surg Res 95:210–219

    Article  CAS  PubMed  Google Scholar 

  12. 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 24:646–651

    Article  PubMed  Google Scholar 

  13. Sariali E, Klouche S, Mouttet A, Pascal-Moussellard H (2014) The effect of femoral offset modification on gait after total hip arthroplasty. Acta Orthop 85:123–127

    Article  PubMed  PubMed Central  Google Scholar 

  14. Maloney WJ, Keeney JA (2004) Leg length discrepancy after total hip arthroplasty. J Arthroplasty 19:108–110

    Article  PubMed  Google Scholar 

  15. Sakalkale DP, Sharkey PF, Eng K, Hozack WJ, Rothman RH (2001) Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res 388:125–134

    Article  PubMed  Google Scholar 

  16. Hayashi S, Nishiyama T, Fujishiro T, Hashimoto S, Kanzaki N, Nishida K, Kuroda R, Kurosaka M (2013) Excessive femoral offset does not affect the range of motion after total hip arthroplasty. Int Orthop 37(7):1233–1237

    Article  PubMed  PubMed Central  Google Scholar 

  17. Schoene D, Wu SM, Mikolaizak AS, Menant JC, Smith ST, Delbaere K, Lord SR (2013) Discriminative ability and predictive validity of the timed up and go test in identifying older people who fall: systematic review and meta-analysis. J Am Geriatr Soc 61:202–208

    Article  PubMed  Google Scholar 

  18. Large J, Gan N, Basic D, Jennings N (2006) Using the timed up and go test to stratify elderly inpatients at risk of falls. Clin Rehabil 20:421–428

    Article  PubMed  Google Scholar 

  19. Weber M, Woerner ML, Springorum HR, Hapfelmeier A, Grifka J, Renkawitz TF (2014) Plain radiographs fail to reflect femoral offset in total hip arthroplasty. J Arthroplasty 29:1661–1665

    Article  PubMed  Google Scholar 

  20. Liebs TR, Nasser L, Herzberg W, Rüther W, Hassenpflug J (2014) The influence of femoral offset on health-related quality of life after total hip replacement. Bone Joint J 96-B:36–42

    Article  CAS  PubMed  Google Scholar 

  21. Sayed-Noor A, Sjoden G (2006) Greater trochanteric pain after total hip arthroplasty: the incidence, clinical outcome and associated factors. Hip Int 16:202

    CAS  PubMed  Google Scholar 

  22. Burgers PT, Van Geene AR, Van den Bekerom MP, Van Lieshout EM, Blom B, Aleem IS, Bhandari M, Poolman RW (2012) Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis and systematic review of randomized trials. Int Orthop 36:1549–1560

    Article  PubMed  PubMed Central  Google Scholar 

  23. Krishnan SP, Carrington RW, Mohiyaddin S, Garlick N (2006) Common misconceptions of normal hip joint relations on pelvic radiographs. J Arthroplasty 21:409–412

    Article  PubMed  Google Scholar 

  24. Stihsen C, Radl R, Keshmiri A, Rehak P, Windhager R (2012) Subsidence of a cementless femoral component influenced by body weight and body mass index. Int Orthop 36:941–947

    Article  PubMed  Google Scholar 

  25. Ström H, Kolstad K, Mallmin H, Sahlstedt B, Milbrink J (2006) Comparison of the uncemented Cone and the cemented Bimetric hip prosthesis in young patients with osteoarthritis: an RSA, clinical and radiographic study. Acta Orthop 77(1):71–78

    Article  PubMed  Google Scholar 

  26. Boese CK, Buecking B, Schwarting T, Debus F, Ruchholtz S, Bliemel C, Frink M, Lechler P (2015) The influence of pre-existing radiographic osteoarthritis on functional outcome after trochanteric fracture. Int Orthop. doi:10.1007/s00264-014-2663-9

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Trauma, Hand and Reconstructive Surgery, University of Marburg, Marburg, Germany

    Benjamin Buecking, Verena Anna Bergmeister, Michael Frink, Steffen Ruchholtz & Philipp Lechler

  2. Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, Germany

    Christoph Kolja Boese

Authors
  1. Benjamin Buecking
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christoph Kolja Boese
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Verena Anna Bergmeister
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Frink
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Steffen Ruchholtz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Philipp Lechler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Philipp Lechler.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Buecking, B., Boese, C.K., Bergmeister, V.A. et al. Functional implications of femoral offset following hemiarthroplasty for displaced femoral neck fracture. International Orthopaedics (SICOT) 40, 1515–1521 (2016). https://doi.org/10.1007/s00264-015-2828-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-015-2828-1

Keywords

Search

Navigation