A Report on Three Consecutive Cases using Computer Tomography 3D Preoperative Planning for Conversion of Arthrodesed Hips to Total Hip Replacements

Abstract

Background

Conversion of an arthrodesed hip to a total hip arthroplasty (THA) is a technically demanding procedure with high complication rates. One important issue is that determining the amount of correction for a leg length discrepancy (LLD) can be difficult at the planning stage.

Questions/Purposes

The aim of this study is to assess the reliable use of computer tomography (CT)-based three-dimensional (3D) preoperative planning for the conversion of arthrodesed hips to THAs.

Patients and Methods

CT-based preoperative 3D planning was used to convert three arthrodesed hips to THAs. The efficacy of the planning was evaluated with postoperative radiographic measurements involving the amount of correction for LLD, position of components, difference between targeted and actual values, and ratio of the moment arms. The clinical assessment was performed with the Japanese Orthopaedic Association (JOA) hip score before and after THA.

Results

The mean amount of LLD correction and median LLD after THA were 16 mm (range, 15–17 mm) and 4 mm (range, 1–10 mm), respectively. The components were implanted close to the positions recommended by the preoperative simulation. The ratio of the moment arms indicated that the converted hips were reconstructed in a biomechanically correct manner. The implants for the conversion to THA were successfully positioned with respect to anatomy and functional outcome. The median JOA hip score improved from 50 points (range, 30–66 points) preoperatively to 79 points (range, 72–86 points) at the latest follow-up.

Conclusions

CT-based preoperative 3D planning could be a powerful guidance tool for conversion of arthrodesed hips to THAs.

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Disclosures

Conflict of Interest

Yutaka Kuroda, MD, PhD, Haruhiko Akiyama, MD, PhD, Manabu Nankaku, BS, MS, Kazutaka So, MD, PhD, Koji Goto, MD, PhD and Shuichi Matsuda, MD, PhD have declared that they have no conflict of interest.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent

Informed consent was obtained from all patients for being included in the study.

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Correspondence to Yutaka Kuroda MD, PhD.

Additional information

Work performed at the Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan, and Department of Orthopaedic Surgery, Gifu University, Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan

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Kuroda, Y., Akiyama, H., Nankaku, M. et al. A Report on Three Consecutive Cases using Computer Tomography 3D Preoperative Planning for Conversion of Arthrodesed Hips to Total Hip Replacements. HSS Jrnl 11, 76–83 (2015). https://doi.org/10.1007/s11420-014-9423-7

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Keywords

  • arthrodesed hip
  • leg length discrepancy
  • preoperative planning
  • total hip arthroplasty