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Hip Offset in Total Hip Arthroplasty: Quantitative Measurement with Navigation

  • Symposium: Papers Presented at the Hip Society Meetings 2010
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Offset in THA correlates to abductor muscle function, wear, and impingement. Femoral offset after THA is not independent of the cup center of rotation (COR) so hip offset, a combination of femoral offset and change in hip COR, becomes the important measurement.

Questions/purposes

We therefore asked whether hip offset in arthritic hips would correlate with cup COR; whether offset could always be balanced within 6 mm of contralateral normal hips; and whether hip length could also be kept within 6 mm.

Methods

We compared hip offset of arthritic and contralateral normal hips on radiographs in 82 patients (82 hips) who had THA. We used computer navigation in all patients with the aim of reconstructing the hip offset and to compare hip offset change to the quantitative change of the hip COR.

Results

The preoperative radiographic change to equalize the offset ranged from −12 to +21 mm (mean, 1.5); postoperatively the change was 1.4 ± 6.4 mm and was within ± 6 mm in 78 of 82 hips. As COR displaced superiorly from 3 to 6+ mm the offset had to be substantially increased. Only with COR 0–3 mm superior and 0–5 mm medial was offset always within 5 mm.

Conclusions

Hip offset reconstruction was directly related to the position of the hip COR, and navigation allowed quantitative control of offset and hip length.

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References

  1. Asayama I, Chamnongkich S, Simpson KJ, Kinsey TL, Mahoney OM. Reconstructed hip joint position and abductor muscle strength after total hip arthroplasty. J Arthroplasty. 2005;20:414–420.

    Article  PubMed  Google Scholar 

  2. Bourne RB, Rorabeck CH. Soft tissue balancing: The hip. J Arthroplasty. 2002; 17(Suppl 1):17–22.

    Article  PubMed  Google Scholar 

  3. Charles MN, Bourne RB, Davey JR, Greenwald AS, Morrey BF, Rorabeck CH. Soft-tissue balancing of the hip: the role of femoral offset restoration. J Bone Joint Surg Am. 2004;86:1078–1088.

    Google Scholar 

  4. Dolhain P, Tsigaras H, Bourne RB, Rorabeck CH, Mac Donald S, Mc Calden R. The effectiveness of dual offset stems in restoring offset during total hip replacement. Acta Orthop Belg, 2002;68:490–499.

    CAS  PubMed  Google Scholar 

  5. Dorr LD. Hip Arthroplasty: Minimally Invasive Techniques and Computer Navigation. 1st ed. Philadelphia, PA: WB Saunders; 2005.

    Google Scholar 

  6. Flecher X, Parratte S, Brassart N, Aubaniac JM, Argenson JN. Evaluation of the hip center in total hip arthroplasty for old development dysplasia. J Arthroplasty. 2008;23:1189–1196.

    Article  PubMed  Google Scholar 

  7. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.

    CAS  PubMed  Google Scholar 

  8. Heaton K, Dorr LD. Surgical release of iliopsoas tendon for groin pain after total hip arthroplasty. J Arthroplasty. 2002;17:779–781.

    Article  PubMed  Google Scholar 

  9. Johnston RC, Brand RA, Crownenshield RD. Reconstruction of the hip. A mathematical approach to determine optimum geometric relationships. J Bone Joint Surg Am. 1979;61:639–652.

    CAS  PubMed  Google Scholar 

  10. Karachalios T, Hartofilakidis G, Zacharakis N, Tsekoura M. A 12- to 18-year radiographic follow-up study of Charnley low-friction arthroplasty. The role of the center of rotation. Clin Orthop Relat Res. 1993;296:140–147.

    PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  12. Kurtz WB, Ecker TM, Reichmann WM, Murphy SB. Factors affecting bony impingement in hip arthroplasty. J Arthroplasty. 2010;25:624–634.

    Article  PubMed  Google Scholar 

  13. Little NJ, Busch CA, Gallagher JA, Rorabeck CH, Bourne RB. Acetabular polyethylene wear and acetabular inclination and femoral offset. Clin Orthop Relat Res. 2009;467:2895–2900.

    Article  PubMed  Google Scholar 

  14. Long WT, Dastane M, Harris MJ, Wan Z, Dorr LD. Failure of the Durom Metasul acetabular component. Clin Orthop Relat Res. 2010;468:400–405.

    Article  PubMed  Google Scholar 

  15. Loughead JM, Chesney D, Holland JP, McCaskie AW. Comparison of offset in Birmingham hip resurfacing and hybrid total hip arthroplasty. J Bone Joint Surg Br. 2005;87:163–166.

    Article  CAS  PubMed  Google Scholar 

  16. Malik A, Maheshwari A, Dorr LD. Impingement with total hip replacement. J Bone Joint Surg Am. 2007;89:1832–1842.

    Article  PubMed  Google Scholar 

  17. McGrory BJ, Morrey BJ, Cahalan TD, An KN, Cabanela ME. Effect of femoral offset on range of motion and abductor muscle strength after total hip arthroplasty. J Bone Joint Surg Br. 1995;77:865–869.

    CAS  PubMed  Google Scholar 

  18. Pagnano MW, Hanssen AD, Lewallen DG, Shaughnessy WJ. Effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg Am. 1996;78:1004–1014.

    CAS  PubMed  Google Scholar 

  19. Ranawat CS, Dorr LD, Inglis AE. Total hip arthroplasty in protusio acetabuli of rheumatoid arthritis. J Bone Joint Surg Am. 1980;62:1059–1065.

    CAS  PubMed  Google Scholar 

  20. Ranawat CS, Rao RR, Rodriguez JA, Bhende HS. Correction of limb-length inequality during total hip arthroplasty. J Arthroplasty. 2001;16:715–720.

    Article  CAS  PubMed  Google Scholar 

  21. Ranawat CS, Rodriguez JA. Functional leg-length inequality following total hip arthroplasty. J Arthroplasty. 1997;12:359–364.

    Article  CAS  PubMed  Google Scholar 

  22. Renkawitz T, Schuster T, Herold T, Goessmann H, Sendtner E, Grifka J, Kalteis T. Measuring leg length and offset with an imageless navigation system during total hip arthroplasty: is it really accurate? Int J Med Robot. 2009;5:192–197.

    PubMed  Google Scholar 

  23. Resnick D. Bone and Joint Imaging. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2005.

    Google Scholar 

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

    Article  PubMed  Google Scholar 

  25. Silva, M, Lee KH, Heisel C, Dela Rosa MS, Schmalzried TP. The biomechanical results of total hip resurfacing arthroplasty. J Bone Joint Surg Am. 2004;86-A:40–60.

    Google Scholar 

  26. Stans AA, Pagnano MW, Shaughnessy WJ, Hanssen AD. Results of total hip arthroplasty for Crowe type III developmental hip dysplasia. Clin Orthop Relat Res. 1998;348:149–157.

    Article  PubMed  Google Scholar 

  27. Sugano N, Noble PC, Kamaric E. Predicting the position of the femoral head center. J Arthroplasty. 1999;14:102–107.

    Article  CAS  PubMed  Google Scholar 

  28. Yoder SA, Brand RA, Pedersen DR, O’Gorman TW. Total hip acetabular component position affects component loosening rates. Clin Orthop Relat Res. 1988;228:79–87.

    PubMed  Google Scholar 

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Acknowledgments

We thank Patricia J. Paul for preparation of this manuscript.

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Authors and Affiliations

  1. The Arthritis Institute at Good Samaritan Hospital, 637 S Lucas Avenue, 5th Floor, Los Angeles, CA, 90017, USA

    Manish Dastane MD, Lawrence D. Dorr MD, Rupesh Tarwala MD & Zhinian Wan MD

Authors
  1. Manish Dastane MD
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  2. Lawrence D. Dorr MD
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  3. Rupesh Tarwala MD
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  4. Zhinian Wan MD
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Corresponding author

Correspondence to Lawrence D. Dorr MD.

Additional information

One or more of the authors (LDD) received royalties from Zimmer, Inc.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Dastane, M., Dorr, L.D., Tarwala, R. et al. Hip Offset in Total Hip Arthroplasty: Quantitative Measurement with Navigation. Clin Orthop Relat Res 469, 429–436 (2011). https://doi.org/10.1007/s11999-010-1554-7

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  • DOI: https://doi.org/10.1007/s11999-010-1554-7

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