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

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Centre Hospitalier Universitaire Vaudois CHUV, Av. Pierre Decker 4, Lausanne, 1011, Switzerland

    Hannes A. Rüdiger

  2. Department of Orthopaedic Surgery, Schulthess Clinic, Lengghalde 2, Zurich, 8008, Switzerland

    Hannes A. Rüdiger

  3. Laboratory of Biomechanical Orthopedics, Ecole Polytechnique Fédérale de Lausanne, Station 15, Lausanne, 1015, Switzerland

    Maïka Guillemin, Adeliya Latypova & Alexandre Terrier

Authors
  1. Hannes A. Rüdiger
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  2. Maïka Guillemin
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  3. Adeliya Latypova
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  4. Alexandre Terrier
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Corresponding author

Correspondence to Hannes A. Rüdiger.

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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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Rüdiger, H.A., Guillemin, M., Latypova, A. et al. Effect of changes of femoral offset on abductor and joint reaction forces in total hip arthroplasty. Arch Orthop Trauma Surg 137, 1579–1585 (2017). https://doi.org/10.1007/s00402-017-2788-6

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  • DOI: https://doi.org/10.1007/s00402-017-2788-6

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