Skip to main content
SpringerLink
Log in

Computerized Virtual Surgery Demonstrates Where Acetabular Rim Osteophytes Most Reduce Range of Motion Following Total Hip Arthroplasty

  • Original Article
  • Published:
HSS Journal ®

Abstract

Background

Acetabular osteophytes are common findings during total hip arthroplasty (THA).

Purpose

This study was designed to determine the extent to which osteophytes may limit range of motion (ROM) and in which locations impingement is likely to occur if osteophytes are not removed during surgery.

Methods

Computer-aided design was used to compare ROM of a modern hip implant in four cadaver models with and without 10-mm acetabular rim osteophytes added. A clock face, with 12 o’clock at the superior pole of the right acetabulum, was used to map impingement.

Results

The osteophyte model limited ROM in flexion (101° v. 113°, p = 0.03), 90° of flexion with internal rotation (16.7° v. 31.6°, p = 0.01), and external rotation (30.4° v. 49.5°, p = 0.01). Impingement occurred between 7 and 8 o’clock in external rotation and 1 and 2 o’clock in the other two motions.

Conclusions

Osteophytes in these positions have the greatest impact on ROM and should be removed during THA.

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
Fig. 4

Similar content being viewed by others

References

  1. Ali Khan MA, Brakenbury PH, Reynolds IS. Dislocation following total hip replacement. J Bone Joint Surg Br. 1981;63:214-218.

    PubMed  Google Scholar 

  2. Amstutz HC, Campbell PA, Le Duff MJ. Fracture of the neck of the femur after surface arthroplasty of the hip. J Bone Joint Surg [Am]. 2004;86(9):1874-1877.

    Google Scholar 

  3. Amstutz H, Lodwig R, Schurman D, Hodgson AG. Range of motion studies for total hp replacements. A comparative study with a new experimental apparatus. Clin Orthop Relat Res. 1975;111:124.

    Article  PubMed  Google Scholar 

  4. Barrack RL, Butler RA, Laster DR, Andrews P. Stem design and dislocation after revision total hip arthroplasty: clinical results and computer modeling. J Arthroplasty. 2001;16(8 Suppl 1):8.

    Article  PubMed  CAS  Google Scholar 

  5. Chandler D, Glousman R, Hull D, et al. Prosthetic hip range of motion and impingement. The effects of head and neck geometry. Clin Orthop Relat Res. 1982;166:284.

    PubMed  Google Scholar 

  6. Cobb J, Logishetty K, Davda K, Iranpour F. Cams and pincer impingement are distinct, not mixed: the acetabular pathomorphology of femoroacetabular impingement. Clin Orthop Relat Res. 2010;468(8):2143-2151.

    Article  PubMed  Google Scholar 

  7. Czubak J, Sionek A, Czwojdziński A. New concepts in the aetiology of primary osteoarthritis of the hip caused by femoroacetabular impingement. Ortop Traumatol Rehabil. 2010;12(6):479-492.

    PubMed  Google Scholar 

  8. DeWal H, Su E, DiCesare PE. Instability following total hip arthroplasty. Am J Orthop (Belle Mead NJ). 2003;32(8):377-382.

    Google Scholar 

  9. Dorr LD, Wolf AW, Chandler R, Conaty JP. Classification and treatment of dislocations of total hip arthroplasty. Clin Orthop Rel Res. 1983;173:151.

    Google Scholar 

  10. Fackler C, Poss R. Dislocation in total hip arthroplasties. Clin Orthop Relat Res. 1980;151:169.

    PubMed  Google Scholar 

  11. Hedlundh U, Ahnfelt L, Hybbinette CH, Weckstrom J, Fredin H. Surgical experience related to dislocations after total hip arthroplasty. J Bone Joint Surg Br. 1996;78:206.

    PubMed  CAS  Google Scholar 

  12. Jolles BM, Zangger P, Leyvraz PF. Factors predisposing to dislocation after primary total hip arthroplasty: a multivariate analysis. J Arthroplasty. 2002;17:282.

    Article  PubMed  CAS  Google Scholar 

  13. Kaplan SJ, Thomas WH, Poss R. Trochanteric advancement for recurrent dislocation after total hip arthroplasty. J Arthroplasty. 1987;2:119.

    Article  PubMed  CAS  Google Scholar 

  14. Kassarjian A, Brisson M, Palmer WE. Femoroacetabular impingement. Eur J Radiol. 2007;63(1):29-35.

    Article  PubMed  Google Scholar 

  15. Katz JN, Losina E, Barrett J, et al. Association between hospital and surgeon procedure volume and outcomes of total hip replacement in the United States medicare population. J Bone Joint Surg [Am]. 2001;83:1622.

    Article  Google Scholar 

  16. Kreder HJ, Deyo RA, Koepsell T, Swiontkowski MF, Kreuter W. Relationship between the volume of total hip replacements performed by providers and the rates of postoperative complications in the state of Washington. J Bone Joint Surg [Am]. 1997;79:485.

    CAS  Google Scholar 

  17. Krushell R, Burke D, Harris W. Range of motion in contemporary total hip arthroplasty. The impact of modular head-neck components. J Arthroplasty. 1991;6(2):97.

    Article  PubMed  CAS  Google Scholar 

  18. Kurtz WB, Ecker TM, Reichmann WM, Murphy SB. Factors affecting bony impingement in hip arthroplasty. J Arthroplasty. 2010;25(4):624-634.

    Article  PubMed  Google Scholar 

  19. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg [Am]. 1978;60:217.

    CAS  Google Scholar 

  20. Malik A, Maheshwari A, Dorr LD. Impingement with total hip replacement. J Bone Joint Surg [Am]. 2007;89:1832-1842.

    Article  Google Scholar 

  21. Nolan D, Fitzgerald R, Beckenbaugh R, Coventry MB. Complications of total hip arthroplasty treated by reoperation. J Bone Joint Surg [Am]. 1975;57:977.

    CAS  Google Scholar 

  22. Padgett DE, Warashina H. The unstable total hip replacement. Clin Orthop Relat Res. 2004;420:72.

    Article  PubMed  Google Scholar 

  23. Patel PD, Potts A, Froimson MI. The dislocating hip arthroplasty: prevention and treatment. J Arthroplasty. 2007;22(4 Suppl 1):86-90.

    Article  PubMed  Google Scholar 

  24. Scifert CF, Brown TD, Pedersen DR, Callaghan JJ. A finite element analysis of factors influencing total hip dislocation. Clin Orthop Rel Res. 1998;355:152.

    Article  Google Scholar 

  25. Soong M, Rubash HE, Macaulay W. Dislocation after total hip arthroplasty. J Am Acad Orthop Surg. 2004;12(5):314-321.

    PubMed  Google Scholar 

  26. Vendittoli P-A, Ganapathi M, Nuño N, Plamondon D, Lavigne M. Factors affecting hip range of motion in surface replacement arthroplasty. Clin Biomech. 2007;22(9):1004-1012.

    Article  Google Scholar 

  27. Wheeless CR III: Wheeless’ textbook of orthopaedics. Data Trace Internet Publishing, Durham. 11 Apr 2011. <http://www.wheelessonline.com>.

  28. Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg [Am]. 1982;64:1295.

    CAS  Google Scholar 

  29. Wright AA, Cook C, Abbott JH. Variables associated with the progression of hip osteoarthritis: a systematic review. Arthritis Rheum. 2009;61(7):925-936.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was partially funded by the generous donation of Dr. Alberto Foglia and his wife Maria Pia. Study was supported by a grant from Stryker Orthopedics.

Disclosure

ᅟ

Conflict of Interest:

Sebastian Rodriguez-Elizalde, MD, Alyssa M. Yeager, BA, Bheeshma Ravi, MD, Eduardo A. Salvati, MD have declared that they have no conflict of interest. Geoffrey H. Westrich, MD received research grant from Stryker Orthopedics in support of the study; is a paid consultant for Stryker Orthopedics, outside the work. Joseph D. Lipman, MS is a paid consultant for Ivy Sport Medicine; employee of Hospital for Special Surgery; has the following patents: Posterior Stabilized Knee Prosthesis, Self-aligning knee prosthesis, Dual radius glenoid prosthetic component for total shoulder arthroplasty, Pelvic Positioner, Trochlear Clamp, Patella Resection Drill and Prosthesis Implantation Device; has pending patents for Constrained Condylar Knee Device, Prosthetic Condylar Joints With Articulating Bearing Surfaces Having A Translating Contact Point During Rotation Thereof, Elbow Replacement Apparatus And Methods, Expanding Cannula And Retractor Device And Methods Of Use and External fixation devices and methods of use; receives royalties payment from Mathys Inc. and Ortho Development Corp; has received travel support for travel to meetings from Chinese Orthopaedic Association, outside the work.

Human/Animal Rights:

This article does not contain any studies with human or animal subjects performed by the any of the authors.

Informed Consent:

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

Required Author Forms

Disclosure forms provided by the authors are available with the online version of this article.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Sebastian Rodriguez-Elizalde MD, Alyssa M. Yeager BA, Eduardo A. Salvati MD & Geoffrey H. Westrich MD

  2. Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, 100 College Street, Toronto, ON, M5G 1L5, Canada

    Bheeshma Ravi MD

  3. Department of Biomechanics, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Joseph D. Lipman MS

Authors
  1. Sebastian Rodriguez-Elizalde MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alyssa M. Yeager BA
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bheeshma Ravi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Joseph D. Lipman MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eduardo A. Salvati MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Geoffrey H. Westrich MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Geoffrey H. Westrich MD.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(PDF 512 kb)

ESM 2

(PDF 510 kb)

ESM 3

(PDF 510 kb)

ESM 4

(PDF 510 kb)

ESM 5

(PDF 510 kb)

ESM 6

(PDF 510 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rodriguez-Elizalde, S., Yeager, A.M., Ravi, B. et al. Computerized Virtual Surgery Demonstrates Where Acetabular Rim Osteophytes Most Reduce Range of Motion Following Total Hip Arthroplasty. HSS Jrnl 9, 223–228 (2013). https://doi.org/10.1007/s11420-013-9337-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11420-013-9337-9

Keywords

Search

Navigation