Do Femoral Neck and Stem Anteversion Affect Final Femur Rotation and Pelvic Positioning after Total Hip Arthroplasty?

Abstract

In this study, we have investigated the rotation of the pre-operative and post-operative femur, and stem anteversion to prevent impingement and dislocation. We studied 126 patients who had undergone primary total hip arthroplasty (THA) for the treatment of osteoarthritis. We compared preoperative tilt of anterior pelvic plane (APP), posterior condylar axis of the femur (PCA) relative to APP (APP-PCA) with those of postoperative ones in supine position. There was a moderate correlation between the preand post-operative APP-PCA values (r = 0.71). The postoperative APP-PCA decreased by approximately 6°. However, there was poor correlation between the stem anteversion and the postoperative APP-PCA (r = -0.27). A greater reduction in APP-PCA was observed among patients who exhibited greater external rotation of femur compared to those who showed less external rotation in supine position before THA. We also observed that the post-operative rotation of the femur was dependent on the pre-operative rotation of the femur while it was independent of the stem anteversion.

Share and Cite:

N. Imai, T. Ito, Y. Takahashi, Y. Horigome, K. Suda, D. Miyasaka and N. Endo, "Do Femoral Neck and Stem Anteversion Affect Final Femur Rotation and Pelvic Positioning after Total Hip Arthroplasty?," Open Journal of Orthopedics, Vol. 3 No. 3, 2013, pp. 183-188. doi: 10.4236/ojo.2013.33033.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] F. J. Kummer, S. Shah, S. Iver and P. E. DiCesare, “The Effect of Acetabular Cup Orientations on Limiting Hip Rotation,” The Journal of Arthroplasty, Vol. 14, No. 4, 1999, pp. 509-513. doi:10.1016/S0883-5403(99)90110-9
[2] A. Malik, A. Maheshwari and L. D. Dorr, “Impingement with Total Hip Replacement,” The Journal of Bone & Joint Surgery (American), Vol. 89, No. 8, 2007, pp. 18321842. doi:10.2106/JBJS.F.01313
[3] L. D. Dorr, A. Malik, M. Dastane and Z. Wan, “Combined Anteversion Technique for Total Hip Arthroplasty,” Clinical Orthopaedics and Related Research, Vol. 467, No. 1, 2009, pp. 119-127. doi:10.1007/s11999-008-0598-4
[4] K. H. Widmer and B. Zurfluh, “Compliant Positioning of Total Hip Components for Optimal Range of Motion,” Journal of Orthopaedic Research, Vol. 22, No. 4, 2004, pp. 815-821. doi:10.1016/j.orthres.2003.11.001
[5] G. E. Lewinnek, J. L. Lewis, R. Tarr, C. L. Compere and J. R. Zimmerman, “Dislocations after Total Hip-Replacement Arthroplasties,” The Journal of Bone & Joint Surgery (American), Vol. 60, No. 2, 1978, pp. 217-220.
[6] A. M. DiGioia, M. A. Hafez, B. Jaramaz, T. J. Levison and J. E. Moody, “Functional Pelvic Orientation Measured from Lateral Standing and Sitting Radiographs,” Clinical Orthopaedics and Related Research, Vol. 453, 2006, pp. 272-276. doi:10.1097/01.blo.0000238862.92356.45
[7] S. Parratte and J. N. Argenson, “Validation and Usefulness of a Computer-Assisted Cup-Positioning System in Total Hip Arthroplasty. A Prospective, Randomized, Controlled Study,” The Journal of Bone & Joint Surgery (American), Vol. 89, No. 3, 2007, pp. 494-499. doi:10.2106/JBJS.F.00529
[8] D. W. Murray, “The Definition and Measurement of Acetabular Orientation,” The Journal of Bone & Joint Surgery (British), Vol. 75, No. 2, 1993, pp. 228-232.
[9] J. F. Crowe, V. J. Mani and C. S. Ranawat, “Total Hip Replacement in Congenital Dislocation and Dysplasia of the Hip,” The Journal of Bone & Joint Surgery, Vol. 61, No. 1, 1979, pp. 15-23.
[10] K. Kobayashi, M. Sakamoto, Y. Tanabe, A. Ariumi, T. Sato, G. Omori and Y. Koga, “Automated Image Registration for Assessing Three-Dimensional Alignment of Entire Lower Extremity and Implant Position Using BiPlane Radiography,” Journal of Biomechanics, Vol. 42, No. 16, 2009, pp. 2818-2822. doi:10.1016/j.jbiomech.2009.08.022
[11] N. Sugano, P. C. Noble, E. Kamaric, J. K. Salama, T. Ochi and H. S. Tullos, “The Morphology of the Femur in Developmental Dysplasia of the Hip,” The Journal of Bone & Joint Surgery (British), Vol. 80, No. 4, 1988, pp. 711-719. doi:10.1302/0301-620X.80B4.8319
[12] S. Blendea, K. Eckman, B. Jaramaz, T. J. Levison and A. M. Digioia, “Measurements of Acetabular Cup Position and Pelvic Spatial Orientation after Total Hip Arthroplasty Using Computed Tomography/Radiography Matching,” Computer Aided Surgery, Vol. 10, No. 1, 2005, pp. 37-43.
[13] S. Nishihara, N. Sugano, T. Nishii, K. Ohzono and H. Yoshikawa, “Measurements of Pelvic Flexion Angle Using Three-Dimensional Computed Tomography,” Clinical Orthopaedics and Related Research, 2003, Vol. 411, pp. 140-151. doi:10.1097/01.blo.0000069891.31220.fd
[14] Z. Wan, A. Malik, B. Jaramaz, L. Chao and L. D. Dorr, “Imaging and Navigation Measurement of Acetabular Component Position in THA,” Clinical Orthopaedics and Related Research, Vol. 467, No. 1, 2009, pp. 32-42. doi:10.1007/s11999-008-0597-5

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.