Effects of femoral offset reconstruction or non-reconstruction on hip joint function in total hip arthroplasty

doi:10.3969/j.issn.2095-4344.2014.04.003

Abstract

Abstract:

BACKGROUND: Femoral offset reconstruction is significant for recovering strength of abductor and the balance of soft tissue tension surrounding hip joint, maintaining joint stabilization, restoring joint function, reducing limping after replacement, decreasing prosthetic abrasion, and the incidence of joint prosthesis dislocation.
OBJECTIVE: To discuss effect of femoral offset reconstruction on hip joint function in total hip arthroplasty.
METHODS: We comparatively analyzed 20 patients (20 hips) undergoing the modular prosthesis (S-ROM) total hip arthroplasty and 19 patients (20 hips) undergoing the one modular prosthesis (Corail) total hip arthroplasty at the same time. According to Harris hip score and radiography results, hip joint function and femoral offset reconstruction rate were comparatively studied in both groups.
RESULTS AND CONCLUSION: No infection, fracture, dislocation, deep venous thrombosis or neurovascular injury occurred in either group. Clinical follow-up results: In the modular prosthesis and one modular prosthesis groups, there was no significant difference in preoperative Harris hip score between the femoral offset reconstruction and non-reconstruction groups (P > 0.05). At 12 months and the latest follow-up, the Harris hip score was higher in the patients with femoral offset reconstruction than those with femoral offset non-reconstruction (P < 0.05). The range of abduction of hip joint was larger in patients with femoral offset reconstruction than those with femoral offset non-reconstruction (P < 0.05). Radiographic follow-up results: significant differences in the rate of femoral offset reconstruction were detected between the modular prosthesis and one modular prosthesis groups (χ² = 3.956, P < 0.05). 39 (98%) femoral stems were in neutral position and one (2.5%) was in mild valgus. There was no significant difference in the abduction angle and the anteversion angle between patients with and without femoral offset reconstruction (P > 0.05). These results indicated that functional recovery and the range of abduction were better in patients with femoral offset reconstruction than those without femoral offset reconstruction. Modular prosthesis has a high rate of femoral offset reconstruction.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: arthroplasty, replacement, hip, hip prosthesis, femur, osteoarthritis, hip, bone remodeling

CLC Number:

R318

Li Yong-wang, He Rong-li, Bai Xiao-liang, An Ming, Zhang Qian, Ma Wen-hai, Song Xing-jian, Sun Jun-ying. Effects of femoral offset reconstruction or non-reconstruction on hip joint function in total hip arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(4): 505-510.

Figures/Tables 5

References

[1] Jolles BM, Zangger P, Leyvraz PF. Factors predisposing to dislocation after primary total hip arthroplasty :a multivariate analysis. J Arthroplasty. 2002;17(3):282-288.

[2] Sakalkale DP, Sharkey PF, Eng K, et al. Effect of femoral component offset on polyethylene wear in total hip arthroplsty. Clin Orthop Relat Res.2001;388:125-134.

[3] Dorr LD, Wan Z. Causes of and treatment protocal for instability of total hip replacement. Clin Orthop Relat Res. 1998;355(6):144-151.

[4] Barrack RL, BuraK C, Skinner HB. Concerns about ceramics in THA. Clin Orthop Relat Res.2004;429(4):73-79.

[5] Cannestra VP, Berger RA, Quigley LR, et al.Hybrid total hip arthroplasty with a precoated offset stem. Four to nine-year results. J Bone Joint Surg AM.2000;82(9):1291-1299．

[6] Kleemann RU, Heller MO, Stoeckle U, et al. THA loading arising from in creased femoral anterversion and offset m ay lead to critical cement stresses. J Orthop Res.2003; 21(5): 767-774.

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

[8] Bourne BR, Rorabeck CH.Soft tissue balancing:the hip. J Arthroplasty.2002;17 (4Suppl):17-22.

[9] 周一新.骨科标准新突破手术技术指导规范-《人工髋、膝关节置换术》解读[J].中国卫生标准管理,2011,2(04):72-74.

[10] Conn KS, Clarke MT, Hallett JP.A simple guide to determine the magnification of radiographs and to improve the accuracy of preoperative templating. J Bone Joint Surg.2002;84(2): 269-272.

[11] Nunn D, Freeman MAR, Hill PF, et al. The measurement of migration of the acetabular component of hip prostheses. J Bone Joint Surg. 1989;71(4):629-631.

[12] Murray DW. The definition and measurement of acetabular orientation.J Bone Joint Surg . 1993;75(2):228-232.

[13] Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg [Am].1982;64(9):1295-1306.

[14] 张晖,裴福兴,杨静,等.混合型全髋关节置换术治疗股骨头缺血性坏死中期评估[J].中华骨科杂志,2007,27(8):590-595.

[15] Rorabeck CH, Bourne RB. The revision hip. Cemented stem revision: Less we forget. Orthopaedics.2003;26(9):933-934.

[16] Sotereanos NG, Sauber TJ, Tupis TT. Modular femoral neck fracture after primary total hip arthroplasty. J Arthroplasty. 2013;28(1):196.e7-9.

[17] Michael JA, Tamara C, Joshua C, et al.A Comparison of Two Implant Systems in Restoration of Hip Geometry in Arthroplasty. Clin Orthop Relat Res. 2011;469(2):443-446.

[18] 史振才,李子荣,介国斌,等.全髋关节置换术的软组织平衡[J].中国矫形外科杂志,2005,13(4):306-309.

[19] 史振才,李子荣,介国斌,等.全髋人工关节置换术的肢体不等长[J].中国矫形外科杂志,2005,13(3):177-180.

[20] 胡弘,夏军. 偏心距重建对股骨颈骨折关节置换术后恢复的影响[J].中华创伤骨科杂志,2008,10(8):711-714.

[21] Manish D, Lawrence D. Dorr, Rupesh T, et al.Hip Offset in Total Hip Arthroplasty: Quantitative Measurement with Navigation. Clin Orthop Relat Res. 2011;469(2):429-436.

[22] Bartz RL, Nobel PC, Kadakia NR, et al. The effect of femoral component head size on posterior dislocation of the artificial hip joint. J Bone Joint Surg Am. 2000;82(9):1300-1307.

[23] 汤宇,孙天胜.股骨偏心距与全髋关节置换术后假体功能及相关生物力学的变化[J].中国临床康复,2006,10(33):133-135.