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Weber, Markus ; Merle, Christian ; Nawabi, Danyal H. ; Dendorfer, Sebastian ; Grifka, Joachim ; Renkawitz, Tobias

Inaccurate offset restoration in total hip arthroplasty results in reduced range of motion

Weber, Markus, Merle, Christian, Nawabi, Danyal H., Dendorfer, Sebastian, Grifka, Joachim and Renkawitz, Tobias (2020) Inaccurate offset restoration in total hip arthroplasty results in reduced range of motion. Scientific Reports 10, p. 13208.

Date of publication of this fulltext: 19 Feb 2021 13:22
Article
DOI to cite this document: 10.5283/epub.44992


Abstract

Offset restoration in total hip arthroplasty (THA) is associated with postoperative range of motion (ROM) and gait kinematics. We aimed to research into the impact of high offset (HO) and standard stems on postoperative ROM. 121 patients received cementless THA through a minimally-invasive anterolateral approach. A 360 degrees hip ROM analysis software calculated impingement-free hip movement ...

Offset restoration in total hip arthroplasty (THA) is associated with postoperative range of motion (ROM) and gait kinematics. We aimed to research into the impact of high offset (HO) and standard stems on postoperative ROM. 121 patients received cementless THA through a minimally-invasive anterolateral approach. A 360 degrees hip ROM analysis software calculated impingement-free hip movement based on postoperative 3D-CTs compared to ROM values necessary for activities of daily living (ADL). The same model was then run a second time after changing the stem geometry between standard and HO configuration with the implants in the same position. HO stems showed higher ROM for all directions between 4.6 and 8.9 degrees (p < 0.001) compared with standard stems but with high interindividual variability. In the subgroup with HO stems for intraoperative offset restoration, the increase in ROM was even higher for all ROM directions with values between 6.1 and 14.4 degrees (p < 0.001) compared to offset underrestoration with standard stems. Avoiding offset underrestoration resulted in a higher amount of patients of over 20% for each ROM direction that fulfilled the criteria for ADL (p < 0.001). In contrast, in patients with standard stems for offset restoration ROM did increase but not clinically relevant by offset overcorrection for all directions between 3.1 and 6.1 degrees (p < 0.001). Offset overcorrection by replacing standard with HO stems improved ROM for ADL in a low number of patients below 10% (p > 0.03). Patient-individual restoration of offset is crucial for free ROM in THA. Both over and underrestoration of offset should be avoided.



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Details

Item typeArticle
Journal or Publication TitleScientific Reports
Publisher:Nature
Open Access Type:DEAL (Springer Gold)
Place of Publication:BERLIN
Volume:10
Page Range:p. 13208
Date6 August 2020
InstitutionsMedicine > Lehrstuhl für Orthopädie
Identification Number
ValueType
10.1038/s41598-020-70059-1DOI
KeywordsFEMORAL OFFSET; LEG LENGTH; STEM ANTEVERSION; RECONSTRUCTION; IMPINGEMENT; NAVIGATION; JOINT; GAIT;
Dewey Decimal Classification600 Technology > 610 Medical sciences Medicine
StatusPublished
RefereedYes, this version has been refereed
Created at the University of RegensburgYes
URN of the UB Regensburgurn:nbn:de:bvb:355-epub-449929
Item ID44992

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