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Weber, Markus ; von Kunow, Frederik ; Innmann, Moritz ; Meyer, Matthias ; Thieme, Max ; Jerabek, Seth ; Renkawitz, Tobias

Which Safe Zone Is Safe in Total Hip Arthroplasty? The Effect of Bony Impingement

Weber, Markus , von Kunow, Frederik, Innmann, Moritz, Meyer, Matthias , Thieme, Max, Jerabek, Seth and Renkawitz, Tobias (2022) Which Safe Zone Is Safe in Total Hip Arthroplasty? The Effect of Bony Impingement. Journal of Personalized Medicine 12 (5), p. 812.

Date of publication of this fulltext: 14 Jul 2022 07:33
Article
DOI to cite this document: 10.5283/epub.52595


Abstract

Safe zones for cup position are currently being investigated in total hip arthroplasty (THA). This study aimed to evaluate the impact of bony impingement on the safe zone and provide recommendations for cup position in THA. CT scans were performed on 123 patients who underwent a cementless THA. Using the implant data and bone morphology from the CT scans, an impingement detection algorithm ...

Safe zones for cup position are currently being investigated in total hip arthroplasty (THA). This study aimed to evaluate the impact of bony impingement on the safe zone and provide recommendations for cup position in THA. CT scans were performed on 123 patients who underwent a cementless THA. Using the implant data and bone morphology from the CT scans, an impingement detection algorithm simulating range of motion (ROM) determined the presence of prosthetic and/or bony impingement. An impingement-free zone of motion was determined for each patient. These zones were then compared across all patients to establish an optimized impingement-free "safe zone". Bony impingement reduced the impingement-free zone of motion in 49.6% (61/123) of patients. A mean reduction of 23.4% in safe zone size was observed in relation to periprosthetic impingement. The superposition of the safe zones showed the highest probability of impingement-free ROM with cup position angles within 40-50 degrees of inclination and 20-30 degrees of anteversion in relation to the applied cup and stem design of this study. Virtual ROM simulations identified bony impingement at the anterosuperior acetabular rim for internal rotation at 90 degrees of flexion and at the posteroinferior rim for adduction as the main reasons for bony impingement.



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Details

Item typeArticle
Journal or Publication TitleJournal of Personalized Medicine
Publisher:MDPI
Open Access Type:Gold (with APC)
Place of Publication:BASEL
Volume:12
Number of Issue or Book Chapter:5
Page Range:p. 812
Date18 May 2022
InstitutionsMedicine > Lehrstuhl für Unfallchirurgie
Medicine > Lehrstuhl für Orthopädie
Identification Number
ValueType
10.3390/jpm12050812DOI
KeywordsNAVIGATION; RANGE; RADIOGRAPHS; ANTEVERSION; DISLOCATION; POSITION; MOTION; CUP; total hip arthroplasty; bony impingement; combined anteversion; safe zone
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-525953
Item ID52595

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