Skip to main content

Advertisement

SpringerLink
Log in

Does total hip arthroplasty restore native hip anatomy? Three-dimensional reconstruction analysis

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

Component orientations and positions in total hip arthroplasty (THA) are important parameters in restoring hip function. However, measurements using plain radiographs and 2D computed tomography (CT) slices are affected by patient position during imaging. This study used 3D CT to determine whether contemporary THA restores native hip geometry.

Methods

Fourteen patients with unilateral THA underwent CT scan for 3D hip reconstruction. Hip models of the nonoperated side were mirrored with the implanted side to quantify the differences in hip geometry between sides.

Results

The study demonstrated that combined hip anteversion (sum of acetabular and femoral anteversion) and vertical hip offset significantly increased by 25.3° ± 29.3° (range, −25.7° to 55.9°, p = 0.003) and 4.1 ± 4.7 mm (range, −7.1 to 9.8 mm, p = 0.009) in THAs.

Conclusions

These data suggest that hip anatomy is not fully restored following THA compared with the contralateral native hip.

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

Similar content being viewed by others

References

  1. Harris WH, Sledge CB (1990) Total hip and total knee replacement (2). N Engl J Med 323:801–807. doi:10.1056/NEJM199009203231206

    Article  CAS  PubMed  Google Scholar 

  2. Renkawitz T, Haimerl M, Dohmen L et al (2012) The association between femoral tilt and impingement-free range-of-motion in total hip arthroplasty. BMC Musculoskelet Disord 13:65. doi:10.1186/1471-2474-13-65

    Article  PubMed Central  PubMed  Google Scholar 

  3. Barrack RL (2003) Dislocation after total hip arthroplasty: implant design and orientation. J Am Acad Orthop Surg 11:89–99

    PubMed  Google Scholar 

  4. Kennedy JG, Rogers WB, Soffe KE et al (1998) Effect of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear, and component migration. J Arthroplasty 13:530–534

    Article  CAS  PubMed  Google Scholar 

  5. Kwon YM, Mellon SJ, Monk P (2012) In vivo evaluation of edge-loading in metal-on-metal hip resurfacing patients with pseudotumours. Bone Joint Res 1:42–49. doi:10.1302/2046-3758.14.2000019

    Article  PubMed Central  PubMed  Google Scholar 

  6. Harris WH (2012) Edge loading has a paradoxical effect on wear in metal-on-polyethylene total hip arthroplasties. Clin Orthop Relat Res 470:3077–3082. doi:10.1007/s11999-012-2330-7

    Article  PubMed Central  PubMed  Google Scholar 

  7. Patel AB, Wagle RR, Usrey MM (2010) Guidelines for implant placement to minimize impingement during activities of daily living after total hip arthroplasty. J Arthroplasty 25:1275–1281. doi:10.1016/j.arth.2009.10.007, e1271

    Article  PubMed  Google Scholar 

  8. Hill JC, Archbold HA, Diamond OJ et al (2012) Using a calliper to restore the centre of the femoral head during total hip replacement. J Bone Joint Surg Br Vol 94:1468–1474. doi:10.1302/0301-620X.94B11.29144

    Article  CAS  Google Scholar 

  9. Lewinnek GE, Lewis JL, Tarr R et al (1978) Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 60:217–220

    CAS  PubMed  Google Scholar 

  10. Doehring TC, Rubash HE, Shelley FJ et al (1996) Effect of superior and superolateral relocations of the hip center on hip joint forces. An experimental and analytical analysis. J Arthroplasty 11:693–703

    Article  CAS  PubMed  Google Scholar 

  11. Yoder SA, Brand RA, Pedersen DR et al. (1988) Total hip acetabular component position affects component loosening rates. Clin Orthop Relat Res:79–87

  12. Girard J, Lavigne M, Vendittoli PA et al (2006) Biomechanical reconstruction of the hip: a randomised study comparing total hip resurfacing and total hip arthroplasty. J Bone Joint Surg Br Vol 88:721–726. doi:10.1302/0301-620X.88B6.17447

    Article  CAS  Google Scholar 

  13. Liebs TR, Nasser L, Herzberg W et al (2014) The influence of femoral offset on health-related quality of life after total hip replacement. Bone Joint J 96:36–42. doi:10.1302/0301-620X.96B1.31530

    Article  PubMed  Google Scholar 

  14. Tsai TY, Li JS, Wang S et al (2013) A novel dual fluoroscopic imaging method for determination of THA kinematics: in-vitro and in-vivo study. J Biomech 46:1300–1304. doi:10.1016/j.jbiomech.2013.02.010

    Article  PubMed  Google Scholar 

  15. Besl PJ, McKay ND (1992) A method for registration of 3-D shapes. IEEE Trans Pattern Anal Mach Intell 14:239–256

    Article  Google Scholar 

  16. Murray DW (1993) The definition and measurement of acetabular orientation. J Bone Joint Surg Br Vol 75:228–232

    CAS  Google Scholar 

  17. Lecerf G, Fessy MH, Philippot R et al (2009) Femoral offset: anatomical concept, definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol Surg Res 95:210–219. doi:10.1016/j.otsr.2009.03.010

    Article  CAS  PubMed  Google Scholar 

  18. Craiovan B, Renkawitz T, Weber M et al (2014) Is the acetabular cup orientation after total hip arthroplasty on a two dimension or three dimension model accurate? Int Orthop. doi:10.1007/s00264-014-2336-8

    Google Scholar 

  19. Merle C, Waldstein W, Pegg E et al (2012) Femoral offset is underestimated on anteroposterior radiographs of the pelvis but accurately assessed on anteroposterior radiographs of the hip. J Bone Joint Surg Br Vol 94:477–482. doi:10.1302/0301-620X.94B4.28067

    Article  CAS  Google Scholar 

  20. Fujishiro T, Hayashi S, Kanzaki N et al (2014) Computed tomographic measurement of acetabular and femoral component version in total hip arthroplasty. Int Orthop. doi:10.1007/s00264-013-2264-z

    Google Scholar 

  21. Reikeras O, Gunderson RB (2011) Components anteversion in primary cementless THA using straight stem and hemispherical cup: a prospective study in 91 hips using CT-scan measurements. Orthop Traumatol Surg Res 97:615–621. doi:10.1016/j.otsr.2011.02.014

    Article  CAS  PubMed  Google Scholar 

  22. Emerson RH Jr (2012) Increased anteversion of press-fit femoral stems compared with anatomic femur. Clin Orthop Relat Res 470:477–481. doi:10.1007/s11999-011-1993-9

    Article  PubMed Central  PubMed  Google Scholar 

  23. Suh KT, Kang JH, Roh HL et al (2006) True femoral anteversion during primary total hip arthroplasty: use of postoperative computed tomography-based sections. J Arthroplasty 21:599–605. doi:10.1016/j.arth.2005.04.042

    Article  PubMed  Google Scholar 

  24. Silva M, Lee KH, Heisel C et al (2004) The biomechanical results of total hip resurfacing arthroplasty. J Bone Joint Surg Am 86-A:40–46

    PubMed  Google Scholar 

  25. Dorr LD, Malik A, Dastane M et al (2009) Combined anteversion technique for total hip arthroplasty. Clin Orthop Relat Res 467:119–127. doi:10.1007/s11999-008-0598-4

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest disclosure

None.

Author information

Authors and Affiliations

  1. Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit St., GRJ-1215, Boston, MA, 02114, USA

    Tsung-Yuan Tsai, Dimitris Dimitriou, Guoan Li & Young-Min Kwon

Authors
  1. Tsung-Yuan Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dimitris Dimitriou
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Guoan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Young-Min Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guoan Li.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tsai, TY., Dimitriou, D., Li, G. et al. Does total hip arthroplasty restore native hip anatomy? Three-dimensional reconstruction analysis. International Orthopaedics (SICOT) 38, 1577–1583 (2014). https://doi.org/10.1007/s00264-014-2401-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-014-2401-3

Keywords

Search

Navigation