A Vertical Measurement System to Predict the Change in Leg Length in Total Hip Arthroplasty

Grobler, G; Nortje, M; Dower, B; Chivers, D

doi:10.1016/j.artd.2020.04.008

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…The mechanical failure rate was 9 % (5 hips). 5,8,9 In this case we demonstrated that a successful hip replacement can be achieved despite altered anatomy secondary to developmental changes. Clearly the abductor and external rotator muscle were atrophic, scarred, and weak.…”

mentioning

confidence: 63%

Management of Secondary Osteoarthritis with Proximal Femoral Deformity due to Previous Coxitis Hip – A case report

Renaldi¹,

Afrian²,

Chilmi³

2023

Hip Knee J.

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IntroductionMost proximal femoral deformities encountered during hip arthroplasty are secondary to degenerative processes, previous osteotomy, or fracture and could be a challenged for surgeons. Femoral deformity may be angular, rotational, or one of bone diameter or length. Fully understanding the anatomy of the deformity is the first element in deciding how to best treat the deformity during Total Hip Arthroplasty (THA). Presentation of CaseFemale 31 years old complaint of pain on her left hip with restricted motion, with a leg length discrepancy (LLD) of 2 cm and a history of operation due to left hip infection when she was a baby. THA was performed with carefully evaluating the abductor muscle to maintain hip stability. Postoperatively the patient has an equal leg length, with less pain on the hip, a good ROM, and able to walk dependently using a cane. Slight tightness on the abductor and adductor muscle was noted postoperatively and the patient undergone physiotherapy. DiscussionMultiple important factor must be considered before considering THA in patients with proximal femoral deformity, including abductor function, osseous anatomy, hip stability and LLD. One must be careful of correction of LLD greater than 3 cm because possible effect on abductor strength, hip stability and sciatic nerve function. In this case, we demonstrated that a successful THA can be achieved despite altered anatomy due to secondary developmental changes. ConclusionIn the setting of sufficient abductor strength and bony stock amenable to implant fixation, THA is a viable option for management and careful preoperative planning helps predict prosthesis requirements and technical challenges. KeywordsOsteoarthritis, Proximal Femoral Deformities, Total Hip Arthroplasty, Abductor Muscle

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mentioning

confidence: 63%

Management of Secondary Osteoarthritis with Proximal Femoral Deformity due to Previous Coxitis Hip – A case report

Renaldi¹,

Afrian²,

Chilmi³

2023

Hip Knee J.

View full text Add to dashboard Cite

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“…The freehand technique is a widely used technique, but it reveals great interobserver and intraobserver variability ( 6 ). Preoperative templates are also widely used, and digital templates have emerged to make the operation more convenient and the results more accurate ( 7 , 8 ). But studies have shown that in up to 60% of the cases, the preoperative template cannot accurately predict the correct size of the implant ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Accuracy of the Horizontal Calibrator in Correcting Leg Length and Restoring Femoral Offset in Total Hip Arthroplasty

Xing

Zhu

et al. 2022

Front. Surg.

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BackgroundLimb length discrepancy (LLD) is one of the most common postoperative complications and can cause serious consequences. Poor recovery of femoral offset (OD) will result in weakness of the patient's external rotator muscles and affect the patient's postoperative function. The study is aimed to present a simple approach that compensates for the shortcomings of previous measuring devices and combines the advantages of different measuring devices to provide more accurate limb length and femoral offset restoration in total hip arthroplasty (THA).MethodsThis study was a prospective controlled trial involving 89 patients with THA. Group I (n = 44) was used for intraoperative measurement of THA with our self-designed horizontal calibrator. Group II (n = 45) was measured by a traditional freehand technique. The main outcome indicators were measured on the Neusoft PACS, including LLD, femoral offset deviation, and operative time. IBM SPSS 23.0 was used for data analysis.ResultsThe independent sample t-test was performed for all the data. The operative time, preoperative radiographic LLD, and OD of Group I and Group II had no statistical significance. Postoperative LLD of Group I and Group II were 2.5 ± 2.1 mm (range −5.7 to 8.3 mm) and 6.2 ± 4.3 mm (range −18.0 to 15.2 mm), and the independent sample t-test data of both (P < 0.001; 95%CI = −5.1, −2.2) showed statistical significance. In Group I, there were 38 THAs with LLD <5 mm, accounting for 86% and there were 44 THAs with LLD <10 mm, accounting for 100%. In Group II, there were 20 THAs with LLD <5 mm, accounting for 44%. There were 36 THAs with LLD <10 mm, covering for 80%. There was no significant difference in postoperative femoral offset and OD.ConclusionThe horizontal calibrator can provide more accurate limb length and femoral offset recovery in THA. It is a simple surgical technique that does not add additionally surgical costs and does not significantly increase operative time, providing a new solution for surgeons to resolve postoperative LLD and restore femoral offset.

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“…LLD can be a cause of patient dissatisfaction because of ipsilateral gait disorder, knee pain, back pain and implant failure associated with inferior clinical outcomes [ 1 – 6 ]. Several methods have been reported for adjusting and equalizing leg length after THA [ 3 , 7 – 12 ]. As one of these methods, use of computer navigation in THA has been increasing over the last decade.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of image-free navigation in intraoperative leg length change from total hip arthroplasty using evaluations from 2D and 3D measurements

Tone

Hasegawa

Naito

et al. 2021

BMC Musculoskelet Disord

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Background Leg length discrepancy is one of the most common problems after total hip arthroplasty (THA). The aim of this study was to investigate the accuracy of image-free navigation in intraoperative leg length change (LLC) using evaluations from anteroposterior radiographs (2D measurement) and 3D bone models using CT data (3D measurement). Methods One hundred THAs with cementless cups and stems were performed using an image-free navigation system in our hospital. We evaluated the accuracy of image-free navigation based on LLC from 2D and 3D measurements. Furthermore, we also investigated error in absolute value and correlations between 2D and 3D measurements in LLC. Results The accuracy of image-free navigation based on 2D measurement was 94% within 5 mm and 76% within 3 mm. The accuracy of image-free navigation based on 3D measurement was 92% within 5 mm and 81% within 3 mm. The error in absolute value in LLC between 2D and 3D measurements was 1.7 ± 1.4 mm (range, 0 to 6 mm). A strong correlation was observed between 2D and 3D measurements in the LLC. Conclusions In the present study, good accuracy of image-free navigation in intraoperative LLC was confirmed for both evaluation methods from 2D and 3D measurements. In addition, the error in absolute value in the LLC between 2D and 3D measurements was very small, and we observed a strong correlation between 2D and 3D measurements. Based on these results, evaluation of LLC from radiographs was considered sufficient if radiographs can be taken accurately.

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A Vertical Measurement System to Predict the Change in Leg Length in Total Hip Arthroplasty

Cited by 4 publications

References 13 publications

Management of Secondary Osteoarthritis with Proximal Femoral Deformity due to Previous Coxitis Hip – A case report

Management of Secondary Osteoarthritis with Proximal Femoral Deformity due to Previous Coxitis Hip – A case report

Accuracy of the Horizontal Calibrator in Correcting Leg Length and Restoring Femoral Offset in Total Hip Arthroplasty

Accuracy of image-free navigation in intraoperative leg length change from total hip arthroplasty using evaluations from 2D and 3D measurements

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