Impingement in Total Hip Arthroplasty

Shon, Won Yong; Baldini, Todd; Peterson, Margaret G. E.; Wright, Timothy M.; Salvati, Eduardo A.

doi:10.1016/j.arth.2004.09.058

Cited by 188 publications

(29 citation statements)

References 27 publications

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“…Cup malposition following THA has been associated with an increased risk of dislocation [6,8,10–12], a limited range of motion [5], component impingement [11,13,14], increased wear of the bearing surface [6,7,15], and a greater likelihood of revision [6]. Despite advances in surgical technique and instrumentation, achievement of proper cup position still remains challenging, with potentially large variations in cup orientation and limited accuracy.…”

Section: Introductionmentioning

confidence: 99%

Level of surgical experience is associated with change in hip center of rotation following cementless total hip arthroplasty: A radiographic assessment

et al. 2017

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ObjectivesAfter total hip arthroplasty (THA), restoration of hip center of rotation (COR) is essential to ensure stability of the prosthetic hip and longevity of the prosthesis. Our aim was to determine whether, and how, the COR changed postoperatively compared to the native COR following implantation of a cementless acetabular component in anatomical position and to compare the accuracy of cup placement between two surgeons with different levels of surgical experience.Materials and methodsWe evaluated 145 patients (145 hips) who underwent unilateral primary THA, who had no distorted acetabulum on the affected hip and a normal contralateral hip. Hip reconstruction was radiologically and clinically assessed at a minimum 2-year follow-up. Perioperative change in COR, initial cup position, offset, leg-length discrepancy (LLD), radiographic cup orientation, Harris Hip Score (HHS), component loosening, and dislocations were compared between the highly experienced surgeon and less-experienced surgeon groups.ResultsThe COR was significantly displaced in the superior and medial directions postoperatively. Significant differences were identified in the vertical COR change, initial cup position, LLD, cup inclination, and cups within safe zones, but not in the horizontal COR change, offset parameters, cup anteversion, or HHS. There were no radiographic evidence of component loosening in both groups, but three dislocations (7%) only in the group operated on by the less-experienced surgeon (p = 0.027).ConclusionsWe found that the postoperative COR tended to be displaced in the superior and medial directions, and that the level of surgical experience strongly affected the accuracy and consistency of cup placement, particularly in COR position and cup inclination.

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Section: Introductionmentioning

confidence: 99%

Level of surgical experience is associated with change in hip center of rotation following cementless total hip arthroplasty: A radiographic assessment

et al. 2017

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“…Third bodies, such as porous ingrowth beads or pieces of bone cement, by definition originate from other than the normal articulation surfaces. Third body particles embedded in retrieved polyethylene acetabular liners have been documented by many studies [1–7], and have also been seen in polyethylene components from other total joint replacement sites such as the knee, ankle, and elbow. Laboratory wear tests of polyethylene against metal have demonstrated increased polyethylene wear under third body conditions [8, 9].…”

Section: Introductionmentioning

confidence: 99%

Scratching Vulnerability of Conventional vs Highly Cross-Linked Polyethylene Liners Because of Large Embedded Third-Body Particles

Heiner¹,

Galvin²,

Fisher³

et al. 2012

The Journal of Arthroplasty

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The hypothesis of this study was that acetabular liner vulnerability to scratching from femoral heads, roughened by third bodies embedded in the liner, is not significantly lower for highly crosslinked polyethylene (HXPE) than for conventional polyethylene (CPE). Six CPE and six HXPE acetabular liners were each reproducibly embedded with five CoCrMo beads, then run for 10,000 cycles in a joint simulator. By visual rank-ordering, there was low association between liner scratch severity and polyethylene type. The CPE and HXPE liner scratches were not significantly different in scratch peak-valley height or width, or in liner roughness in the vicinity of the embedded beads. This model indicated that high crosslinking of polyethylene does not offer appreciable protection against severe scratching induced by large embedded third body particles.

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“…Malalignment of the acetabular cup may lead to dislocation (Jolles et al 2002, Shon et al 2005), accelerated wear or breakage of the bearing, and component loosening (Kennedy et al 1998). The use of a mechanical guide for cup implantation may give inaccurate results because of pelvic rotation on the operating table (Sugano et al 2007, Minoda et al 2010).…”

mentioning

confidence: 99%

Is the transverse acetabular ligament a reliable cup orientation guide?

Abe¹,

Sakai²,

Hamasaki³

et al. 2012

Acta Orthopaedica

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Background and purpose It is controversial whether the transverse acetabular ligament (TAL) is a reliable guide for determining the cup orientation during total hip arthroplasty (THA). We investigated the variations in TAL anatomy and the TAL-guided cup orientation.Methods 80 hips with osteoarthritis secondary to hip dysplasia (OA) and 80 hips with osteonecrosis of the femoral head (ON) were examined. We compared the anatomical anteversion of TAL and the TAL-guided cup orientation in relation to both disease and gender using 3D reconstruction of computed tomography (CT) images.Results Mean TAL anteversion was 11° (SD 10, range –12 to 35). The OA group (least-square mean 16°, 95% confidence interval (CI): 14–18) had larger anteversion than the ON group (least-square mean 6.2°, CI: 3.8 – 7.5). Females (least-square mean 20°, CI: 17–23) had larger anteversion than males (least-square mean 7.0°, CI: 4.6–9.3) in the OA group, while there were no differences between the sexes in the ON group. When TAL was used for anteversion guidance with the radiographic cup inclination fixed at 40°, 39% of OA hips and 9% of ON hips had more than 10° variance from the target anteversion, which was 15°.Interpretation In ON hips, TAL is a good guide for determining cup orientation during THA, although it is not a reliable guide in hips with OA secondary to dysplasia. This is because TAL orientation has large individual variation and is influenced by disease and gender.

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Impingement in Total Hip Arthroplasty

Cited by 188 publications

References 27 publications

Level of surgical experience is associated with change in hip center of rotation following cementless total hip arthroplasty: A radiographic assessment

Level of surgical experience is associated with change in hip center of rotation following cementless total hip arthroplasty: A radiographic assessment

Scratching Vulnerability of Conventional vs Highly Cross-Linked Polyethylene Liners Because of Large Embedded Third-Body Particles

Is the transverse acetabular ligament a reliable cup orientation guide?

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