Is there a role for femoral offset restoration during total hip arthroplasty? A systematic review

Fine, Marcello De; Romagnoli, Matteo; Toscano, Angelo; Bondi, Alice; Nanni, Matteo; Zaffagnini, Stefano

doi:10.1016/j.otsr.2016.12.013

Cited by 40 publications

(36 citation statements)

References 59 publications

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“…Like in THA, the FO is important in BHA. FO is the perpendicular distance between the center of rotation of the femoral head and a line drawn down the centre of the femoral shaft, and this is a critical in biomechanical studies on arti cial hip joints [6][7][8][9][10][11] . The hip joint is the lever arm of body weight and the abductor mechanism and hip abductor muscles act as the lever arm extending from the lateral aspect of the greater trochanter and the femoral head, and a greater FO reduces forces required by the abductors by increasing the abductor moment arm.…”

Section: Discussionmentioning

confidence: 99%

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Relationship of Femoral Offset and Clinical Outcomes of Femoral Neck Fracture Patients Following Bipolar Hip Arthroplasty

Kim

Lee

2020

Preprint

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Background This study aimed to investigate the relationship between femoral offset(FO) and clinical outcomes of patients with femoral neck fracture following bipolar hip arthroplasty(BHA). Methods A hospital registry-based retrospective study, involving 520 patients who underwent BHA for femoral neck fracture and with a minimum follow-up of one year, Dong-A university hospital, from December 1, 2003, to September 31, 2018, was carried out. Excluding those with unclear medical records, a previous surgical history on the affected or contralateral hip, a congenital deformity and preoperative trauma history of the hip, high-energy multiple trauma, a history of neurodegenerative disease or cerebrovascular disease, a total of 77 patients were included in the analysis. The subjects were 54 females and 23 males. The mean age of patients was 74.6(65–95) years old and the mean follow-up period was 30.5 (12–136) months. For clinical assessment, postoperative pain visual analogue scale(VAS) and Harris hip score (HHS) were analyzed at each follow-up period. For radiological assessment, the difference in leg length discrepancy (LLD) and FO was measured. FO nearest to the real value was calculated using the values corrected for magnification and rotation errors on the anteroposterior view of plain radiographs taken at the first year of follow-up. In statistical analyses, the statistical significance between FO and clinical outcomes was analyzed using the Pearson correlation tests with SPSS v. 25.0. A value of p < 0.05 was considered statistically significant. Results The difference in mean FO postoperatively was 6.7(± 4.8) mm, and the difference in mean postoperative LLD was 4.9 (± 3.4). The mean HHS was 77.1(± 7.7), 82.3(± 8.6), 83.4(± 7.7), and 86.4(± 6.7) at 1st, 3rd, 6th and 12th postoperative months, respectively. In the analysis using the Pearson correlation coefficient, the correlation coefficient between FO and HHS in 1-year follow-up was − 0.38, and a significant outcome was found (p = 0.001). Of HHS domain, the correlation coefficient for function in 1-year follow-up was − 0.42, revealing a significant outcome (p = 0.0001). Conclusions There was a stastically significant correlation between clinical oucomes and FO difference at 1 year after BHA in patients with femoral neck fractures older than 65 years.

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Section: Discussionmentioning

confidence: 99%

“…However, since THA is more extensive surgery and has the higher risk of dislocation compared to bipolar hip arthroplasty(BHA), BHA remains the preferred treatment in Korea 5) . In hip arthroplasty, biomechanical restoration is important and femoral offset (FO) is the most critical factor towards a successful hip replacement [6][7][8][9][10][11] .…”

mentioning

confidence: 99%

Relationship of Femoral Offset and Clinical Outcomes of Femoral Neck Fracture Patients Following Bipolar Hip Arthroplasty

Kim

Lee

2020

Preprint

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“…Like in THA, the FO is important in BHA. FO is the perpendicular distance between the center of rotation of the femoral head and a line drawn down the centre of the femoral shaft, and this is a critical in biomechanical studies on artificial hip joints [6][7][8][9][10][11] . The hip joint is the lever arm of body weight and the abductor mechanism and hip abductor muscles act as the lever arm extending from the lateral aspect of the greater trochanter and the femoral head, and a greater FO reduces forces required by the abductors by increasing the abductor moment arm.…”

Section: Discussionmentioning

confidence: 99%

“…Bjordal et al 9) compared clinical results between two groups with increased FO by more than 5mm and decreased FO by more than 5mm at 1 year follow-up after THA, and reported significantly poor functional results including pain severity, HHS and others in the group with a reduction of FO by more than 5mm. De Fine et al 10) investigated the association of FO with bearing surface wear, implant loosening and dislocation rate in a systematic review on FO restoration during THA. Two of three articles revealed a statistical association between bearing surface wear and FO restoration and showed no statistical significance between implant loosening and dislocation rate.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Relationship of femoral offset and clinical outcomes of femoral neck fracture patients following bipolar hip arthroplasty

Kim

Lee

2020

Preprint

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PurposeThis study aimed to investigate the relationship between femoral offset(FO) and clinical outcomes of patients with femoral neck fracture following bipolar hip arthroplasty(BHA). Materials and MethodsThis study recruited 520 patients who underwent BHA for femoral neck fracture from December 2003 to September 2018 with a minimum follow-up of one year. Excluding those with unclear medical records, a previous surgical history on the affected or contralateral hip, a congenital deformity and preoperative trauma history of the hip, high-energy multiple trauma, a history of neurodegenerative disease or cerebrovascular disease, a total of 77 patients were included in the analysis. The subjects were 54 females and 23 males. The mean age of patients was 74.6(65-95) years old and the mean follow-up period was 30.5 (12-136) months. For clinical assessment, postoperative pain visual analogue scale(VAS) and Harris hip score (HHS) were analyzed at each follow-up period. For radiological assessment, the difference in leg length discrepancy (LLD) and FO was measured. FO nearest to the real value was calculated using the values corrected for magnification and rotation errors on the anteroposterior view of plain radiographs taken at the first year of follow-up. In statistical analyses, the statistical significance between FO and clinical outcomes was analyzed using the Pearson correlation tests with SPSS v. 25.0. A value of p < 0.05 was considered statistically significant.ResultsThe difference in mean FO postoperatively was 6.7(±4.8) mm, and the difference in mean postoperative LLD was 4.9 (±3.4). The mean HHS was 77.1(±7.7), 82.3(±8.6), 83.4(±7.7), and 86.4(±6.7) at 1st , 3rd , 6th and 12th postoperative months, respectively. In the analysis using the Pearson correlation coefficient, the correlation coefficient between FO and HHS in 1-year follow-up was -0.38, and a significant outcome was found (p=0.001). Of HHS domain, the correlation coefficient for function in 1-year follow-up was -0.42, revealing a significant outcome (p=0.0001).ConclusionThere was a stastically significant correlation between clinical oucomes and FO difference at 1 year after BHA in patients with femoral neck fractures older than 65 years.

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Biomechanics of Total Hip Arthroplasty

Tokgoz

2022

Total Hip Arthroplasty

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Is there a role for femoral offset restoration during total hip arthroplasty? A systematic review

Abstract: level III, systematic review of case-control studies.

Cited by 40 publications

References 59 publications

Relationship of Femoral Offset and Clinical Outcomes of Femoral Neck Fracture Patients Following Bipolar Hip Arthroplasty

Relationship of Femoral Offset and Clinical Outcomes of Femoral Neck Fracture Patients Following Bipolar Hip Arthroplasty

Relationship of femoral offset and clinical outcomes of femoral neck fracture patients following bipolar hip arthroplasty

Biomechanics of Total Hip Arthroplasty

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