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

Kim, Seung-Chan; Lim, Young Wook; Kwon, Soon-Yong; Jo, Woo-Lam; Ju, Sung-Hun; Park, Chanjoo; Lee, Choong-Woo; Kim, Yong-Sik

doi:10.1371/journal.pone.0178300

Cited by 20 publications

(27 citation statements)

References 31 publications

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“…Several studies reported the significant differences in the radiographic and clinical outcomes between surgeons with different levels of surgical expertise, such as change in the COR, initial cup position, cup orientation, number of cups within the safe zones, and dislocation rate. The percentage of hips located within the safe zones varies from 70.5 to 25.7% [11–13, 17]. In the present study, patients using this positioner have less vertical displacement of the COR of the hip when compared with those in group B.…”

Section: Discussionmentioning

confidence: 52%

“…However, RCH is not a definite anatomical structure, and its position rests with variables of acetabular cup depth, height, and angular position (anteversion and inclination) [9, 10]. These variables are able to be obtained on the postoperative X-ray of CT via many kinds of ways, but the methods that help to definite the position of RCH during surgery are seldom, mainly relying on experience of the surgeon, which attributes to great differences of accuracy rate of RCH between different medical centers [11–13]. So a simple, reproducible, and affordable method is needed to resolve the problem.…”

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confidence: 99%

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A novel positioner for accurately sitting the acetabular component: a retrospective comparative study

et al. 2019

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Introduction In this study, we described a positioner which allows a combination of preoperative plan and intraoperative insertion of the cup to improve the reconstruction of the rotation center of the hip. Materials and methods A retrospective study was conducted on 32 consecutive patients (group A) using this positioner and 40 consecutive patients (group B) using conventional method; radiological parameters and clinical measurements before operation and at last follow-up were collected and evaluated. Results Group A had a reconstructed center of rotation (COR) that was 0.19 mm closer to the anatomic COR in height ( P < 0.005), compared with group B with 3.45 mm vertical dislocation. There were no statistically significant differences in the horizontal displacement between the two groups. The accuracy of cup inclination was 42.14 ± 3.57 in the group A and 38.73 ± 7.65 in the group B ( P = 0.015). The accuracy of cup anteversion was 14.82 ± 1.44 in the group A and 13.08 ± 5.95 in the group B ( P = 0.082). All cups in the group A were radiologically stable, while one cup in the group B was radiologically unstable and was successfully treated with second-stage revision. Both of the groups obtained a higher mean postoperative Harris Hip Score. Conclusions Utilizing this positioner helps to restore the COR position more precisely and provides satisfactory radiological and clinical outcomes in the short term, and more studies are required before its widespread adoption for complicated cases.

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Section: Discussionmentioning

confidence: 52%

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confidence: 99%

A novel positioner for accurately sitting the acetabular component: a retrospective comparative study

et al. 2019

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“…Accurate restoration of hip rotation center is one of the main factors affecting the stress distribution between the prosthesis interface, the prosthesis-bone interface, and the soft tissue around hip joint. Improper position of hip rotation center will result in polyethylene wear, prosthesis loosening, lameness, and other complications [11]. The anatomical restoration of hip rotation center can make uniform stress distribution of the prosthesis, recover the soft tissue tension, extend the survivorship of the prosthesis, and reconstruct the function of the hip joint to the maximum extent, which will improve the patients' satisfaction and clinical therapy effect [12].…”

Section: Discussionmentioning

confidence: 99%

Mid-term and long-term results of restoring rotation center in revision hip arthroplasty

et al. 2020

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Background: To restore rotation center exactly in revision hip arthroplasty is technically challenging, especially in Paprosky type III. The technical difficulty is attributable to the complicated acetabular bone defect. In this study, we discussed the method of restoring rotation center in revision hip arthroplasty and reported the clinical and radiological outcome of mid-term and long-term follow-up. Methods: This study retrospectively reviewed 45 patients (48 hips) who underwent revision hip arthroplasty, in which 35 cases (35 hips) were available for complete follow-up data. During the operation, the acetabular bone defect was reconstructed by impaction morselized bone graft, and the hip rotation center was restored by using remnant Harris fossa and acetabular notches as the marks. The clinical outcome was assessed using the Harris hip score. Pelvis plain x-ray was used to assess implant migration, stability of implants, and incorporation of the bone graft to host bone. Result: The average follow-up duration was 97.60 months (range 72-168 months). The average Harris hip score improved from 29.54 ± 10.87 preoperatively to 83.77 ± 5.78 at the last follow-up. The vertical distance of hip rotation center measured on pelvis x-ray was restored to normal, with the mean distance (15.24 ± 1.31) mm (range 12.4~17.3 mm). The mean loss of vertical distance of hip rotation center was (2.21 ± 0.72) mm (range 1.1~5.3 mm) at the last follow-up. Conclusion: Satisfactory clinical and radiological outcome can be obtained through restoring hip rotation center by using remnant Harris fossa and acetabular notches as the anatomical marks in revision hip arthroplasty.

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“…The abduction and anteversion angles of the acetabular component, center of rotation (COR) in the horizontal and vertical planes [17], femoral/hip offset [17], and leg-length discrepancy (LLD) were measured as radiographic parameters after THA on 3-month standardized radiographs. Intraclass correlation coefficient values for intra-rater and inter-rater reliability were demonstrated to be excellent (all > 0.85) for these parameters in our previous studies [17, 18]. We used the method described by Lewinnek et al [19, 20] for the measurement of anteversion.…”

Section: Methodsmentioning

confidence: 99%

Fourth-generation ceramic-on-ceramic THA results in improvements in midterm outcomes compared to third-generation THA but does not resolve noise problems: a cohort study of a single-hip system

Kim

Lim

et al. 2019

BMC Musculoskelet Disord

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Background Using data from the Korean Hip Registry, we aimed to investigate mid-term clinical and radiographic outcomes, including the prevalence of periprosthetic joint infection (PJI), osteolysis, and component loosening or dislocation, and to analyze the incidence of bearing-related complications following modern ceramic-on-ceramic (COC) total hip arthroplasty (THA) using a single cementless hip system. Methods Four hundred eighty-two patients (602 hips) who underwent Forte or Delta COC THAs with a single hip system and had a minimum 5-year follow-up were identified. The sample included 243 (50.4%) women and 239 (49.6%) men with a mean age of 50.6 years (range: 18–83 years). The Forte group comprised 310 hips, and the Delta group comprised 292 hips. The mean follow-up was 6.1 years (range: 5–10.2 years). Results Cup orientation did not differ between groups. No hip had a PJI or osteolysis in either group. All acetabular components and all but two femoral components (in the Delta group) were well fixed. Dislocations occurred in six (1.9%) hips in the Forte group and one (0.3%) hip in the Delta group ( p = 0.124). A total of nine (1.5%) revisions were performed. The 5-year survival rates for all-cause revisions were 98.4 and 98.6%, respectively. One (0.3%) ceramic head fracture occurred in the Forte group. Sixteen (5%) hips exhibited clicking and 6 (2%) hips had squeaking in the Forte group; 16 (6%) hips exhibited clicking and 5 (2%) hips had squeaking in the Delta group. Multiple regression analysis revealed that noise generation was unassociated with any factor. Conclusions From the Korean Hip Registry data, THA with modern ceramic bearings showed encouraging results, with lower risks of PJI, osteolysis, and component loosening. In particular, Delta COC THA resulted in no PJI or ceramic fracture and had a reduced dislocation risk. However, associated noise remains a concern.

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

Cited by 20 publications

References 31 publications

A novel positioner for accurately sitting the acetabular component: a retrospective comparative study

A novel positioner for accurately sitting the acetabular component: a retrospective comparative study

Mid-term and long-term results of restoring rotation center in revision hip arthroplasty

Fourth-generation ceramic-on-ceramic THA results in improvements in midterm outcomes compared to third-generation THA but does not resolve noise problems: a cohort study of a single-hip system

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