Oversized Cups as a Major Risk Factor of Postoperative Pain After Total Hip Arthroplasty

Odri, G.; Padiolleau, Giovany; Gouin, F.

doi:10.1016/j.arth.2013.07.001

Cited by 63 publications

(39 citation statements)

References 19 publications

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“…By contrast, a cup that is too large can lead to intraoperative fractures of the acetabulum. Odri et al [21] found a significant increase in the risk of postoperative pain in the case of overdimensioning.…”

Section: Discussionmentioning

confidence: 98%

Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs

Knafo¹,

Houfani²,

Zaharia³

et al. 2019

BioMed Research International

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Two-dimensional (2D) planning on standard radiographs for total hip arthroplasty may not be sufficiently accurate to predict implant sizing or restore leg length and femoral offset, whereas 3D planning avoids magnification and projection errors. Furthermore, weightbearing measures are not available with computed tomography (CT) and leg length and offset are rarely checked postoperatively using any imaging modality. Navigation can usually achieve a surgical plan precisely, but the choice of that plan remains key, which is best guided by preoperative planning. The study objectives were therefore to (1) evaluate the accuracy of stem/cup size prediction using dedicated 3D planning software based on biplanar radiographic imaging under weightbearing and (2) compare the preplanned leg length and femoral offset with the postoperative result. This single-centre, single-surgeon prospective study consisted of a cohort of 33 patients operated on over 24 months. The routine clinical workflow consisted of preoperative biplanar weightbearing imaging, 3D surgical planning, navigated surgery to execute the plan, and postoperative biplanar imaging to verify the radiological outcomes in 3D weightbearing. 3D planning was performed with the dedicated hipEOS® planning software to determine stem and cup size and position, plus 3D anatomical and functional parameters, in particular variations in leg length and femoral offset. Component size planning accuracy was 94% (31/33) within one size for the femoral stem and 100% (33/33) within one size for the acetabular cup. There were no significant differences between planned versus implanted femoral stem size or planned versus measured changes in leg length or offset. Cup size did differ significantly, tending towards implanting one size larger when there was a difference. Biplanar radiographs plus hipEOS planning software showed good reliability for predicting implant size, leg length, and femoral offset and postoperatively provided a check on the navigated surgery. Compared to previous studies, the predictive results were better than 2D planning on conventional radiography and equal to 3D planning on CT images, with lower radiation dose, and in the weightbearing position.

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Section: Discussionmentioning

confidence: 98%

Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs

Knafo¹,

Houfani²,

Zaharia³

et al. 2019

BioMed Research International

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“…42,60 Head-neck geometry and ratio, a lateralized horizontal position of the acetabular cup, an oversized acetabular cup, and residual acetabular osteophytes increase the likelihood of iliopsoas tendon impingement. 40,42,61,62 Fluoroscopic or ultrasound-guided injections of the iliopsoas tendon sheath can provide diagnostic information and short-term symptomatic relief, but definitive treatment may require iliopsoas tendon release. [63][64][65][66] Bulky heterotopic ossification, which appears at 3 to 4 weeks and matures over 3 to 6 months, may also limit range of motion or cause pain from lateral soft tissue impingement.…”

Section: Dislocationmentioning

confidence: 99%

Radiographic Evaluation of Hip Implants

Chang

Huang

Palmer

2015

Semin Musculoskelet Radiol

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Serial radiographs are the mainstay in the longitudinal assessment of hip implants. The prosthesis, periprosthetic bone, and juxta-articular soft tissues are inspected for fracture, periosteal reaction, stress shielding, calcar resorption, osteolysis, bony remodeling, metallic debris, and heterotopic ossification. Comparison radiographs best confirm implant migration, subsidence, and aseptic loosening. Infection, particle disease, reaction to metal, and mechanical impingement are important causes of postsurgical pain, but in their earliest stages they may be difficult to diagnose using radiographs. This article addresses the role of radiography following hip arthroplasty.

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“…17 Odri recently described oversized cups as a major risk factor for postoperative pain and proved that a cup size of 6 mm greater than the native femoral head was a statistically significant predictor of post-operative pain after total hip replacement. 18 O'Connor describes the use of a specifically designed anatomical acetabular component in a revision case for a patient with psoas impingement. 19…”

Section: Iliopsoas Impingement: Literature Reviewmentioning

confidence: 99%

Iliopsoas tendon impingement following total hip replacement surgery

Riemer¹,

Nortje²,

Dower³

et al. 2015

SA orthop. j.

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We have recently seen and successfully treated four patients with iliopsoas-related groin pain post total hip replacement. Their clinical pictures were all typical of iliopsoas-related groin pain. After the exclusion of other causes, surgical release of this tendon resulted in successful treatment with complete resolution of symptoms. We subsequently carried out an anatomic dissection of the iliopsoas tendon on a cadaver torso to better understand the relationship between the iliopsoas tendon and the acetabular component in total hip replacement surgery. It was apparent that cup position and placement were critical to prevent contact of the iliopsoas tendon with the rim of the acetabular component. We have subsequently modified our positioning of the acetabular component.

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Oversized Cups as a Major Risk Factor of Postoperative Pain After Total Hip Arthroplasty

Cited by 63 publications

References 19 publications

Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs

Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs

Radiographic Evaluation of Hip Implants

Iliopsoas tendon impingement following total hip replacement surgery

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