Reconstructed Hip Joint Position and Abductor Muscle Strength After Total Hip Arthroplasty

Asayama, Isao; Chamnongkich, Samatchai; Simpson, Kathy J.; Kinsey, Tracy L.; Mahoney, Ormonde M.

doi:10.1016/j.arth.2004.01.016

Cited by 286 publications

(214 citation statements)

References 10 publications

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“…We aimed to assess the results of the bimodular implants used in the THAs we performed. Questions/purposes We asked: (1) What is the survivorship of the PROFEMUR 1 bimodular femoral neck stems? (2) What are the modes of failure of this bimodular femoral neck implant?…”

Section: Introductionmentioning

confidence: 99%

“…Hip offset and length are known to affect the forces around the joint, stability of the hip, and even longevity of the bearing surface [1,6,20]. A decrease or increase greater than 5 mm in offset can negatively affect the wear of the contact surfaces by increasing the joint reaction forces [24,25].…”

Section: Introductionmentioning

confidence: 99%

“…We asked: (1) What is the survivorship of bimodular PROFEMUR 1 femoral stems? (2) What are the modes of failure of this bimodular femoral neck implant?…”

Section: Introductionmentioning

confidence: 99%

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High Risk of Failure With Bimodular Femoral Components in THA

Pour

Borden

Murayama

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background The bimodular femoral neck implant (modularity in the neck section and prosthetic head) offers several implant advantages to the surgeon performing THAs, however, there have been reports of failure of bimodular femoral implants involving neck fractures or adverse tissue reaction to metal debris. We aimed to assess the results of the bimodular implants used in the THAs we performed. Questions/purposes We asked: (1) What is the survivorship of the PROFEMUR 1 bimodular femoral neck stems? (2) What are the modes of failure of this bimodular femoral neck implant? (3) What are the major risk factors for the major modes of failure of this device?Methods Between 2003 and 2009, we used one family of bimodular femoral neck stems for all primary THAs (PRO-FEMUR 1 Z and PROFEMUR 1 E). During this period, 277 THAs (in 242 patients) were performed with these implants. One hundred seventy were done with the bimodular PROFE-MUR 1 E (all are accounted for here), and when that implant was suspected of having a high risk of failure, the bimodular PROFEMUR 1 Z was used instead. One hundred seven THAs were performed using this implant (all are accounted for in this study). All bearing combinations, including metal-on-metal, metal-on-polyethylene, and ceramic-on-ceramic, are included here. Data for the cohort included patient demographics, BMI, implant dimensions, type of articular surface, length of followup, and C-reactive protein serum level. We assessed survivorship of the two stems using Kaplan-Meier curves and determined the frequency of the different modes of stem failure. For each of the major modes of failure, we performed binary logistic regression to identify associated risk factors. Results Survivorship of the stems, using aseptic revision as the endpoint, was 85% for the patients with the PROFE-MUR 1 E stems with a mean followup of 50 months (range, 1-125 months) and 85% for the PROFEMUR 1 Z with a mean followup of 50 months (range, 1-125 months)(95% CI, 74-87 months). The most common modes of failure were loosening (9% for the PROFEMUR 1 E), neck fracture (6% for the PROFEMUR 1 Z and 0.6% for the PROFEMUR 1 E), metallosis (1%), and periprosthetic fracture (1%). Only the bimodular PROFEMUR 1 E was associated with femoral stem loosening (odds ratio [OR] =1.1; 95% CI, 1.04-1.140; p = 0.032). Larger head (OR = 3.2; 95% CI, 0.7-14; p = 0.096), BMI (OR = 1.19; 95% CI, 1-1.4; p = 0.038) and total offset (OR = 1.83; 95% CI, 1.13-2.9; p = 0.039) were associated with neck fracture.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

High Risk of Failure With Bimodular Femoral Components in THA

Pour

Borden

Murayama

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…Abductor dysfunction may lead to joint instability, resulting in a high rate of recurrent dislocation [3,4]. The gluteus medius muscle, which plays a key role in exerting abduction force across the hip joint, providing stabilization of the pelvis during single leg stance [5], is the main muscle in the hip abductor muscle group that also includes gluteus maximus, gluteus minimus, piriformis muscles, and tensor fascia lata.…”

Section: Introductionmentioning

confidence: 99%

Changes of gluteus medius muscle in the adult patients with unilateral developmental dysplasia of the hip

Liu

Wen

Tong

et al. 2012

BMC Musculoskelet Disord

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BackgroundThe gluteus medius muscle is essential for gait and hip stability. Changes that occur in the gluteus medius muscles in patients with developmental dysplasia of the hip (DDH) are not well understood. A better understanding of DDH related changes will have positive repercussions toward hip soft tissue reconstruction.Methods19 adult patients with unilateral DDH scheduled for total hip arthroplasty were assessed for: cross-sectional area (CSA), radiological density (RD) and the length of gluteus medius using computed tomograhpy(CT) (scanned before THA). Hip abductor moment arm and gluteus medius activation angle were also measured via hip anteroposterior radiographs.ResultsBoth CSA and RD of gluteus medius muscle were significantly reduced (p < 0.05) in the affected hip compared to the control. In the affected hip, the length of the gluteus medius muscle was reduced by 8-11 % (p < 0.05) while the gluteus medius activation angle was significantly increased (p < 0.05) and the hip abductor moment arm was decreased (p < 0.05).ConclusionsThe gluteus medius showed substantial loss of CSA, RD as well as decreased length in patients with DDH in the affected hip. These changes should be considered in both hip reconstruction and postoperative rehabilitation training in patients with DDH.

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“…The joint contact forces about a reconstructed hip are greater when the hip center is located superiorly, laterally, and posteriorly compared with the original location [18]. Moreover, the force-and momentgenerating capacities of the hip muscles are sensitive to the location of the hip center [2,[10][11][12]. A 2-cm superior displacement, for instance, decreases abduction force by 44% and moment by 49%, whereas a 2-cm medial displacement decreases adduction force by 26% and moment by 40% [10].…”

Section: Introductionmentioning

confidence: 99%

Can the Acetabular Position be Derived from a Pelvic Frame of Reference?

Dandachli

Nakhla

Iranpour

et al. 2008

Clin Orthop Relat Res

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Acetabular center positioning has an effect on hip function. However, reported clinical and plain radiographic methods are inaccurate and unreliable for ascertaining acetabular implant location. In an exploratory study we asked whether the normal acetabular position can be derived from simple radiographically measurable pelvic dimensions. We analyzed computed tomographic scans of 37 normal hips using a pelvic frame of reference centered on the ipsilateral anterior-superior iliac spine. We defined the x-, y-, and z-coordinates of the hip center (C x ,C y ,C z ) as a percentage of the corresponding pelvic dimensions (D x ,D y ,D z ). C x /D x averaged 9%, C y /D y 34%, and C z /D z 37%. These ratios had narrow distributions with small confidence intervals. Interobserver agreement tests showed a mean intraclass correlation coefficient of 0.95. We observed gender differences in the ratios of as much as 4%, which correspond to differences of as much as 9 mm in the hip center position. The ratios provide a simple and reliable way of deriving the normal position of the hip center from the pelvic dimensions alone. This gives the surgeon a simple way of planning where the hip center should be and may be particularly helpful in revision hip arthroplasty or in cases involving extensive osteophytes, dysplasia, or protrusio.

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Reconstructed Hip Joint Position and Abductor Muscle Strength After Total Hip Arthroplasty

Cited by 286 publications

References 10 publications

High Risk of Failure With Bimodular Femoral Components in THA

High Risk of Failure With Bimodular Femoral Components in THA

Changes of gluteus medius muscle in the adult patients with unilateral developmental dysplasia of the hip

Can the Acetabular Position be Derived from a Pelvic Frame of Reference?

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