Restoring femoral medial offset could reduce pelvic obliquity following primary total hip arthroplasty, an observational study

Moharrami, Alireza; Zare, Nima Hoseini; Kaseb, Mohammad Hasan; Jamshidi, Seyed Mir Mansour Moazen; Mansour, Ahmed Kareem; Mortazavi, Seyed Mohammad Javad

doi:10.1007/s00264-022-05506-x

Cited by 12 publications

(9 citation statements)

References 27 publications

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“…Also, THA may affect intra-PO, the most common cause of LLD. PO before THA is a crucial factor in post-operative PO [10].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, detecting PO may facilitate diagnosis of underlying conditions. Moreover, PO is essential when planning hip arthroplasty, including cup implantation and restoring leg length discrepancy (LLD) [6, 10]. Coronal pelvic malrotation causes the bony acetabulum to be displaced from its normal location.…”

Section: Introductionmentioning

confidence: 99%

“…In patients with PO greater than 6 degrees, cup inclination may increase, which could lead to cup instability [19]. It may be necessary to rebalance the pelvis through preoperative skeletal traction or release hip contractures to address this problem [10].…”

Section: Introductionmentioning

confidence: 99%

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Slight pelvic obliquity is normal in a healthy population: a cross‐sectional study

et al. 2023

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Purpose Pelvic obliquity (PO) has not been extensively investigated, and there is no gold standard for measurement. The PO is essential for surgeons in planning hip arthroplasty, which includes the restoration of leg length discrepancy (LLD). We aimed to establish a normative range of PO angles by measuring healthy individuals without musculoskeletal disorders. Methods Our study included 134 consecutive cases (70 females) referred to our institution between April 2020 and September 2021 for non-orthopedic problems. Patients were screened for normal gait and posture using the visual observation method (VOM) and the Modified Gait Abnormality Rating Scale (GARS-M). In standing standard radiographs, the PO angle was measured as the angle between the horizontal plane and the inter-teardrop line. Results Patients' mean age and Body Mass Index (BMI) were 39.7 ± 16.8 and 22.3 ± 3.1, respectively. PO angles did not follow a normal distribution, with a median (IQR) of 2.0° (0.9°—3.1°). According to the Wilcoxon one-sample test, the median PO angle differed significantly from zero (P < 0.001). The PO angle did not differ significantly between males and females (2° vs. 2°, P = 0.46), nor did it correlate significantly with age (P = 0.24). Considering the 95% percentile of PO angles was 5.6°, this range (0°—5.6°) was regarded as a normative value. Conclusion Normative values for PO in the normal healthy population range from 0° to 5.6°, with a median value of 2.0°. The PO angle was independent of age and sex and differed significantly from 0°. Slight pelvic obliquity may be normal, and physicians should not always assume that it is caused by pain, scoliosis, or weakness of the abductors. Level of evidence III.

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“…Also, THA may affect intra-PO, the most common cause of LLD. PO before THA is a crucial factor in post-operative PO [10].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Slight pelvic obliquity is normal in a healthy population: a cross‐sectional study

et al. 2023

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“…As a result of the COVID-19 pandemic, access to elective healthcare has been adversely affected, especially orthopedic surgical procedures such as joint replacements ( 1 , 2 , 3 , 4 , 5 , 6 , 7 ). A COVID-19 pandemic-related surgical delay exacerbated osteoarthritis (OA), caused discomfort, and lowered quality of life in severe OA patients ( 8 , 9 , 10 , 11 , 12 , 13 ). It is possible for surgical patients to acquire COVID-19 infections despite low rates of COVID-19 infection in the area ( 14 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Infection Risk Following Elective Arthroplasty and Surgical Complications in COVID-19-vaccinated Patients: A Multicenter Comparative Cohort Study

Salimi¹,

Moharrami²,

Dolama³

et al. 2022

Arthroplasty Today

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“…As a result of asymmetric enlarged femoral heads (coxa magna) not adequately contained by the acetabulum, femoroacetabular impingement (FAI) and hinged abduction occurred [3]. Eventually, altered hip biomechanics cause premature joint degeneration [4] and if hip preservation strategies do not work, these adolescents may have to undergo total hip resurfacing or arthroplasty [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Simultaneous femoral head reduction osteotomy (FHRO) combined with periacetabular osteotomy (PAO) for the treatment of severe femoral head asphericity in Perthes disease

2022

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Background The purpose of this study is to describe the midterm clinical and radiologic outcomes of concurrent femoral head reduction osteotomy (FHRO) and periacetabular osteotomy (PAO) in Legg–Calvé–Perthes disease (LCPD) patients with major aspherical femoral head deformities. Methods The study included four Perthes patients in Stage IV of Waldenstrom’s classification with a mean age of 10.5 and severe femoral head asphericity. They were treated with a combination of FHRO + PAO and followed for at least 2 years. An evaluation of the radiological outcome of the surgery was carried out based on the lateral center to edge angle (LCEA), the anterior center to edge angle (ACEA), the Tönnis angle, the head sphericity index, the Stulberg classification, the extrusion index, and Shenton’s line integrity. An evaluation of the clinical outcome was made by evaluating hip range of motion (ROM), Harris hip score (HHS), and Merle d’Aubigne´-Postel score. Results All radiographic measures improved; three patients were classified as Stulberg class II and one as class III. The LCEA, ACEA, and Tönnis angle improved by 29° (from 3° to 32°), 16° (from 14° to 30°), and − 10° (from 18° to 8°), respectively. The mean femoral head sphericity index and extrusion index improved by 12% (from 83 to 95%) and − 33% (from 40 to 7%). No disruption was observed in the postoperative Shenton’s line. According to HHS, all patients have shown excellent hip function, which improved by 27 points (from 69 to 96). Moreover, the hip ROM was increased from 222° to 267°. The follow-up period did not reveal any serious postoperative complications, such as osteonecrosis or conversion to arthroplasty. Conclusions Combined FHRO with PAO may improve the hip joint’s morphology and function in patients with residual femoral head deformity and acetabular dysplasia due to LCPD. Despite being considered a complex and demanding hip surgery, these results suggest a more widespread implication of the salvage procedure.

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Restoring femoral medial offset could reduce pelvic obliquity following primary total hip arthroplasty, an observational study

Cited by 12 publications

References 27 publications

Slight pelvic obliquity is normal in a healthy population: a cross‐sectional study

Slight pelvic obliquity is normal in a healthy population: a cross‐sectional study

COVID-19 Infection Risk Following Elective Arthroplasty and Surgical Complications in COVID-19-vaccinated Patients: A Multicenter Comparative Cohort Study

Simultaneous femoral head reduction osteotomy (FHRO) combined with periacetabular osteotomy (PAO) for the treatment of severe femoral head asphericity in Perthes disease

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