Subscribe to RSS
DOI: 10.1055/s-0041-1732367
The Effect of Femoral Malrotation in Offset Templating for Total Hip Arthroplasty: A Cadaveric Study and Curvilinear Analysis
Source of Funding No external funding was provided for this project.![](https://www.thieme-connect.de/media/10.1055-s-00031934/202104/lookinside/thumbnails/10-1055-s-0041-1732367_210013oa-1.jpg)
Abstract
Techniques allow assessment of preoperative offset in hip arthroplasty. This study assessed femoral rotation in preoperative offset templating using a cadaveric model. Ten femurs were imaged at degrees of rotation. Offset was measured. A generalizable equation predicting change in offset was derived with a curvilinear model. Statistically significant differences at rotational positions were found. For 30 degrees of internal rotation, 2.1 mm change in adjusted mean offset existed; for 30 degrees of external rotation, 8.4 mm change existed. Improved awareness of malrotation of the proximal femur and templating adjustments may improve total hip arthroplasty outcomes. This study reflects level of evidence III.
Ethical Approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Publication History
Received: 11 March 2021
Accepted: 21 June 2021
Article published online:
01 October 2021
© 2021. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Tripuraneni KR, Archibeck MJ, Junick DW, Carothers JT, White RE. Common errors in the execution of preoperative templating for primary total hip arthroplasty. J Arthroplasty 2010; 25 (08) 1235-1239
- 2 Sugano N, Noble PC, Kamaric E. Predicting the position of the femoral head center. J Arthroplasty 1999; 14 (01) 102-107
- 3 Lindgren JU, Rysavy J. Restoration of femoral offset during hip replacement. A radiographic cadaver study. Acta Orthop Scand 1992; 63 (04) 407-410
- 4 Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS. The anatomic basis of femoral component design. Clin Orthop Relat Res 1988; (235) 148-165
- 5 Davey JR, O'Connor DO, Burke DW, Harris WH. Femoral component offset. Its effect on strain in bone-cement. J Arthroplasty 1993; 8 (01) 23-26
- 6 Woolson ST, Rahimtoola ZO. Risk factors for dislocation during the first 3 months after primary total hip replacement. J Arthroplasty 1999; 14 (06) 662-668
- 7 Charnley J. Biomechanics. In: Low Friction Arthroplasty of the Hip: Theory and Practice. New York, NY: Springer; 1979: 332-344
- 8 McGrory BJ, Morrey BF, Cahalan TD, An KN, Cabanela ME. Effect of femoral offset on range of motion and abductor muscle strength after total hip arthroplasty. J Bone Joint Surg Br 1995; 77 (06) 865-869
- 9 Radin EL. Biomechanics of the human hip. 1980; (152) 28-34
- 10 Sakai T, Sugano N, Ohzono K, Nishii T, Haraguchi K, Yoshikawa H. Femoral anteversion, femoral offset, and abductor lever arm after total hip arthroplasty using a modular femoral neck system. J Orthop Sci 2002; 7 (01) 62-67
- 11 Sakalkale DP, Sharkey PF, Eng K, Hozack WJ, Rothman RH. Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res 2001; (388) 125-134
- 12 Scheerlinck T. Primary hip arthroplasty templating on standard radiographs. A stepwise approach. Acta Orthop Belg 2010; 76 (04) 432-442
- 13 Girard J, Krantz N, Bocquet D, Wavreille G, Migaud H. Femoral head to neck offset after hip resurfacing is critical for range of motion. Clin Biomech (Bristol, Avon) 2012; 27 (02) 165-169
- 14 Herman KA, Highcock AJ, Moorehead JD, Scott SJ. A comparison of leg length and femoral offset discrepancies in hip resurfacing, large head metal-on- metal and conventional total hip replacement: a case series. J Orthop Surg Res 2011; 6: 65
- 15 Pasquier G, Ducharne G, Ali ES, Giraud F, Mouttet A, Durante E. Total hip arthroplasty offset measurement: is CT scan the most accurate option?. Orthop Traumatol Surg Res 2010; 96 (04) 367-375
- 16 Franken M, Grimm B, Heyligers I. A comparison of four systems for calibration when templating for total hip replacement with digital radiography. J Bone Joint Surg Br 2010; 92 (01) 136-14
- 17 Levy RN. The location of the level of femoral neck transection for prosthetic hip arthroplasty. Clin Orthop Relat Res 1982; (171) 51-52
- 18 Noble PC, Box GG, Kamaric E, Fink MJ, Alexander JW, Tullos HS. The effect of aging on the shape of the proximal femur. Clin Orthop Relat Res 1995; (316) 31-44
- 19 Johnston RC, Brand RA, Crowninshield RD. Reconstruction of the hip. A mathematical approach to determine optimum geometric relationships. J Bone Joint Surg Am 1979; 61 (05) 639-652
- 20 Fehring KA, Fehring TK. Modes of failure in metal-on-metal total hip arthroplasty. Orthop Clin North Am 2015; 46 (02) 185-192
- 21 Fabi D, Levine B, Paprosky W. et al. Metal-on-metal total hip arthroplasty: causes and high incidence of early failure. Orthopedics 2012; 35 (07) e1009-e1016
- 22 Pokorný D, Jahoda D, Veigl D, Pinskerová V, Sosna A. Topographic variations of the relationship of the sciatic nerve and the piriformis muscle and its relevance to palsy after total hip arthroplasty. Surg Radiol Anat 2006; 28 (01) 88-91
- 23 Jafri AA, Green SM, Partington PF, McCaskie AW, Muller SD. Pre-heating of components in cemented total hip arthroplasty. J Bone Joint Surg Br 2004; 86 (08) 1214-1219
- 24 Alnahhal A, Aslam-Pervez N, Sheikh HQ. Templating hip arthroplasty. Open Access Maced J Med Sci 2019; 7 (04) 672-685