Weber, Markus and Woerner, Michael and Craiovan, Benjamin and Voellner, Florian and Worlicek, Michael and Springorum, Hans-Robert and Grifka, Joachim and Renkawitz, Tobias (2016) Current standard rules of combined anteversion prevent prosthetic impingement but ignore osseous contact in total hip arthroplasty. INTERNATIONAL ORTHOPAEDICS, 40 (12). pp. 2495-2504. ISSN 0341-2695, 1432-5195
Full text not available from this repository. (Request a copy)Abstract
In this prospective study of 135 patients undergoing cementless total hip arthroplasty (THA) we asked whether six current definitions of combined anteversion prevent impingement and increase postoperative patient individual impingement-free range-of-motion (ROM). Implant position was measured by an independent, external institute on 3D-CT performed six weeks post-operatively. Post-operative ROM was calculated using a CT-based algorithm detecting osseous and/or prosthetic impingement by virtual hip movement. Additionally, clinical ROM was evaluated pre-operatively and one-year post-operatively by a blinded observer. Combined component position of cup and stem according to the definitions of Ranawat, Widmer, Dorr, Hisatome and Yoshimine inhibited prosthetic impingement in over 90 %, while combined osseous and prosthetic impingement still occurred in over 40 % of the cases. The recommendations by Jolles, Widmer, Dorr, Yoshimine and Hisatome enabled higher flexion (p aecurrency sign 0.001) and internal rotation (p aecurrency sign 0.006). Clinically, anteversion rules of Widmer and Yoshimine provided one-year post-operatively statistically but not clinically relevant higher internal rotation (p aecurrency sign0.034). Standard rules of combined anteversion detect prosthetic but fail to prevent combined osseous and prosthetic impingement in THA. Future models will have to account for the patient-individual anatomic situation to ensure impingement-free ROM.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RANDOMIZED CONTROLLED-TRIAL; COMPONENT VERSION; STEM VERSION; FREE RANGE; MOTION; NAVIGATION; CUP; RADIOGRAPHS; Combined anteversion; Impingement; Range of motion; Outcome; Total hip arthroplasty |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Orthopädie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 10 Apr 2019 13:27 |
| Last Modified: | 10 Apr 2019 13:27 |
| URI: | https://pred.uni-regensburg.de/id/eprint/3901 |
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