Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-04-2020 | Computed Tomography | Hip Arthroplasty

Pre-operative planning in THA. Part III: do implant size prediction and offset restoration influence functional outcomes after THA?

Authors: Alexandre Cech, Masanori Kase, Hideo Kobayashi, Geert Pagenstert, Yannick Carrillon, Padhraig F. O’Loughlin, Tarik Aït-Si-Selmi, Hugo Bothorel, Michel P. Bonnin

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2020

Abstract

Introduction

Few studies evaluated clinical benefits of pre-operative templating in total hip arthroplasty (THA). We investigated whether mismatch between planned and real implant sizes and medio-lateral offsets compromises THA outcomes.

Materials and methods

We reviewed records of 184 primary THAs with pre-operative CT scans used for templating. Acetabular offset (AO), femoral offset (FO) and global offset (GO) were measured on pre-operative CT scans, during acetate templating, and post-operative antero-posterior radiographs. Multivariable analyses were performed to determine if Forgotten Joint Score (FJS) and Oxford Hip Score (OHS) at > 2 years were associated with differences between post-operative and planned parameters.

Results

The FJS and OHS were not influenced by mismatch of component sizes nor of FO and GO. The FJS was better when the post-operative AO was greater than planned (p = 0.050). The FJS differed among arthritic types (p = 0.015). Multivariable analyses confirmed that older patients had better OHS (beta − 0.16; p = 0.033) and FJS (beta 0.74; p = 0.002), medialized hips had worse FJS (beta − 20.1; p = 0.041) and hips with greater AO than planned had better FJS (beta 1.71; p = 0.024)

Conclusions

Implanting a component of different size than planned did not compromise THA outcomes, but medialized hips had worse scores, and conservative acetabular reaming improved scores.

Della Valle AG, Padgett DE, Salvati EA (2005) Preoperative planning for primary total hip arthroplasty. J Am Acad Orthop Surg 13(7):455–462CrossRef

Shemesh SS, Robinson J, Keswani A, Bronson MJ, Moucha CS, Chen D (2017) The Accuracy of digital templating for primary total hip arthroplasty: is there a difference between direct anterior and posterior approaches? J Arthroplasty 32(6):1884–1889. https://doi.org/10.1016/j.arth.2016.12.032 CrossRefPubMed

Shin JK, Son SM, Kim TW, Shin WC, Lee JS, Suh KT (2016) Accuracy and reliability of preoperative on-screen templating using digital radiographs for total hip arthroplasty. Hip Pelvis 28(4):201–207. https://doi.org/10.5371/hp.2016.28.4.201 CrossRefPubMedPubMedCentral

Schmalzried TP (2005) Preoperative templating and biomechanics in total hip arthroplasty. Orthopedics 28(8 Suppl):s849–s851CrossRef

Gonzalez Della Valle A, Slullitel G, Piccaluga F, Salvati EA (2005) The precision and usefulness of preoperative planning for cemented and hybrid primary total hip arthroplasty. J Arthroplasty 20(1):51–58. https://doi.org/10.1016/j.arth.2004.04.016 CrossRefPubMed

Jolles BM, Zangger P, Leyvraz PF (2002) Factors predisposing to dislocation after primary total hip arthroplasty: a multivariate analysis. J Arthroplasty 17(3):282–288CrossRef

Biedermann R, Tonin A, Krismer M, Rachbauer F, Eibl G, Stockl B (2005) Reducing the risk of dislocation after total hip arthroplasty: the effect of orientation of the acetabular component. J Bone Jt Surg Br 87(6):762–769. https://doi.org/10.1302/0301-620X.87B6.14745 CrossRef

Fottner A, Woiczinski M, Kistler M, Schroder C, Schmidutz TF, Jansson V, Schmidutz F (2017) Influence of undersized cementless hip stems on primary stability and strain distribution. Arch Orthop Trauma Surg 137(10):1435–1441. https://doi.org/10.1007/s00402-017-2784-x CrossRefPubMed

Rudiger HA, Guillemin M, Latypova A, Terrier A (2017) Effect of changes of femoral offset on abductor and joint reaction forces in total hip arthroplasty. Arch Orthop Trauma Surg 137(11):1579–1585. https://doi.org/10.1007/s00402-017-2788-6 CrossRefPubMed

10.

Petretta R, Strelzow J, Ohly NE, Misur P, Masri BA (2015) Acetate templating on digital images is more accurate than computer-based templating for total hip arthroplasty. Clin Orthop Relat Res 473(12):3752–3759. https://doi.org/10.1007/s11999-015-4321-y CrossRefPubMedPubMedCentral

11.

Asayama I, Chamnongkich S, Simpson KJ, Kinsey TL, Mahoney OM (2005) Reconstructed hip joint position and abductor muscle strength after total hip arthroplasty. J Arthroplasty 20(4):414–420. https://doi.org/10.1016/j.arth.2004.01.016 CrossRefPubMed

12.

Sakalkale DP, Sharkey PF, Eng K, Hozack WJ, Rothman RH (2001) Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res 388:125–134CrossRef

13.

Liebs TR, Nasser L, Herzberg W, Ruther W, Hassenpflug J (2014) The influence of femoral offset on health-related quality of life after total hip replacement. Bone Jt J 96-B(1):36–42. https://doi.org/10.1302/0301-620X.96B1.31530 CrossRef

14.

Cassidy KA, Noticewala MS, Macaulay W, Lee JH, Geller JA (2012) Effect of femoral offset on pain and function after total hip arthroplasty. J Arthroplasty 27(10):1863–1869. https://doi.org/10.1016/j.arth.2012.05.001 CrossRefPubMed

15.

Hassani H, Cherix S, Ek ET, Rudiger HA (2014) Comparisons of preoperative three-dimensional planning and surgical reconstruction in primary cementless total hip arthroplasty. J Arthroplasty 29(6):1273–1277. https://doi.org/10.1016/j.arth.2013.12.033 CrossRefPubMed

16.

Dastane M, Dorr LD, Tarwala R, Wan Z (2011) Hip offset in total hip arthroplasty: quantitative measurement with navigation. Clin Orthop Relat Res 469(2):429–436. https://doi.org/10.1007/s11999-010-1554-7 CrossRefPubMed

17.

Kumar PG, Kirmani SJ, Humberg H, Kavarthapu V, Li P (2009) Reproducibility and accuracy of templating uncemented THA with digital radiographic and digital TraumaCad templating software. Orthopedics 32(11):815. https://doi.org/10.3928/01477447-20090922-08 CrossRefPubMed

18.

Bertz A, Indrekvam K, Ahmed M, Englund E, Sayed-Noor AS (2012) Validity and reliability of preoperative templating in total hip arthroplasty using a digital templating system. Skeletal Radiol 41(10):1245–1249. https://doi.org/10.1007/s00256-012-1431-4 CrossRefPubMed

19.

Bono JV (2004) Digital templating in total hip arthroplasty. J Bone Jt Surg Am 86-A(Suppl 2):118–122CrossRef

20.

Crooijmans HJ, Laumen AM, van Pul C, van Mourik JB (2009) A new digital preoperative planning method for total hip arthroplasties. Clin Orthop Relat Res 467(4):909–916. https://doi.org/10.1007/s11999-008-0486-y CrossRefPubMed

21.

Gamble P, de Beer J, Petruccelli D, Winemaker M (2010) The accuracy of digital templating in uncemented total hip arthroplasty. J Arthroplasty 25(4):529–532. https://doi.org/10.1016/j.arth.2009.04.011 CrossRefPubMed

22.

Della Valle AG, Comba F, Taveras N, Salvati EA (2008) The utility and precision of analogue and digital preoperative planning for total hip arthroplasty. Int Orthop 32(3):289–294. https://doi.org/10.1007/s00264-006-0317-2 CrossRef

23.

Iorio R, Siegel J, Specht LM, Tilzey JF, Hartman A, Healy WL (2009) A comparison of acetate vs digital templating for preoperative planning of total hip arthroplasty: is digital templating accurate and safe? J Arthroplasty 24(2):175–179. https://doi.org/10.1016/j.arth.2007.11.019 CrossRefPubMed

24.

Kosashvili Y, Shasha N, Olschewski E, Safir O, White L, Gross A, Backstein D (2009) Digital versus conventional templating techniques in preoperative planning for total hip arthroplasty. Can J Surg 52(1):6–11PubMedPubMedCentral

25.

The B, Diercks RL, van Ooijen PM, van Horn JR (2005) Comparison of analog and digital preoperative planning in total hip and knee arthroplasties. A prospective study of 173 hips and 65 total knees. Acta Orthop 76(1):78–84. https://doi.org/10.1080/00016470510030364 CrossRefPubMed

26.

Flecher X, Ollivier M, Argenson JN (2016) Lower limb length and offset in total hip arthroplasty. Orthop Traumatol Surg Res 102(1 Suppl):S9–20. https://doi.org/10.1016/j.otsr.2015.11.001 CrossRefPubMed

27.

Ollivier M, Parratte S, Lecoz L, Flecher X, Argenson JN (2013) Relation between lower extremity alignment and proximal femur anatomy. Parameters during total hip arthroplasty. Orthop Traumatol Surg Res 99(5):493–500. https://doi.org/10.1016/j.otsr.2013.02.006 CrossRefPubMed

28.

Pasquier G, Ducharne G, Ali ES, Giraud F, Mouttet A, Durante E (2010) Total hip arthroplasty offset measurement: is CT scan the most accurate option? Orthop Traumatol Surg Res 96(4):367–375. https://doi.org/10.1016/j.otsr.2010.02.006 CrossRefPubMed

29.

Sariali E, Klouche S, Mouttet A, Pascal-Moussellard H (2014) The effect of femoral offset modification on gait after total hip arthroplasty. Acta Orthop 85(2):123–127. https://doi.org/10.3109/17453674.2014.889980 CrossRefPubMedPubMedCentral

30.

Sariali E, Mauprivez R, Khiami F, Pascal-Mousselard H, Catonne Y (2012) Accuracy of the preoperative planning for cementless total hip arthroplasty. A randomised comparison between three-dimensional computerised planning and conventional templating. Orthop Traumatol Surg Res 98(2):151–158. https://doi.org/10.1016/j.otsr.2011.09.023 CrossRefPubMed

31.

Sariali E, Mouttet A, Pasquier G, Durante E, Catone Y (2009) Accuracy of reconstruction of the hip using computerised three-dimensional pre-operative planning and a cementless modular neck. J Bone Jt Surg Br 91(3):333–340. https://doi.org/10.1302/0301-620X.91B3.21390 CrossRef

32.

Inoue D, Kabata T, Maeda T, Kajino Y, Fujita K, Hasegawa K, Yamamoto T, Tsuchiya H (2015) Value of computed tomography-based three-dimensional surgical preoperative planning software in total hip arthroplasty with developmental dysplasia of the hip. J Orthop Sci 20(2):340–346. https://doi.org/10.1007/s00776-014-0683-3 CrossRefPubMed

33.

Liu YP, Hao YD (2014) Restoration of femoral offset, rotation centers, limbs length equality of Chinese total hip arthroplasty patients. Pak J Med Sci 30(1):116–121. https://doi.org/10.12669/pjms.301.3635 CrossRefPubMedPubMedCentral

34.

Mahmood SS, Mukka SS, Crnalic S, Wretenberg P, Sayed-Noor AS (2016) Association between changes in global femoral offset after total hip arthroplasty and function, quality of life, and abductor muscle strength. A prospective cohort study of 222 patients. Acta Orthop 87(1):36–41. https://doi.org/10.3109/17453674.2015.1091955 CrossRefPubMed

35.

Kase M, O'Loughlin PF, Ait-Si-Selmi T, Pagenstert G, Langlois J, Bothorel H, Bonnin MP (2019) Pre-operative templating in THA. Part I: a classification of architectural hip deformities. Arch Orthop Trauma Surg 140:129–137. https://doi.org/10.1007/s00402-019-03298-1 CrossRefPubMed

36.

Kobayashi H, Cech A, Kase M, Pagenstert G, Carrillon G, O'Loughlin PF, Bothorel H, Ait-Si-Selmi T, Bonnin MP (2019) Pre-operative templating in THA. Part II: a CT-based strategy to correct architectural hip deformities. Arch Orthop Trauma Surg 140:129–137. https://doi.org/10.1007/s00402-019-03298-1 CrossRef

37.

Bonnin MP, Neto CC, Aitsiselmi T, Murphy CG, Bossard N, Roche S (2015) Increased incidence of femoral fractures in small femurs and women undergoing uncemented total hip arthroplasty—why? Bone Jt J 97-B(6):741–748. https://doi.org/10.1302/0301-620X.97B6.35022 CrossRef

38.

Murphy CG, Bonnin MP, Desbiolles AH, Carrillon Y, Aїt Si Selmi T (2016) Varus will have varus; a radiological study to assess and predict varus stem placement in uncemented femoral stems. Hip Int 26(6):554–560. https://doi.org/10.5301/hipint.5000412 CrossRefPubMed

39.

Bonnin MP, Archbold PH, Basiglini L, Fessy MH, Beverland DE (2012) Do we medialise the hip centre of rotation in total hip arthroplasty? Influence of acetabular offset and surgical technique. Hip Int 22(4):371–378. https://doi.org/10.5301/HIP.2012.9350 CrossRefPubMed

40.

Meermans G, Doorn JV, Kats JJ (2016) Restoration of the centre of rotation in primary total hip arthroplasty: the influence of acetabular floor depth and reaming technique. Bone Jt J 98-B(12):1597–1603. https://doi.org/10.1302/0301-620X.98B12.BJJ-2016-0345.R1 CrossRef

41.

Khanuja HS, Vakil JJ, Goddard MS, Mont MA (2011) Cementless femoral fixation in total hip arthroplasty. J Bone Jt Surg Am 93(5):500–509. https://doi.org/10.2106/JBJS.J.00774 CrossRef

42.

Behrend H, Giesinger K, Giesinger JM, Kuster MS (2012) The "forgotten joint" as the ultimate goal in joint arthroplasty: validation of a new patient-reported outcome measure. J Arthroplasty 27(3):430–436e431. https://doi.org/10.1016/j.arth.2011.06.035 CrossRefPubMed

43.

Delaunay C, Epinette JA, Dawson J, Murray D, Jolles BM (2009) Cross-cultural adaptations of the Oxford-12 HIP score to the French speaking population. Orthop Traumatol Surg Res 95(2):89–99. https://doi.org/10.1016/j.otsr.2009.01.003 CrossRefPubMed

44.

Baghdadi YM, Larson AN, Sierra RJ (2013) Restoration of the hip center during THA performed for protrusio acetabuli is associated with better implant survival. Clin Orthop Relat Res 471(10):3251–3259. https://doi.org/10.1007/s11999-013-3072-x CrossRefPubMedPubMedCentral

45.

Bonnin MP, Archbold PH, Basiglini L, Selmi TA, Beverland DE (2011) Should the acetabular cup be medialised in total hip arthroplasty. Hip Int 21(4):428–435. https://doi.org/10.5301/HIP.2011.8582 CrossRefPubMed

46.

Terrier A, Levrero Florencio F, Rudiger HA (2014) Benefit of cup medialization in total hip arthroplasty is associated with femoral anatomy. Clin Orthop Relat Res 472(10):3159–3165. https://doi.org/10.1007/s11999-014-3787-3 CrossRefPubMedPubMedCentral

47.

Terrier A, Parvex V, Rudiger HA (2016) Impact of individual anatomy on the benefit of cup medialisation in total hip arthroplasty. Hip Int 26(6):537–542. https://doi.org/10.5301/hipint.5000392 CrossRefPubMed

48.

Tezuka T, Inaba Y, Kobayashi N, Ike H, Kubota S, Kawamura M, Saito T (2015) Effects of hip joint center location and femoral offset on abductor muscle strength after total hip arthroplasty. Mod Rheumatol 25(4):630–636. https://doi.org/10.3109/14397595.2014.988863 CrossRefPubMed

49.

Delp SL, Maloney W (1993) Effects of hip center location on the moment-generating capacity of the muscles. J Biomech 26(4–5):485–499CrossRef

50.

Delp SL, Wixson RL, Komattu AV, Kocmond JH (1996) How superior placement of the joint center in hip arthroplasty affects the abductor muscles. Clin Orthop Relat Res 328:137–146CrossRef

51.

Doehring TC, Rubash HE, Dore DE (1999) Micromotion measurements with hip center and modular neck length alterations. Clin Orthop Relat Res 362:230–239CrossRef

52.

Doehring TC, Rubash HE, Shelley FJ, Schwendeman LJ, Donaldson TK, Navalgund YA (1996) Effect of superior and superolateral relocations of the hip center on hip joint forces. An experimental and analytical analysis. J Arthroplasty 11(6):693–703CrossRef

53.

Miles AW, McNamee PB (1989) Strain gauge and photoelastic evaluation of the load transfer in the pelvis in total hip replacement: the effect of the position of the axis of rotation. Proc Inst Mech Eng H 203(2):103–107. https://doi.org/10.1243/PIME_PROC_1989_203_018_01 CrossRefPubMed

54.

Little NJ, Busch CA, Gallagher JA, Rorabeck CH, Bourne RB (2009) Acetabular polyethylene wear and acetabular inclination and femoral offset. Clin Orthop Relat Res 467(11):2895–2900. https://doi.org/10.1007/s11999-009-0845-3 CrossRefPubMedPubMedCentral

55.

Ji HM, Won SH, Han J, Won YY (2017) Does femoral offset recover and affect the functional outcome of patients with displaced femoral neck fracture following hemiarthroplasty? Injury 48(6):1170–1174. https://doi.org/10.1016/j.injury.2017.03.022 CrossRefPubMed

Title: Pre-operative planning in THA. Part III: do implant size prediction and offset restoration influence functional outcomes after THA?
Authors: Alexandre Cech
Masanori Kase
Hideo Kobayashi
Geert Pagenstert
Yannick Carrillon
Padhraig F. O’Loughlin
Tarik Aït-Si-Selmi
Hugo Bothorel
Michel P. Bonnin
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Hip-TEP
Hip-TEP
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 4/2020
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03342-5

At a glance: The STEP trials

Springer Medicine

Pre-operative planning in THA. Part III: do implant size prediction and offset restoration influence functional outcomes after THA?

Abstract

Introduction

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2020

Detecting scaphoid fractures in wrist injury: a clinical decision rule

Radiation exposure in the treatment of pediatric supracondylar humerus fractures

External iliac artery thrombosis following open reduction of acetabular fracture: a case report and literature review

The single-suture technique for anterior cruciate ligament graft preparation provides similar stability as a three-suture technique: a biomechanical in vitro study in a porcine model

Intrathoracic shoulder dislocation causing rupture of the right main bronchus

Tactile techniques are associated with a high variability of tunnel positions in lateral extra-articular tenodesis procedures