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Archives of Orthopaedic and Trauma Surgery

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01-11-2017 | Hip Arthroplasty

Effect of changes of femoral offset on abductor and joint reaction forces in total hip arthroplasty

Authors: Hannes A. Rüdiger, Maïka Guillemin, Adeliya Latypova, Alexandre Terrier

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2017

Abstract

Background

Anatomical reconstruction in total hip arthroplasty (THA) allows for physiological muscle function, good functional outcome and implant longevity. Quantitative data on the effect of a loss or gain of femoral offset (FO) are scarce. The aim of this study was to quantitatively describe the effect of FO changes on abductor moment arms, muscle and joint reactions forces.

Methods

THA was virtually performed on 3D models built from preoperative CT scans of 15 patients undergoing THA. Virtual THA was performed with a perfectly anatomical reconstruction, a loss of 20% of FO (−FO), and a gain of 20% of FO (+FO). These models were combined with a generic musculoskeletal model (OpenSim) to predict moment arms, muscle and joint reaction forces during normal gait cycles.

Results

In average, with −FO reconstructions, muscle moment arms decreased, while muscle and hip forces increased significantly (p < 0.001). We observed the opposite with +FO reconstructions. Gluteus medius was more affected than gluteus minimus. −FO had more effect than +FO. A change of 20% of FO induced an average change 8% of abductor moment arms, 16% of their forces, and 6% of the joint reaction force.

Conclusions

To our knowledge, this is the first report providing quantitative data on the effect of FO changes on muscle and joint forces during normal gait. A decrease of FO necessitates an increase of abductor muscle force to maintain normal gait, which in turn increases the joint reaction force. This effect underscores the importance of an accurate reconstruction of the femoral offset.

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Title: Effect of changes of femoral offset on abductor and joint reaction forces in total hip arthroplasty
Authors: Hannes A. Rüdiger
Maïka Guillemin
Adeliya Latypova
Alexandre Terrier
Publication date: 01-11-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 11/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-017-2788-6

At a glance: The STEP trials

Springer Medicine

Effect of changes of femoral offset on abductor and joint reaction forces in total hip arthroplasty

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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