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Journal of Orthopaedic Science

Published in:

01-03-2013 | Original Article

Strict component positioning is necessary in hip resurfacing

Authors: Yoshitomo Kajino, Tamon Kabata, Toru Maeda, Shintaro Iwai, Kazunari Kuroda, Kenji Fujita, Hiroyuki Tsuchiya

Published in: Journal of Orthopaedic Science | Issue 2/2013

Abstract

Background

Hip resurfacing arthroplasty has some advantages, including improved metal-on-metal articulation, a lower dislocation rate and preserved femoral bone. This procedure is a surgical option for younger and more active patients with osteoarthritis and osteonecrosis of the femoral head. Although there have been some reports about the efficacy of this technique, others report serious complications caused by metal debris. Additionally, femoral neck preservation adversely decreases the head–neck ratio and results in postoperative impingement.

Methods

We evaluated the range of motion after hip resurfacing with various component orientations and optimal component orientations to avoid postoperative impingement using computer simulations in 10 male patients with osteonecrosis.

Results

The mean ranges of motion in flexion, extension, abduction, adduction and internal rotation at 90° of flexion were 92.4° ± 13.8°, 25.7° ± 13.8°, 38.0° ± 11.1°, 29.1° ± 10.0° and 20.9° ± 11.5°, respectively. The oscillation angle in flexion and extension motion was 118.1° ± 10.3°. More than 100° of flexion was acquired in 79 of 240 simulations (32.9 %), and more than 20° extension was acquired in 142 simulations (59.2 %). Combined anteversion was significantly correlated with maximal flexion and extension angles. The component safe zone to fulfill the range of motion criteria varied among patients, and 4 of 10 patients had no safe zone.

Conclusions

Postoperative impingement occurs relatively frequently in hip resurfacing because of preservation of the femoral neck and component malpositioning. The safe zone of the acetabular component to avoid postoperative impingement is very narrow. Greater care should be taken regarding patient selection, rigorous preoperative planning and accurate component positioning.

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Title: Strict component positioning is necessary in hip resurfacing
Authors: Yoshitomo Kajino
Tamon Kabata
Toru Maeda
Shintaro Iwai
Kazunari Kuroda
Kenji Fujita
Hiroyuki Tsuchiya
Publication date: 01-03-2013
Publisher: Springer Japan
Published in: Journal of Orthopaedic Science / Issue 2/2013
Print ISSN: 0949-2658
Electronic ISSN: 1436-2023
DOI: https://doi.org/10.1007/s00776-012-0351-4

At a glance: The STEP trials

Springer Medicine

Strict component positioning is necessary in hip resurfacing

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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