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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 12/2010

01-12-2010 | Basic Research

Modular Necks Improve the Range of Hip Motion in Cases with Excessively Anteverted or Retroverted Femurs in THA

Authors: Akinobu Matsushita, MD, PhD, Yasuharu Nakashima, MD, PhD, Masanori Fujii, MD, Taishi Sato, MD, Yukihide Iwamoto, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 12/2010

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Abstract

Background

Anteversion of an acetabular component often is difficult to ascertain in patients with THA in whom excessively anteverted or retroverted femurs may result in limited ROM or risk of dislocation. Restriction of motion, however, is determined by the combination of version of both components.

Questions/purposes

We therefore determined the combined anteversion values that provide adequate ROM. We varied acetabular version by differing implantations and varied femoral version with modular necks.

Methods

ROM was tested by changing cup anteversion after setting the femoral version to 20° or 60° anteversion or 20° retroversion. The angle of the modular neck was adjusted in 11 increments of 5° each. Range of internal rotation (IR) at 90° flexion, external rotation (ER) at 0° extension, and flexion (Flex) were measured when any impingement occurred before dislocation. We defined a required ROM as having 40° IR, 30° ER, and 110° Flex.

Results

At 60° anteversion, ER was less than 10° even when the acetabular component was set at 10° retroversion because of posterior impingement. When a modular neck with 25° retroversion was used, ER improved to greater than 30°. At 20° retroversion, IR was 31° even when the acetabular component was opened to 35° anteversion. IR improved to 34° and 40° with 20° and 25° anteverted modular necks, respectively.

Conclusions and Clinical Relevance

In cases with excessive femoral anteversion or retroversion, the required ROM could not be achieved by simply changing the version of acetabular components. The adjustment of femoral versions using the modular necks allowed additional improvement of ROM.
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Metadata
Title
Modular Necks Improve the Range of Hip Motion in Cases with Excessively Anteverted or Retroverted Femurs in THA
Authors
Akinobu Matsushita, MD, PhD
Yasuharu Nakashima, MD, PhD
Masanori Fujii, MD
Taishi Sato, MD
Yukihide Iwamoto, MD, PhD
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 12/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1385-6

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