Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2018

Open Access 01-12-2018 | Research article

The influence of patient factors on femoral rotation after total hip arthroplasty

Authors: Taro Tezuka, Yutaka Inaba, Naomi Kobayashi, Hyonmin Choe, Syota Higashihira, Tomoyuki Saito

Published in: BMC Musculoskeletal Disorders | Issue 1/2018

Login to get access

Abstract

Background

A postoperative change in femoral rotation following total hip arthroplasty (THA) might be the cause of dislocation due to the change in combined anteversion. However, very few studies have evaluated the femoral rotation angle following THA, or the factors that influence femoral rotation. We aimed to evaluate changes in femoral rotation after THA, and to investigate preoperative patient factors that influence femoral rotation after THA.

Methods

This study involved 211 hips treated with primary THA. We used computed tomography to measure the femoral rotation angle before and one week after THA. In addition, multiple regression analysis was performed to evaluate preoperative patient factors that could influence femoral rotation after THA.

Results

The femoral rotation angle was 0.2 ± 14° externally before surgery and 4.4 ± 12° internally after surgery (p < 0.001). Multiple regression analysis revealed that sex (β = 0.19; p = 0.003), age (β = 0.15; p = 0.017), preoperative anatomical femoral anteversion (β = − 0.25; p = 0.002), and preoperative femoral rotation angle (β = 0.36; p < 0.001) were significantly associated with the postoperative femoral rotation angle. The final model of the regression formula was described by the following equation: [postoperative femoral rotation angle = 5.41 × sex (female: 0, male: 1) + 0.15 × age - 0.22 × preoperative anatomical femoral anteversion + 0.33 × preoperative femoral rotation angle - 10.1].

Conclusion

The current study showed the mean internal change of 4.6° in the femoral rotation angle one week after THA. Sex, age, preoperative anatomical femoral anteversion and preoperative femoral rotation were associated with postoperative femoral rotation. The patients who were male, older, and who exhibited lesser preoperative anatomical femoral anteversion or greater preoperative femoral rotation angles, tended to demonstrate an externally rotated femur after THA. Conversely, patients who were female, younger, and who exhibited greater preoperative anatomical femoral anteversion or lesser preoperative femoral rotation angles, tended to demonstrate an internal rotation of the femur after THA.
Literature
1.
Morrey BF. Difficult complications after hip joint replacement. Dislocation. Clin Orthop Relat Res. 1997;344:179–87.CrossRef
2.
Brennan SA, et al. Dislocation of primary total hip arthroplasty and the risk of redislocation. Hip Int. 2012;22(5):500–4.CrossRefPubMed
3.
Bozic KJ, et al. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009;91(1):128–33.CrossRefPubMed
4.
Suzuki H, et al. Postural and chronological change in pelvic tilt five years after Total hip arthroplasty in patients with developmental dysplasia of the hip: a three-dimensional analysis. J Arthroplast. 2016;31(1):317–22.CrossRef
5.
Siebenrock KA, Kalbermatten DF, Ganz R. Effect of pelvic tilt on acetabular retroversion: a study of pelves from cadavers. Clin Orthop Relat Res. 2003;407:241–8.CrossRef
6.
Lazennec JY, et al. Hip-spine relationship: a radio-anatomical study for optimization in acetabular cup positioning. Surg Radiol Anat. 2004;26(2):136–44.CrossRefPubMed
7.
Zhu J, Wan Z, Dorr LD. Quantification of pelvic tilt in total hip arthroplasty. Clin Orthop Relat Res. 2010;468(2):571–5.CrossRefPubMed
8.
Lembeck B, et al. Pelvic tilt makes acetabular cup navigation inaccurate. Acta Orthop. 2005;76(4):517–23.CrossRefPubMed
9.
Babisch JW, Layher F, Amiot LP. The rationale for tilt-adjusted acetabular cup navigation. J Bone Joint Surg Am. 2008;90(2):357–65.CrossRefPubMed
10.
Stefl M, et al. Spinopelvic mobility and acetabular component position for total hip arthroplasty. Bone Joint J. 2017;99-B(1 Supple A):37–45.CrossRefPubMed
11.
12.
Uemura K, et al. The validity of using the posterior condylar line as a rotational reference for the femur. J Arthroplast. 2016;31(1):302–6.CrossRef
13.
Akiyama K, et al. Changes in axial alignment of the ipsilateral hip and knee after total hip arthroplasty. Bone Joint J. 2016;98-B(3):349–58.CrossRefPubMed
14.
Uemura K, et al. Can anatomic measurements of stem Anteversion angle be considered as the functional Anteversion angle? J Arthroplast. 2018;33(2):595–600.CrossRef
15.
Widmer KH, Zurfluh B. Compliant positioning of total hip components for optimal range of motion. J Orthop Res. 2004;22(4):815–21.CrossRefPubMed
16.
Inaba Y, et al. Preoperative planning for implant placement with consideration of pelvic tilt in total hip arthroplasty: postoperative efficacy evaluation. BMC Musculoskelet Disord. 2016;17:280.CrossRefPubMedPubMedCentral
17.
Ike H, et al. Comparison between mechanical stress and bone mineral density in the femur after total hip arthroplasty by using subject-specific finite element analyses. Comput Methods Biomech Biomed Engin. 2015;18(10):1056–65.CrossRefPubMed
18.
Oba M, et al. Effect of femoral canal shape on mechanical stress distribution and adaptive bone remodelling around a cementless tapered-wedge stem. Bone Joint Res. 2016;5(9):362–9.CrossRefPubMedPubMedCentral
19.
Charnley J. Total hip replacement by low-friction arthroplasty. Clin Orthop Relat Res. 1970;72:7–21.PubMed
20.
Harris WH. Advances in surgical technique for total hip replacement: without and with osteotomy of the greater trochanter. Clin Orthop Relat Res. 1980;(146):188–204.
21.
Lewinnek GE, et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978;60(2):217–20.CrossRefPubMed
22.
Dorr LD, et al. Combined anteversion technique for total hip arthroplasty. Clin Orthop Relat Res. 2009;467(1):119–27.CrossRefPubMed
23.
Nakashima Y, et al. Combined anteversion technique reduced the dislocation in cementless total hip arthroplasty. Int Orthop. 2014;38(1):27–32.CrossRefPubMed
24.
Blondel B, et al. Pelvic tilt measurement before and after total hip arthroplasty. Orthop Traumatol Surg Res. 2009;95(8):568–72.CrossRefPubMed
25.
Taki N, et al. Change in pelvic tilt angle 2 to 4 years after total hip arthroplasty. J Arthroplast. 2012;27(6):940–4.CrossRef
26.
Tannast M, et al. Anatomic referencing of cup orientation in total hip arthroplasty. Clin Orthop Relat Res. 2005;(436):144–50.
27.
Haenle M, et al. Assessment of cup position from plain radiographs: impact of pelvic tilting. Surg Radiol Anat. 2007;29(1):29–35.CrossRefPubMed
28.
Kalteis TA, et al. In vitro investigation of the influence of pelvic tilt on acetabular cup alignment. J Arthroplast. 2009;24(1):152–7.CrossRef
29.
Nishihara S, et al. Measurements of pelvic flexion angle using three-dimensional computed tomography. Clin Orthop Relat Res. 2003;411:140–51.CrossRef
30.
Miki H, Kyo T, Sugano N. Anatomical hip range of motion after implantation during total hip arthroplasty with a large change in pelvic inclination. J Arthroplast. 2012;27(9):1641–50. e1CrossRef
Metadata
Title
The influence of patient factors on femoral rotation after total hip arthroplasty
Authors
Taro Tezuka
Yutaka Inaba
Naomi Kobayashi
Hyonmin Choe
Syota Higashihira
Tomoyuki Saito
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2018
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-018-2110-y

Other articles of this Issue 1/2018

BMC Musculoskeletal Disorders 1/2018 Go to the issue

Research article

The use of bidirectional rapid reductor in minimally invasive treatment of bicondylar tibial plateau fractures: preliminary radiographic and clinical results

Research article

Early rehabilitation for volumetric muscle loss injury augments endogenous regenerative aspects of muscle strength and oxidative capacity

Research article

Association between IGF-1 polymorphisms and risk of osteoporosis in Chinese population: a meta-analysis

Correction

Correction to: Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY

Research article

Objective quantification of ligament balancing using VERASENSE in measured resection and modified gap balance total knee arthroplasty

Research article

Biomechanical comparison of screw-based zoning of PHILOS and Fx proximal humerus plates