Are Leg Length and Hip Offset Comparable After Hip Resurfacing and Cementless Total Hip Arthroplasty?

Overview

Journal Ann R Coll Surg Engl

Specialty General Surgery

Date 2011 Sep 21

PMID 21929917

Citations 3

Authors

S Patel

R R Thakrar

J Bhamra

F Hossain

M Tengrootenhuysen

F S Haddad

Affiliations

Soon will be listed here.

Abstract

Introduction: The purpose of this study was to determine if hip resurfacing arthroplasty (HRA) and cementless total hip arthroplasty (THA) were comparable in correcting leg length and hip offset in patients with primary osteoarthritis.

Methods: A retrospective analysis was performed of 80 patients who underwent either HRA or cementless THA for primary osteoarthritis (40 in each group) between 2006 and 2008. Standardised anteroposterior radiographs taken pre-operatively and at one year following surgery were used to calculate the total offset and leg length in both hips.

Results: At one year following surgery, no leg length discrepancy was identified in either group. A difference of 0.39 cm (p=0.046) remained between the mean total offset of the operated hip and the contralateral non-operated hip in the HRA group. No difference in offset was observed between the two hips after surgery in the THA group (p=0.875).

Conclusions: Leg length is restored by HRA and THA. A difference remains in offset after HRA although we attribute this to intentional medialisation of the acetabular cup.

Citing Articles

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Fluoroscopy and imageless navigation enable an equivalent reconstruction of leg length and global and femoral offset in THA.

Weber M, Woerner M, Springorum R, Sendtner E, Hapfelmeier A, Grifka J Clin Orthop Relat Res. 2014; 472(10):3150-8.

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References

Ball S, Le Duff M, Amstutz H . Early results of conversion of a failed femoral component in hip resurfacing arthroplasty. J Bone Joint Surg Am. 2007; 89(4):735-41. DOI: 10.2106/JBJS.F.00708. View

Asayama I, Naito M, Fujisawa M, Kambe T . Relationship between radiographic measurements of reconstructed hip joint position and the Trendelenburg sign. J Arthroplasty. 2002; 17(6):747-51. DOI: 10.1054/arth.2002.33552. View

Jolles B, Zangger P, Leyvraz P . Factors predisposing to dislocation after primary total hip arthroplasty: a multivariate analysis. J Arthroplasty. 2002; 17(3):282-8. DOI: 10.1054/arth.2002.30286. View

Hofmann A, Skrzynski M . Leg-length inequality and nerve palsy in total hip arthroplasty: a lawyer awaits!. Orthopedics. 2000; 23(9):943-4. DOI: 10.3928/0147-7447-20000901-20. View

Silva M, Lee K, Heisel C, dela Rosa M, Schmalzried T . The biomechanical results of total hip resurfacing arthroplasty. J Bone Joint Surg Am. 2004; 86(1):40-6. DOI: 10.2106/00004623-200401000-00007. View

Woolson S, Hartford J, Sawyer A . Results of a method of leg-length equalization for patients undergoing primary total hip replacement. J Arthroplasty. 1999; 14(2):159-64. DOI: 10.1016/s0883-5403(99)90119-5. View

Pollard T, Baker R, Eastaugh-Waring S, Bannister G . Treatment of the young active patient with osteoarthritis of the hip. A five- to seven-year comparison of hybrid total hip arthroplasty and metal-on-metal resurfacing. J Bone Joint Surg Br. 2006; 88(5):592-600. DOI: 10.1302/0301-620X.88B5.17354. View

de Haan R, Pattyn C, Gill H, Murray D, Campbell P, De Smet K . Correlation between inclination of the acetabular component and metal ion levels in metal-on-metal hip resurfacing replacement. J Bone Joint Surg Br. 2008; 90(10):1291-7. DOI: 10.1302/0301-620X.90B10.20533. View

Ollivere B, Darrah C, Barker T, Nolan J, Porteous M . Early clinical failure of the Birmingham metal-on-metal hip resurfacing is associated with metallosis and soft-tissue necrosis. J Bone Joint Surg Br. 2009; 91(8):1025-30. DOI: 10.1302/0301-620X.91B8.21701. View

10.

Loughead J, Starks I, Chesney D, Matthews J, McCaskie A, Holland J . Removal of acetabular bone in resurfacing arthroplasty of the hip: a comparison with hybrid total hip arthroplasty. J Bone Joint Surg Br. 2005; 88(1):31-4. DOI: 10.1302/0301-620X.88B1.16764. View

11.

Loughead J, Chesney D, Holland J, McCaskie A . Comparison of offset in Birmingham hip resurfacing and hybrid total hip arthroplasty. J Bone Joint Surg Br. 2005; 87(2):163-6. DOI: 10.1302/0301-620x.87b2.15151. View

12.

Landis J, Koch G . The measurement of observer agreement for categorical data. Biometrics. 1977; 33(1):159-74. View

13.

Ahmad R, Gillespie G, Annamalai S, Barakat M, Ahmed S, Smith L . Leg length and offset following hip resurfacing and hip replacement. Hip Int. 2009; 19(2):136-40. DOI: 10.1177/112070000901900210. View

14.

Goldsmith A, Dowson D, Isaac G, Lancaster J . A comparative joint simulator study of the wear of metal-on-metal and alternative material combinations in hip replacements. Proc Inst Mech Eng H. 2000; 214(1):39-47. DOI: 10.1243/0954411001535228. View

15.

Clark C, Huddleston H, Schoch 3rd E, Thomas B . Leg-length discrepancy after total hip arthroplasty. J Am Acad Orthop Surg. 2006; 14(1):38-45. DOI: 10.5435/00124635-200601000-00007. View

16.

Kellgren J, Lawrence J . Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957; 16(4):494-502. PMC: 1006995. DOI: 10.1136/ard.16.4.494. View

17.

Su E, Sheehan M, Su S . Comparison of bone removed during total hip arthroplasty with a resurfacing or conventional femoral component: a cadaveric study. J Arthroplasty. 2008; 25(2):325-9. DOI: 10.1016/j.arth.2008.10.004. View

18.

Tanaka R, Shigematsu M, Motooka T, Mawatari M, Hotokebuchi T . Factors influencing the improvement of gait ability after total hip arthroplasty. J Arthroplasty. 2009; 25(6):982-5. DOI: 10.1016/j.arth.2009.06.009. View

19.

Moonot P, Singh P, Cronin M, Kalairajah Y, Kavanagh T, Field R . Birmingham hip resurfacing: is acetabular bone conserved?. J Bone Joint Surg Br. 2008; 90(3):319-23. DOI: 10.1302/0301-620X.90B3.18803. View

20.

De Smet K, Pattyn C, Verdonck R . Early results of primary Birmingham hip resurfacing using a hybrid metal-on-metal couple. Hip Int. 2017; 12(2):158-162. DOI: 10.1177/112070000201200225. View