Capsular Ligament Function After Total Hip Arthroplasty

The Journal of Bone and Joint Surgery. American Volume
Richard J van ArkelJonathan R T Jeffers

Abstract

The hip joint capsule passively restrains extreme range of motion, protecting the native hip against impingement, dislocation, and edge-loading. We hypothesized that following total hip arthroplasty (THA), the reduced femoral head size impairs this protective biomechanical function. In cadavers, THA was performed through the acetabular medial wall, preserving the entire capsule, and avoiding the targeting of a particular surgical approach. Eight hips were examined. Capsular function was measured by rotating the hip in 5 positions. Three head sizes (28, 32, and 36 mm) with 3 neck lengths (anatomical 0, +5, and +10 mm) were compared. Internal and external rotation range of motion increased following THA, indicating late engagement of the capsule and reduced biomechanical function (p < 0.05). Internal rotation was affected more than external. Increasing neck length reduced this hypermobility, while too much lengthening caused nonphysiological restriction of external rotation. Larger head sizes only slightly reduced hypermobility. Following THA, the capsular ligaments were unable to wrap around the reduced-diameter femoral head to restrain extreme range of motion. The posterior capsule was the most affected, indicating that native ...Continue Reading

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Citations

Oct 1, 2019·The Journal of Bone and Joint Surgery. American Volume·K C Geoffrey NgPaul E Beaulé
Dec 5, 2019·The Journal of Bone and Joint Surgery. American Volume·K C Geoffrey NgPaul E Beaulé
Dec 1, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Ahmed M SamyAhmad El-Tantawy
Apr 19, 2021·The Journal of Arthroplasty·Andrew M SchwartzThomas L Bradbury
Aug 12, 2021·EFORT Open Reviews·Riccardo D'AmbrosiMichael Tobias Hirschmann
Aug 25, 2021·British Medical Bulletin·Luca MirandaNicola Maffulli
Sep 25, 2021·Bone & Joint Research·Kabelan J KarunaseelanJonathan R T Jeffers

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Methods Mentioned

BETA
total hip arthroplasty

Software Mentioned

PLSclear
SPSS

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