Lower limb length and offset in total hip arthroplasty

Orthopaedics & Traumatology, Surgery & Research : OTSR
X FlecherJ N Argenson

Abstract

Restoration of normal hip biomechanics is a key goal of total hip arthroplasty (THA) and favorably affects functional recovery. Furthermore, a major concern for both the surgeon and the patient is preservation or restoration of limb length equality, which must be achieved without compromising the stability of the prosthesis. Here, definitions are given for anatomic and functional limb length discrepancies and for femoral and hip offset, determined taking anteversion into account. Data on the influence of operated-limb length and offset on patient satisfaction, hip function, and prosthesis survival after THA are reviewed. Errors may adversely impact function, quality of life, and prosthetic survival and may also generate conflicts between the surgeon and patient. Surgeons rely on two- or three-dimensional preoperative templating and on intraoperative landmarks to manage offset and length. Accuracy can be improved by using computer-assisted planning or surgery and the more recently introduced EOS imaging system. The prosthetic's armamentarium now includes varus-aligned and lateralized implants, as well as implants with modular or custom-made necks, which allow restoration of the normal hip geometry, most notably in patients with ...Continue Reading

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Citations

Mar 24, 2017·Orthopaedics & Traumatology, Surgery & Research : OTSR·X Flecher, H Migaud
Jan 17, 2019·The Bone & Joint Journal·B KayaniF S Haddad
Mar 30, 2019·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Oliver EnkeWarwick Jm Bruce
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Dec 15, 2020·Orthopaedics & Traumatology, Surgery & Research : OTSR·Felix W A WaibelPatrick O Zingg
Dec 12, 2020·European Journal of Medical Research·Sebastian SerongMarcel Haversath
Feb 19, 2021·Archives of Orthopaedic and Trauma Surgery·Christian KlemtYoung-Min Kwon
Feb 22, 2021·BMC Musculoskeletal Disorders·Anna Di LauraAlister J Hart
Feb 27, 2021·Journal of Orthopaedic Surgery and Research·Mingchen ZouZhaohui Song
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Apr 5, 2021·The Journal of Arthroplasty·Curtis T AdamsJared T Roberts
Jun 12, 2021·The Journal of Arthroplasty·Michael S PheasantJohn J Mercuri

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