The association between Femoral Tilt and impingement-free range-of-motion in total hip arthroplasty.

BMC Musculoskeletal Disorders
T RenkawitzJ Grifka

Abstract

There is a complex interaction among acetabular component position and antetorsion of the femoral stem in determining the maximum, impingement-free prosthetic range-of-motion (ROM) in total hip arthroplasty (THA). By insertion into the femoral canal, stems of any geometry follow the natural anterior bow of the proximal femur, creating a sagittal Femoral Tilt (FT). We sought to study the incidence of FT as measured on postoperative computed tomography scans and its influence on impingement-free ROM in THA. The incidence of the postoperative FT was evaluated on 40 computed tomography scans after cementless THA. With the help of a three-dimensional computer model of the hip, we then systematically analyzed the effects of FT on femoral antetorsion and its influence on calculations for a ROM maximized and impingement-free compliant stem/cup orientation. The mean postoperative FT on CT scans was 5.7° ± 1.8°. In all tests, FT significantly influenced the antetorsion values. Re-calculating the compliant component positions according to the concept of combined anteversion with and without the influence of FT revealed that the zone of compliance could differ by more than 200%. For a 7° change in FT, the impingement-free cup position diff...Continue Reading

References

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Citations

Dec 25, 2012·Medical & Biological Engineering & Computing·Glen A TurleyDamian R Griffin
Jun 27, 2014·International Orthopaedics·Tsung-Yuan TsaiYoung-Min Kwon
Jun 29, 2015·Clinical Biomechanics·Tsung-Yuan TsaiYoung-Min Kwon
Apr 25, 2015·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Tsung-Yuan TsaiYoung-Min Kwon
Nov 20, 2015·BioMed Research International·Tim A WeberTobias Renkawitz
Jan 13, 2018·Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine·Jim PierrepontQing Li
Dec 25, 2017·International Orthopaedics·Keisuke Akiyama, Takaaki Shibuya
Apr 19, 2020·JBJS Reviews·Dimitrios A FlevasAndreas F Mavrogenis
Jun 9, 2021·Archives of Orthopaedic and Trauma Surgery·Joost H J van ErpArthur de Gast
Sep 17, 2021·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Ahmed K EmaraAtul F Kamath

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Methods Mentioned

BETA
total hip arthroplasty

Software Mentioned

Hip CT
Excel
Hip Storage Viewer

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