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The optimal combined anteversion pattern to achieve a favorable impingement-free angle in total hip arthroplasty.
- Source :
-
Journal of Orthopaedic Science . May2019, Vol. 24 Issue 3, p474-481. 8p. - Publication Year :
- 2019
-
Abstract
- <bold>Background: </bold>There have been no studies on the differences in impingement-free angle that result from different combined anteversion (CA) patterns. The aim of this study was to find the optimal CA pattern for achieving a favorable impingement-free angle, including bony and prosthetic impingement, in total hip arthroplasty.<bold>Methods: </bold>We evaluated 100 patients with no hip arthritis. We investigated the impingement-free angle (flexion, internal rotation with 90° flexion, extension, and external rotation) after changing the stem and cup anteversions to satisfy several CA patterns [cup anteversion + stem anteversion = 30°, 40°, 50°, and 60°; cup anteversion + 0.7 × stem anteversion = 37.3° (:Widmer's theory); and cup anteversion + 0.77 × stem anteversion = 43.3° (:Yoshimine's theory)] using 3-dimensional templating software.<bold>Results: </bold>The impingement-free angle changed dramatically among the various CA patterns. The optimal CA was changed by various stem anteversion. Only CA: Widmer with stem anteversion of 20° satisfied daily-life range of motion (ROM) requirements (flexion ≥130°, internal rotation with 90° flexion ≥ 45°, extension ≥ 40°, external rotation ≥ 40°).<bold>Conclusion: </bold>Good impingement-free angle cannot be obtained with single fixed CA. Different CA patterns should be used, depending on the differences in the stem anteversion. A CA of 30° with 0° ≤ stem anteversion ≤10°; a CA:Widmer with 20° of stem anteversion; a CA of 40° or Widmer with 30° of stem anteversion. When stem anteversion is ≥40°, CA should be decided by each patient's state. Among them, a stem anteversion of 20° with cup anteversion of 23.3° was found to be the best CA pattern. [ABSTRACT FROM AUTHOR]
- Subjects :
- *TOTAL hip replacement
Subjects
Details
- Language :
- English
- ISSN :
- 09492658
- Volume :
- 24
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Journal of Orthopaedic Science
- Publication Type :
- Academic Journal
- Accession number :
- 136157458
- Full Text :
- https://doi.org/10.1016/j.jos.2018.11.008