1,504 results match your criteria femoral offset

High varus stem alignment in short-stem total hip arthroplasty: a risk for reconstruction of femoro-acetabular offset, leg length discrepancy and stem undersizing?

Arch Orthop Trauma Surg 2021 Sep 23. Epub 2021 Sep 23.

Department for Orthopedics and Traumatology, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020, Linz, Austria.

Purpose: Short stems are increasingly used in in total hip arthroplasty (THA) because of advantages in bone and soft tissue preservation and reconstruction of hip geometry. Short stems can be inserted in a more varus position compared to conventional straight stems. This poses the risk of final varus misplacement of the femoral component, which is not intended in all femoral short stems. Read More

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September 2021

External snapping hip syndrome is associated with an increased femoral offset.

Eur J Orthop Surg Traumatol 2021 Sep 22. Epub 2021 Sep 22.

Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.

Background: External snapping hip syndrome (ESH) is postulated to be one of the causes of greater trochanteric pain syndrome, which also includes greater trochanteric bursitis and tendinopathy or tears of the hip abductor mechanism. However, it was not yet described what kind of bony morphology can cause the snapping and whether symptomatic and asymptomatic individuals have different imaging features.

Purpose: It was the purpose of this study to look for predisposing morphological factors for ESH and to differentiate between painful and asymptomatic snapping. Read More

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September 2021

Association of the lateral wall integrity with clinical outcomes in older patients with intertrochanteric hip fractures treated with the proximal femoral nail anti-rotation-Asia.

Int Orthop 2021 Sep 21. Epub 2021 Sep 21.

Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China.

Purpose: The purpose of this study is to assess the role of the lateral wall in post-operative clinical outcomes in patients with intertrochanteric fractures treated with the proximal femoral nail anti-rotation-Asia (PFNA-II).

Methods: A cohort of 466 patients (OTA type 31A1 or A2) was divided into two groups: one was intact lateral wall group, and the other was fractured lateral wall group. Radiographic outcomes were measured by using the loss of neck-shaft angle (NSA), femoral neck shortening (FNS), and offset shortening (OS). Read More

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September 2021

The effect of range of motion simulated with a patient-specific three-dimensional simulation analysis on dislocation after total hip arthroplasty.

Hip Int 2021 Sep 19:11207000211044807. Epub 2021 Sep 19.

Department of Orthopaedic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.

Background: Dislocation continues to be a common complication following total hip arthroplasty (THA). Although previous studies of computed simulation analysis investigated the range of motion (ROM), it is unclear whether the ROM before impingement simulated using computed tomography-based 3-dimensional simulation analysis (simulated ROM) is related to dislocation after THA. It is also unclear what angles are required in computed simulation analyses for stable hips after THA. Read More

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September 2021

Dunn View Alpha Angle More Useful Than Femoral Head-Neck Offset to Predict Acetabular Cartilage Damage in Patients with FAIS Undergoing Hip Arthroscopy.

Arthroscopy 2021 Sep 16. Epub 2021 Sep 16.

American Hip Institute Research Foundation, Chicago, IL 60018; American Hip Institute, Chicago, IL 60018; AMITA Health St. Alexius Medical Center, Hoffman Estates, IL 60169. Electronic address:

Purpose: To identify radiographic measurements and demographics that are predictive of acetabular cartilage damage in patients with femoroacetabular impingement syndrome (FAIS) undergoing hip arthroscopy. More specifically, to compare the predictive value of alpha angle and femoral head-neck offset, as measured on Dunn view radiographs, in determining the preoperative likelihood and severity of acetabular cartilage damage.

Methods: Patients were included if they underwent primary hip arthroscopy for FAIS between February 2008 and June 2020. Read More

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September 2021

Comparing Postoperative Leg Length Discrepancy and Femoral Offset Using Two Different Surgical Approaches for Hemiarthroplasty of the Hip.

Spartan Med Res J 2021 30;6(2):25096. Epub 2021 Aug 30.

Ascension St. John Hospital.

Introduction: The direct anterior approach (DAA) and anterolateral approach (ALA) may be used for hip hemiarthroplasty (HHA) as a treatment for femoral neck fractures. The DAA often utilizes intraoperative fluoroscopy to determine leg length and offset, while the ALA traditionally utilizes an intraoperative clinical exam to determine offset and leg length. This study will evaluate two techniques: the "grid fluoroscopy [GF] technique" and the "intraoperative exam [IE] technique," each performed by one of two separate surgeons, and compare each technique's accuracy to restore leg length and femoral offset in a patient population that underwent HHA. Read More

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Robotic-arm assisted versus manual total hip arthroplasty: Systematic review and meta-analysis of radiographic accuracy.

Int J Med Robot 2021 Sep 16:e2332. Epub 2021 Sep 16.

Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, 44195, USA.

Background: We systematically reviewed the radiological outcomes of studies comparing robotic-assisted (RA-THA) and manual total hip arthroplasty (mTHA).

Methods: The PubMed, Embase, and Cochrane databases were queried from 1994-2021 for articles comparing radiographic outcomes between RA-THA and mTHA cohorts. A meta-analysis was conducted whenever sufficient data was present for common outcomes. Read More

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September 2021

Radiographic Findings in Flexion Instability after Total Knee Arthroplasty.

J Knee Surg 2021 Sep 10. Epub 2021 Sep 10.

Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Flexion instability (FI) is one of the leading causes of knee pain and revision surgery. Generally, the biomechanical etiology is considered to be a larger flexion than extension gap. This may be due to mismatch of components sizes to the bone or malalignment. Read More

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September 2021

Deep-Freezing Temperatures During Irradiation Preserves the Compressive Strength of Human Cortical Bone Allografts: A Cadaver Study.

Clin Orthop Relat Res 2021 Sep 6. Epub 2021 Sep 6.

Bone Bank, National Orthopaedic Centre of Excellence in Research and Learning, Kuala Lumpur, Malaysia.

Background: Gamma irradiation, which minimizes the risk of infectious disease transmission when human bone allograft is used, has been found to negatively affect its biomechanical properties. However, in those studies, the deep-freezing temperature during irradiation was not necessarily maintained during transportation and sterilization, which may have affected the findings. Prior reports have also suggested that controlled deep freezing may mitigate the detrimental effects of irradiation on the mechanical properties of bone allograft. Read More

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September 2021

Clinical impact of component placement in manually instrumented total knee arthroplasty : a systematic review.

Bone Joint J 2021 Sep;103-B(9):1449-1456

Department of Orthopaedic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Missouri, USA.

Aims: The goal of the current systematic review was to assess the impact of implant placement accuracy on outcomes following total knee arthroplasty (TKA).

Methods: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using the Ovid Medline, Embase, Cochrane Central, and Web of Science databases in order to assess the impact of the patient-reported outcomes measures (PROMs) and implant placement accuracy on outcomes following TKA. Studies assessing the impact of implant alignment, rotation, size, overhang, or condylar offset were included. Read More

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September 2021

The ability to kneel before and after total knee arthroplasty : the role of the pattern of osteoarthritis and the position of the femoral component.

Bone Joint J 2021 Sep;103-B(9):1514-1525

Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.

Aims: The aims of this study were to investigate the ability to kneel after total knee arthroplasty (TKA) without patellar resurfacing, and its effect on patient-reported outcome measures (PROMs). Secondary aims included identifying which kneeling positions were most important to patients, and the influence of radiological parameters on the ability to kneel before and after TKA.

Methods: This prospective longitudinal study involved 209 patients who underwent single radius cruciate-retaining TKA without patellar resurfacing. Read More

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September 2021

Evaluation of anteroposterior accelerometric change after bi-cruciate stabilized total knee arthroplasty and posterior stabilized total knee arthroplasty.

Knee 2021 Aug 27;32:121-130. Epub 2021 Aug 27.

Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan; Akita Sports, Arthroscopy, and Knee Group (ASKAG), Akita, Japan.

Background: In conventional total knee arthroplasty (TKA), the anterior cruciate ligament (ACL) is resected. ACL dysfunction causes knee instability and is regarded as one factor in poor TKA outcomes. In bi-cruciate stabilized (BCS) TKA, the implant reproduces ACL function and provides anterior stability. Read More

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Radiographic Cam Morphology of the Hip May Be Associated with ACL Injury of the Knee: A Case-Control Study.

Arthrosc Sports Med Rehabil 2021 Aug 24;3(4):e1165-e1170. Epub 2021 Jun 24.

University of Iowa, Department of Orthopedics and Rehabilitation, Iowa City, Iowa.

Purpose: To evaluate femoral and acetabular morphology in patients who underwent anterior cruciate ligament reconstruction (ACLR).

Methods: A retrospective review of a prospectively collected ACL registry was performed to identify patients with pelvis radiographs before undergoing either primary or revision ACLR between January 2010 and August 2020. Alpha angle (AA), head-neck offset ratio (HNOR), lateral center edge angle (LCEA), and crossover sign (COS) were measured on the operative side. Read More

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Mismatch between Conventional Femoral Arthroplasty Stems and Hip Morphology in the Elderly Chinese Hip Fracture Population.

Jwx Siow Ebk Kwek

Malays Orthop J 2021 Jul;15(2):101-106

Department of Orthopaedic Surgery, Woodlands Health Campus, Singapore.

Introduction: The morphology of the proximal femur differs in various populations. Based on our clinical experience, conventional femoral stems used in hip arthroplasty do not fit the Chinese population well. Hence, this study aims to evaluate the suitability of conventional femoral stems in the elderly Chinese hip fracture population requiring hip arthroplasty and to establish if gender and age related differences exist within this population. Read More

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How Does Implant Survivorship Vary with Different Corail Femoral Stem Variants? Results of 51,212 Cases with Up to 30 Years Of Follow-up from the Norwegian Arthroplasty Register.

Clin Orthop Relat Res 2021 Oct;479(10):2169-2180

The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway.

Background: The Corail® cementless stem (DePuy Synthes) has been used in Norway since 1987 and is one of the most frequently used stems in THA worldwide. Although the published survival results of the standard Corail stem have been good, little is known about the long-term (more than 20 years) survival of other stem design variants. Further, some changes were made to the extramedullary part of the stem in 2003, and the effect of these changes on survival is unknown. Read More

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October 2021

Preoperative radiographs to predict component malposition in direct anterior approach total hip arthroplasty.

Hip Int 2021 Aug 23:11207000211037596. Epub 2021 Aug 23.

Orthopaedics Department, Royal Hobart Hospital, Hobart, TAS, Australia.

Introduction: There is conflicting evidence as to whether or not patients undergoing total hip arthroplasty (THA) via the direct anterior approach (DAA) have increased risk of component malposition. The aim of this study was to investigate whether specific preoperative radiographic features were predictive of postoperative component malposition in DAA THA.

Patients And Methods: We examined 204 THA operations performed for osteoarthritis via the DAA at a single institution. Read More

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The Role of Imaging in Femoroacetabular Impingement: History, Current Practices, and Future Applications.

JBJS Rev 2021 08 20;9(8). Epub 2021 Aug 20.

Department of Orthopaedic Surgery and Sports Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio.

»: Femoroacetabular impingement (FAI) is one of the most common causes of early hip articular cartilage wear and labral damage, and subsequently leads to the onset of hip osteoarthritis.

»: Cam-type FAI impingement lesions can be best identified with a 90° Dunn lateral radiograph and a cross-table lateral radiograph with 15° of internal rotation; the alpha angle and the femoral head-neck offset are the most used predictive radiographic markers.

»: FAI lesions with pincer impingement are associated with acetabular retroversion and are more difficult to identify on traditional radiographic imaging; however, the presence of a crossover sign, an ischial spine sign, and/or a posterior wall sign can be useful radiographic markers. Read More

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Comparison of periprosthetic bone mineral density between two types of short-stems in total hip arthroplasty with a mean follow-up of 4 years.

Orthop Traumatol Surg Res 2021 Aug 10:103044. Epub 2021 Aug 10.

Service de chirurgie orthopédique et traumatologie, CHU Amiens-Picardie, 80480 Salouël, France.

Introduction: The use of short stems in primary hip arthroplasty has grown considerably in recent years, with a large variety of designs and stabilization methods available. Few studies have directly compared how these designs and fixation modes influence the bone mineral density (BMD) that is said to be better preserved with shorter implants. This led us to carry out a medium-term retrospective comparative study to (1) specify how the design of two different types of short stems influences the periprosthetic BMD, (2) compare the radiological and clinical outcomes of these stems. Read More

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No benefits of minimally invasive total hip arthroplasty via Watson-Jones approach: A retrospective cohort study.

Surgeon 2021 Aug 10. Epub 2021 Aug 10.

Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081, Baronissi, (SA), Italy; School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, England, UK; Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, England, UK. Electronic address:

Introduction: There is controversy about the role of minimally invasive surgery (MIS) for total hip arthroplasty (THA). The present study aimed to investigate whether a MIS approach has a positive impact on the outcome of THA via the Watson-Jones anterolateral approach. Clinical scores and radiological findings of minimally and standard invasive exposures were evaluated and compared. Read More

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Editorial Commentary: Outcomes After Anterior Cruciate Ligament Reconstruction Are Defined by Individual Anatomy, Including Both Soft Tissue and Bone Morphology: It's All Important.

Arthroscopy 2021 08;37(8):2542-2544

University of Pittsburgh Medical Center.

Well-designed studies add to our understanding of the anatomy, biology, biomechanics, and outcomes of the anterior cruciate ligament (ACL) following injury. Despite improvements in ACL treatment, we are still unable to exactly restore the individually unique function of the native ACL due to the complexity of knee physiology. The ACL is a dynamic structure with a rich neurovascular supply, distinct bundles, and 3-dimensional architecture that function in synergy with the bony morphology to facilitate healthy knee kinematics. Read More

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Restoring hip biomechanics during the learning curve of a novice surgeon: Direct anterior approach vs posterior approach.

J Orthop 2021 Jul-Aug;26:72-78. Epub 2021 Jul 13.

Hip Surgery Unit, Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona Departament de Cirurgia, Barcelona, Spain.

Introduction: It remains controversial whether the direct anterior approach (DAA) or the posterior approach (PA) allows better restoration of hip biomechanics after total hip arthroplasty (THA). Besides, it is not certain which approach is best for a novice surgeon to avoid implant malposition, neither during the learning curve nor once the curve plateau has been reached.

Methods: We performed a retrospective cohort study of THAs operated on between 2014 and 2019 by a single novice surgeon (DAA, n = 187; PA, n = 184). Read More

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A Workflow Change in Anterior Approach Total Hip Arthroplasty Leads to Improved Accuracy of Biomechanical Reconstruction Without Increased Risk of Complications.

Arthroplast Today 2021 Aug 15;10:99-104. Epub 2021 Jul 15.

Department of Orthopedic Surgery, Illinois Bone & Joint Institute, Morton Grove, IL, USA.

Background: During anterior approach total hip arthroplasty (THA), the femur may be an impediment for acetabular access, pushing reamers proximally and consequently altering the hip center. In an effort to address this, the senior author changed the surgical workflow from acetabulum first (AF) to femur first (FF). The objective of this study was to compare the precision of biomechanical hip reconstruction and clinical outcomes between the FF and AF techniques. Read More

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A prospective, phase II, single-centre, cross-sectional, randomised study investigating Dehydroepiandrosterone supplementation and its Profile in Trauma: ADaPT.

BMJ Open 2021 07 26;11(7):e040823. Epub 2021 Jul 26.

NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital Birmingham, Birmingham, UK.

Introduction: The improvements in short-term outcome after severe trauma achieved through early resuscitation and acute care can be offset over the following weeks by an acute systemic inflammatory response with immuneparesis leading to infection, multiorgan dysfunction/multiorgan failure (MOF) and death. Serum levels of the androgen precursor dehydroepiandrosterone (DHEA) and its sulfate ester DHEAS, steroids with immune-enhancing activity, are low after traumatic injury at a time when patients are catabolic and immunosuppressed. Addressing this deficit and restoring the DHEA(S) ratio to cortisol may provide a range of physiological benefits, including immune modulatory effects. Read More

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Revision Hip Arthroscopy in the Native Hip: A Review of Contemporary Evaluation and Treatment Options.

Front Surg 2021 5;8:662720. Epub 2021 Jul 5.

Hospital for Special Surgery, New York, NY, United States.

Hip arthroscopy is a reproducible and efficacious procedure for the treatment of femoroacetabular impingement syndrome (FAIS). Despite this efficacy, clinical failures are observed, clinical entities are challenging to treat, and revision hip arthroscopy may be required. The most common cause of symptom recurrence after a hip arthroscopy that leads to a revision arthroscopy is residual cam morphology as a result of inadequate femoral osteochondroplasty and restoration of head-neck offset, though several other revision etiologies including progressive chondral and labral pathologies also exist. Read More

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Short stem hip arthroplasty via the minimally invasive direct anterior approach.

Oper Orthop Traumatol 2021 Aug 12;33(4):288-303. Epub 2021 Jul 12.

Department of Orthopaedic Surgery, University of Wuerzburg, Koenig-Ludwig-Haus, Brettreichstr. 11, 97074, Wuerzburg, Germany.

Objective: Tissue-sparing, minimally invasive hip arthroplasty via the direct anterior approach (DAA) using a partially neck-preserving, calcar-guided short stem.

Indications: Primary and secondary osteoarthritis of the hip due to developmental dysplasia, femoroacetabular impingement, femoral head necrosis or trauma sequelae.

Contraindications: Severe osteoporosis, active infection, American Society of Anesthesiologists (ASA) > III, large metaphyseal bone defects, severe metaphyseal deformities, Dorr type C femur. Read More

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Cement-a-TAN Temporary Proximal Femoral Replacement for Staged Joint Replacement - A Case Report.

J Orthop Case Rep 2021 Mar;11(3):85-89

Department of Trauma and Orthopaedics, Bristol Royal Infirmary, Bristol. UK.

Introduction: Infected non-unions of proximal femoral fractures are difficult to treat. If debridement and revision fixation is unsuccessful, staged revision arthroplasty may be required. Non-viable tissue must be resected; coupled with the introduction of an antibiotic-eluting temporary spacer before definitive reconstruction. Read More

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Hip implants can restore anatomical and medialized rotation centres in most cases : a 3D templating study comparing four implantation strategies.

Bone Jt Open 2021 Jul;2(7):476-485

Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, Brussel, Belgium.

Aims: Hip arthroplasty does not always restore normal anatomy. This is due to inaccurate surgery or lack of stem sizes. We evaluated the aptitude of four total hip arthroplasty systems to restore an anatomical and medialized hip rotation centre. Read More

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A neck-preserving short stem better reconstructs the centre of rotation than straight stems: a computed tomography-based cadaver study.

Arch Orthop Trauma Surg 2021 Jul 6. Epub 2021 Jul 6.

Expert and Product Management Department, BBraun Aesculap, Tuttlingen, Germany.

Introduction: Short femoral hip stems with a metaphyseal anchoring concept have been designed to treat younger patients with good bone quality. The aim of this study was to reconstruct the centre of rotation and soft tissue balancing and preserve bone in the long-term perspective.

Materials And Methods: Eighteen human femurs were randomised into three groups: (1) metaphyseal anchoring short stem, (2) shortened straight stem, (3) straight stem). Read More

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Significance of Tip Apex Distance in Intertrochanteric Fracture femur managed with Proximal femoral nailing.

Orthop Traumatol Surg Res 2021 Jul 1:103009. Epub 2021 Jul 1.

Department of Orthopaedics, National Institute of Medical Sciences, Jaipur, India.

Introduction: Tip Apex distance (TAD) is well established method of prediction of outcome in intertrochanteric fractures managed by Dynamic Hip Screw. This retrospective study was done to assess the significance of Tip Apex Distance in the management of the intertrochanteric fractures by Proximal femoral nail.

Material And Methods: The study was done in a tertiary care centre where 174 follow-up patients operated for intertrochanteric fractures with proximal femoral nail were included in the study. Read More

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Dual Modular Titanium Alloy Femoral Stem Failure Mechanisms and Suggested Clinical Approaches.

Materials (Basel) 2021 Jun 4;14(11). Epub 2021 Jun 4.

Department of Orthopaedic Surgery, University Medical Centre Maribor, 5 Ljubljanska Street, 2000 Maribor, Slovenia.

Titanium (Ti) alloys have been proven to be one of the most suitable materials for orthopaedic implants. Dual modular stems have been introduced to primary total hip arthroplasty (THA) to enable better control of the femoral offset, leg length, and hip stability. This systematic review highlights information acquired for dual modular Ti stem complications published in the last 12 years and offers a conclusive discussion of the gathered knowledge. Read More

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