Restoration of hip anatomy using computer modelling prior to total hip arthroplasty and its potential consequences in terms of lower limb-length difference.

IF 1.3 4区医学 Q3 ORTHOPEDICS

HIP International Pub Date : 2024-05-01 Epub Date: 2023-12-14 DOI:10.1177/11207000231216937

Thomas Aubert, Guillaume Rigoulot, Philippe Gerard, Guillaume Auberger, Philippe Leclerc

{"title":"Restoration of hip anatomy using computer modelling prior to total hip arthroplasty and its potential consequences in terms of lower limb-length difference.","authors":"Thomas Aubert, Guillaume Rigoulot, Philippe Gerard, Guillaume Auberger, Philippe Leclerc","doi":"10.1177/11207000231216937","DOIUrl":null,"url":null,"abstract":"Background: Restoring hip anatomy during total hip arthroplasty (THA) is the gold standard. The general goal is for hips to be symmetrical in terms of height. This study aimed to analyse the effect of simulating hip length (HL) equalisation on leg-length difference (LLD) before and after THA with a computerised plan.Methods: 141 consecutive patients were enrolled following THA. Outcomes of interest were preoperative hip-length difference (HLD) and LLD as determined on CT and final LLD as determined by simulating HL equalisation. We divided patients into 3 groups: no LLD, LLD >5 mm and LLD ⩾10 mm.Results: The rate of preoperative LLD >5 mm and LLD ⩾10 mm was 37.5% and 14.8%, respectively. HL equalisation did not change LLD distribution in the overall cohort. Among patients with smaller preoperative HLs and LLDs, HL equalisation changed the rate of LLD >5 mm from 100% (n = 24) to 41.7% (n = 10) (p < 0.0001) and of LLD ⩾10 mm from 100% (n = 12) to 16.7% (n = 2) (p < 0.0001). Among patients with no preoperative LLD, HL equalisation changed the rate of LLD ⩽5 mm from 100% (n = 64) to 59.3% (n = 38) (p < 0.0001) and of LLD<10 mm from 100% (n = 76) to 89.5% (n = 68) (p = 0.006).Conclusions: Restoring biomechanical hip anatomy by HL equalisation may not be the correct goal for all patients. In patients with no LLD and shorter HLs, equalisation could result in LLD >5 mm in 40% of patients and LLD >10 mm in 10%, demonstrating the necessity to further analyse individuals and propose a personalised stem position.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"344-349"},"PeriodicalIF":1.3000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"HIP International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/11207000231216937","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/14 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Restoring hip anatomy during total hip arthroplasty (THA) is the gold standard. The general goal is for hips to be symmetrical in terms of height. This study aimed to analyse the effect of simulating hip length (HL) equalisation on leg-length difference (LLD) before and after THA with a computerised plan.

Methods: 141 consecutive patients were enrolled following THA. Outcomes of interest were preoperative hip-length difference (HLD) and LLD as determined on CT and final LLD as determined by simulating HL equalisation. We divided patients into 3 groups: no LLD, LLD >5 mm and LLD ⩾10 mm.

Results: The rate of preoperative LLD >5 mm and LLD ⩾10 mm was 37.5% and 14.8%, respectively. HL equalisation did not change LLD distribution in the overall cohort. Among patients with smaller preoperative HLs and LLDs, HL equalisation changed the rate of LLD >5 mm from 100% (n = 24) to 41.7% (n = 10) (p < 0.0001) and of LLD ⩾10 mm from 100% (n = 12) to 16.7% (n = 2) (p < 0.0001). Among patients with no preoperative LLD, HL equalisation changed the rate of LLD ⩽5 mm from 100% (n = 64) to 59.3% (n = 38) (p < 0.0001) and of LLD<10 mm from 100% (n = 76) to 89.5% (n = 68) (p = 0.006).

Conclusions: Restoring biomechanical hip anatomy by HL equalisation may not be the correct goal for all patients. In patients with no LLD and shorter HLs, equalisation could result in LLD >5 mm in 40% of patients and LLD >10 mm in 10%, demonstrating the necessity to further analyse individuals and propose a personalised stem position.

查看原文本刊更多论文

全髋关节置换术前利用计算机建模恢复髋关节解剖结构及其对下肢长度差异的潜在影响。

背景：在全髋关节置换术（THA）中恢复髋关节解剖结构是金标准。其总体目标是使髋部高度对称。本研究旨在分析在全髋关节置换术前后使用计算机计划模拟髋长（HL）均衡对腿长差（LLD）的影响。相关结果为术前髋长差（HLD）和 CT 确定的 LLD，以及模拟 HL 平衡确定的最终 LLD。我们将患者分为三组：无 LLD、LLD >5 mm 和 LLD ⩾10 mm：术前 LLD >5 mm 和 LLD ⩾10 mm 的比例分别为 37.5% 和 14.8%。HL均衡化并没有改变整个队列中LLD的分布。在术前HL和LLD较小的患者中，HL均等化使LLD>5 mm的比例从100%（n = 24）变为41.7%（n = 10）（p n = 12）变为16.7%（n = 2）（p n = 64）变为59.3%（n = 38）（p n = 76）变为89.5%（n = 68）（p = 0.006）：结论：通过 HL 平衡来恢复髋关节生物力学解剖结构可能不是所有患者的正确目标。在无LLD和HL较短的患者中，均衡术可能导致40%的患者LLD>5 mm，10%的患者LLD>10 mm，这表明有必要进一步分析个体情况，并提出个性化的骨干位置。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

HIP International 医学-整形外科

CiteScore

4.20

自引率

0.00%

发文量

审稿时长

2 months

期刊介绍： HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology