Biomechanical reconstruction of the hip

  • J. Girard
    Department of Orthopaedics Maisonneuve-Rosemont Hospital, 5345 Boul L’Assomption, Suite 55, Montréal, Québec H1T 4B3, Canada.
  • M. Lavigne
    Department of Orthopaedics Maisonneuve-Rosemont Hospital, 5345 Boul L’Assomption, Suite 55, Montréal, Québec H1T 4B3, Canada.
  • P.-A. Vendittoli
    Department of Orthopaedics Maisonneuve-Rosemont Hospital, 5345 Boul L’Assomption, Suite 55, Montréal, Québec H1T 4B3, Canada.
  • A. G. Roy
    Department of Orthopaedics Maisonneuve-Rosemont Hospital, 5345 Boul L’Assomption, Suite 55, Montréal, Québec H1T 4B3, Canada.

書誌事項

タイトル別名
  • A RANDOMISED STUDY COMPARING TOTAL HIP RESURFACING AND TOTAL HIP ARTHROPLASTY
公開日
2006-06
権利情報
  • https://online.boneandjoint.org.uk/TDM
DOI
  • 10.1302/0301-620x.88b6.17447
公開者
British Editorial Society of Bone & Joint Surgery

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説明

<jats:p> We have compared the biomechanical nature of the reconstruction of the hip in conventional total hip arthroplasty (THA) and surface replacement arthroplasty (SRA) in a randomised study involving 120 patients undergoing unilateral primary hip replacement. The contralateral hip was used as a control. </jats:p><jats:p> Post-operatively, the femoral offset was significantly increased with THA (mean 5.1 mm; −2.8 to 11.6) and decreased with SRA (mean −3.3 mm; −8.9 to 8.2). Femoral offset was restored within sd 4 mm in 14 (25%) of those with THA and in 28 (57%) of the patients receiving SRA (p < 0.001). In the THA group, the leg was lengthened by a mean of 2.6 mm (−6.04 to +12.9), whereas it was shortened by a mean of 1.9 mm (−7.1 to +2.05) in the SRA group, compared with the contralateral side. Leg-length inequality was restored within sd 4 mm in 42 (86%) of the SRA and 33 (60%) of the THA patients. The radiological parameters of acetabular reconstruction were similar in both groups. </jats:p><jats:p> Restoration of the normal proximal femoral anatomy was more precise with SRA. The enhanced stability afforded by the use of a large-diameter femoral head avoided over-lengthening of the limb or increased offset to improve soft-tissue tension as occurs sometimes in THA. In a subgroup of patients with significant pre-operative deformity, restoration of the normal hip anatomy with lower pre-operative femoral offset or significant shortening of the leg was still possible with SRA. </jats:p>

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