Better restoration of femoral offset and leg length with the short curved stem in total hip arthroplasty.

Snijders, T.E. (2013) Better restoration of femoral offset and leg length with the short curved stem in total hip arthroplasty. thesis, Medicine.

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Abstract

Total hip arthroplasty has become a common and successful procedure in orthopedics with more than one million operations globally every year. Polyethylene wear from increased joint reaction forces and gait deficits have been frequently observed. Polyethylene wear is, among others, related to an imbalance between the weight of the body and the abductor moment arm. Gait deficits are also, among others, related to this imbalance and to leg length discrepancy. The design geometry of the stem influences both leg length and the abductor moment arm by the femoral offset. The aim of this study is to test the hypothesis that a short curved stem has the ability to better restore femoral offset and leg length than a conventional straight stem. In this radio-anatomical study a total of 112 patients underwent 126 primary total hip arthroplasties between December 2009 and August 2011 with a mean age of 63.46 years (range 39-86). The predominant diagnosis was osteoarthritis (92.8%). Femoral offset and leg length were compared between the conventional straight stem in vivo with a simulation of a short curved stem, which was templated on pre- and postoperative anteroposterior (AP) radiographs of the pelvis. Statistical analysis showed a significantly improved restoration of femoral offset (p=0.010) and leg length (p=0.000) with the short curved stem. The short curved stem gives less leg lengthening and less increase of femoral offset compared to the conventional straight stem. This outcome shows that the design geometry of the short curved stem is beneficial for femoral offset and leg length restoration in total hip arthroplasty.

Item Type:	Thesis (Thesis)
Supervisor name:	Verheyen, Dr. C.C.P.M.
Supervisor name:	Gast, Dr. A. de and Halma, Drs. J.J. and Diakonessenhuis Utrecht
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:47
Last Modified:	25 Jun 2020 10:47
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/806

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