학술논문
Femoral Anteversion in Total Hip Arthroplasty: Retrospective Comparison of Short- and Straight-Stem Models Using CT Scans.
Document Type
Academic Journal
Author
Klim SM; Department of Orthopaedics & Traumatology, Medical University of Graz, Augenbruggerplatz 5, 8036 Graz, Austria.; Reinbacher P; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria.; Smolle MA; Department of Orthopaedics & Traumatology, Medical University of Graz, Augenbruggerplatz 5, 8036 Graz, Austria.; Hecker A; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria.; Maier M; Department of Orthopaedics & Traumatology, Medical University of Graz, Augenbruggerplatz 5, 8036 Graz, Austria.; Friesenbichler J; Department of Orthopaedics & Traumatology, Medical University of Graz, Augenbruggerplatz 5, 8036 Graz, Austria.; Leithner A; Department of Orthopaedics & Traumatology, Medical University of Graz, Augenbruggerplatz 5, 8036 Graz, Austria.; Leitner L; Department of Orthopaedics & Traumatology, Medical University of Graz, Augenbruggerplatz 5, 8036 Graz, Austria.; Draschl A; Department of Orthopaedics & Traumatology, Medical University of Graz, Augenbruggerplatz 5, 8036 Graz, Austria.; Lewis J; Department of Orthopaedics & Traumatology, Medical University of Graz, Augenbruggerplatz 5, 8036 Graz, Austria.; Brunnader K; Department of Orthopaedics & Traumatology, Medical University of Graz, Augenbruggerplatz 5, 8036 Graz, Austria.; Maurer-Ertl W; Department of Orthopaedics & Traumatology, Medical University of Graz, Augenbruggerplatz 5, 8036 Graz, Austria.
Source
Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2077-0383
Abstract
Data on reconstruction of the femoral anteversion (FA) and the center of rotation after total hip arthroplasty (THA) are rare. We aimed to answer whether a short-stem fixation enables improved anatomical reconstruction of the FA compared to a straight-stem.
Methods: One hundred and thirty patients who underwent short- (n = 89, group A, prospective) or straight-stem THA (n = 41, group B, retrospective) were included. CT scans of the hip, knee, and ankle were performed pre- and postoperatively in group A and in group B during the last follow-up. Femoral torsion was determined using three-dimensional models.
Results: The mean preoperative FA was 22.4° ± 11.0°, and the mean postoperative FA was 23.4° ± 10.1°. The relative difference was -0.8° ± 8°, and the absolute difference was 6.4° ± 4.9°. Gender analysis revealed significant differences in preoperative FA between female (f) and male (m) patients (28.1° ± 11.2° (f) vs. 18.4° ± 8.3° (m); p > 0.001) as well as in postoperative FA (26.7° ± 23.5° (f) vs. 21.0° ± 9.7° (m); p < 0.007) in group A. Postoperative FA was higher in group A (mean 6.8°; 23.9° ± 10.1° (f) vs. 16.6° ± 8.6° (m); p < 0.001).
Conclusions: The study's findings suggest that short-stem THA leads to improved anatomical FA reconstruction; however, a substantial postoperative gender-related FA difference was detectable, which may warrant consideration by surgeons when determining the final stem anteversion. It should be noted that the impact of the postoperative gender-related FA difference on clinical outcomes is not entirely clear, and further research is warranted to elucidate this relationship.
Methods: One hundred and thirty patients who underwent short- (n = 89, group A, prospective) or straight-stem THA (n = 41, group B, retrospective) were included. CT scans of the hip, knee, and ankle were performed pre- and postoperatively in group A and in group B during the last follow-up. Femoral torsion was determined using three-dimensional models.
Results: The mean preoperative FA was 22.4° ± 11.0°, and the mean postoperative FA was 23.4° ± 10.1°. The relative difference was -0.8° ± 8°, and the absolute difference was 6.4° ± 4.9°. Gender analysis revealed significant differences in preoperative FA between female (f) and male (m) patients (28.1° ± 11.2° (f) vs. 18.4° ± 8.3° (m); p > 0.001) as well as in postoperative FA (26.7° ± 23.5° (f) vs. 21.0° ± 9.7° (m); p < 0.007) in group A. Postoperative FA was higher in group A (mean 6.8°; 23.9° ± 10.1° (f) vs. 16.6° ± 8.6° (m); p < 0.001).
Conclusions: The study's findings suggest that short-stem THA leads to improved anatomical FA reconstruction; however, a substantial postoperative gender-related FA difference was detectable, which may warrant consideration by surgeons when determining the final stem anteversion. It should be noted that the impact of the postoperative gender-related FA difference on clinical outcomes is not entirely clear, and further research is warranted to elucidate this relationship.