Abstract
BackgroundA proper restoration of hip biomechanics is fundamental to achieve satisfactory outcomes after total hip arthroplasty (THA). A global hip offset (GO) postoperatively reduction of more than 5 mm was known to impair hip functionality after THA. This study aimed to verify the restoration of the GO radiographic parameter after primary THA by the use of a cementless femoral stem available in three different offset options without length changing.MethodsFrom a consecutive series of 201 patients (201 hips) underwent primary cementless THA in our center with a minimum 3-year follow up, 80 patients (80 hips) were available for complete radiographic evaluation for GO and limb length (LL) and clinical evaluation with Harris hip score (HHS). All patients received the same femoral stem with three different offset options (option A with – 5 mm offset, option B and option C with + 5 mm offset, constant for each sizes) without changing stem length.ResultsMean GO significantly increased by + 3 mm (P < 0.05) and mean LL significantly decreased by + 5 mm (P < 0.05) after surgery, meaning that postoperatively the limb length of the operated side increased by + 5 mm. HHS significantly improved from 56.3 points preoperatively to 95.8 postoperatively (P < 0.001). Offset option A was used in 1 hip (1%), B in 59 hips (74%) and C in 20 hips (25%).ConclusionsThe femur is lateralized with a mean of + 5 mm after surgery than, the native anatomy, whatever type of stem was used. Thus, the use of this 3-offset options femoral stem is effective in restoring the native biomechanical hip parameters as GO, even if 2 offset options were considered sufficient to restore GO.
Highlights
A proper restoration of hip biomechanics is fundamental to achieve satisfactory outcomes after total hip arthroplasty (THA)
global hip offset (GO) is the distance from the anatomical axis of the femur to the medial margin of the acetabulum and it is usually defined as the sum of the femoral offset (FO) and the acetabular offset (AO) [1]
When studying hip parameters restoration after primary THA, GO is more reliable as joint parameter than considering only FO because it takes into account the acetabular cup placement
Summary
A proper restoration of hip biomechanics is fundamental to achieve satisfactory outcomes after total hip arthroplasty (THA). A proper restoration of joint biomechanical parameters is fundamental to achieve satisfactory outcomes in terms of hip functionality and patient’s quality of life after total hip arthroplasty (THA). GO is the distance from the anatomical axis of the femur to the medial margin of the acetabulum and it is usually defined as the sum of the femoral offset (FO) and the acetabular offset (AO) [1]. FO is defined as the distance from the center of rotation of the femoral head to the anatomical axis of the femur [2]. AO is defined as the distance from the center of rotation of the femoral head to the perpendicular line passing through the medial edge of the ipsilateral teardrop [3].
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