Abstract
BackgroundThe purpose of total hip arthroplasty (THA) post-surgery and proper physiotherapy is positive recovery for the patient. Consideration is given to hip replacement biomechanics by ensuring no discrepancies in limb length (LL) and a stable prosthesis. Therefore, the patient must have proper preoperative planning and communication and a clear understanding of what to expect.MethodsA prospective series of 59 THA operated by a single surgeon via Hardinge approach was studied, using an intraoperative calliper (CAL) to predict the change of LL and offset. We compared the results of the intraoperative changes before and after THA implantation with the reference of these values on anteroposterior x-ray pelvis. The importance of leg length balance and a good offset restoration is questioned, and the effect of component subsidence on leg length is considered.ResultsThe average preoperative leg length discrepancy was −6.0 mm, postoperatively +3.6 mm. There was a strong correlation between the CAL measurements and the values on the x-ray (LL, r=0.873, p<0.01; offset, r=0.542, p<0.01). Reliability is better for limb length than for offset. These results are comparable within the literature and the statistical results from other studies reviewed. In addition, we evaluate the importance of subsidence of the prosthesis components for long-term results.ConclusionThe intraoperative use of CAL gives excellent results in predicting the final LL and offset after THA. Considering subsidence of prosthesis components, a target zone around +5 mm might be more suitable for leg length directly postoperatively. Moreover, surgeons must discuss the topic of leg length discrepancy (LLD) intensively with the patient pre-operatively.Level of evidenceLevel 4, prospective cohort study
Highlights
Since its introduction more than 70 years ago, total hip arthroplasty (THA) is one of the most successful and Fansur et al Journal of Orthopaedic Surgery and Research (2021) 16:424 uncertainty about the ideal postoperative leg length and offset after THA
The hypothesis of this study is that the use of an intraoperative calliper can predict the postoperative leg length and offset, and improve the outcome of THA operations
The first section presents the results related to postoperative leg length and offset using an intraoperative calliper (CAL)
Summary
Since its introduction more than 70 years ago, total hip arthroplasty (THA) is one of the most successful and Fansur et al Journal of Orthopaedic Surgery and Research (2021) 16:424 uncertainty about the ideal postoperative leg length and offset after THA. The authors decided it was valuable to present the results from this study suggesting the value of an intraoperative calibration gauge to make THA more predictable. The hypothesis of this study is that the use of an intraoperative calliper can predict the postoperative leg length and offset, and improve the outcome of THA operations. The values from anterior-posterior (AP) x-ray of the pelvis with a calibration ball are used as a reference Utilizing this measurement method, the target zone for intraoperative leg length measurement is discussed with respect to other interfering factors. The purpose of total hip arthroplasty (THA) post-surgery and proper physiotherapy is positive recovery for the patient. The patient must have proper preoperative planning and communication and a clear understanding of what to expect
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