Risk factors for iliopsoas impingement after total hip arthroplasty using a collared femoral prosthesis
Abstract Background The relationship between collar design of a femoral component and iliopsoas impingement (IPI) after total hip arthroplasty (THA) is still underrecognized. The purpose of our study was to determine the possible risk factors for IPI related to the femoral component, when using a co...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01787-3 |
| _version_ | 1828351032419155968 |
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| author | Jiandi Qiu Xiurong Ke Shanxi Chen Liben Zhao Fanghui Wu Guojing Yang Lei Zhang |
| author_facet | Jiandi Qiu Xiurong Ke Shanxi Chen Liben Zhao Fanghui Wu Guojing Yang Lei Zhang |
| author_sort | Jiandi Qiu |
| collection | DOAJ |
| description | Abstract Background The relationship between collar design of a femoral component and iliopsoas impingement (IPI) after total hip arthroplasty (THA) is still underrecognized. The purpose of our study was to determine the possible risk factors for IPI related to the femoral component, when using a collared femoral prosthesis. Methods A total of 196 consecutive THA patients (206 hips) using a collared femoral prosthesis were reviewed retrospectively after exclusion of the factors related to acetabular component and femoral head. The patients were divided into +IPI and −IPI group according to the presence of IPI. Radiological evaluations were performed including femoral morphology, stem positioning, and collar protrusion length (CPL). Multivariate regression analysis was performed to assess the risk factors for IPI. Results At a minimum follow-up of 1 year, IPI was observed in 15 hips (7.3%). Dorr type C proximal femur was found in nine hips (60%) in the +IPI group and in 28 hips in the −IPI group (14.7%, p < 0.001). The mean stem anteversion in the +IPI group was significantly greater than that in the −IPI group (19.1° vs. 15.2°, p < 0.001), as well as the mean CPL (2.6 mm vs. − 0.5 mm, p < 0.001). The increased stem anteversion (OR = 1.745, p = 0.001) and CPL (OR = 13.889, p = 0.001) were potential risk factors for IPI. Conclusions The incidence of IPI after THA is higher than expected when using a collared femoral prosthesis. Among the factors related to collared femoral prosthesis, excessively increased stem anteversion and prominent collar protrusion are independent predictors for IPI. In addition, high risk of IPI should be carefully considered in Dorr type C bone, despite that femoral morphology is not a predictive factor. Level of evidence Level IV, clinical cohort study |
| first_indexed | 2024-04-14T01:33:41Z |
| format | Article |
| id | doaj.art-27d5de0fae2c450c86c509ff59237e49 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T01:33:41Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-27d5de0fae2c450c86c509ff59237e492022-12-22T02:20:04ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-07-011511810.1186/s13018-020-01787-3Risk factors for iliopsoas impingement after total hip arthroplasty using a collared femoral prosthesisJiandi Qiu0Xiurong Ke1Shanxi Chen2Liben Zhao3Fanghui Wu4Guojing Yang5Lei Zhang6Department of Adult Reconstruction, The Third Affiliated Hospital of Wenzhou Medical UniversityDepartment of Adult Reconstruction, The Third Affiliated Hospital of Wenzhou Medical UniversityDepartment of Radiology, The Third Affiliated Hospital of Wenzhou Medical UniversityDepartment of Adult Reconstruction, The Third Affiliated Hospital of Wenzhou Medical UniversityDepartment of Adult Reconstruction, The Third Affiliated Hospital of Wenzhou Medical UniversityDepartment of Adult Reconstruction, The Third Affiliated Hospital of Wenzhou Medical UniversityDepartment of Adult Reconstruction, The Third Affiliated Hospital of Wenzhou Medical UniversityAbstract Background The relationship between collar design of a femoral component and iliopsoas impingement (IPI) after total hip arthroplasty (THA) is still underrecognized. The purpose of our study was to determine the possible risk factors for IPI related to the femoral component, when using a collared femoral prosthesis. Methods A total of 196 consecutive THA patients (206 hips) using a collared femoral prosthesis were reviewed retrospectively after exclusion of the factors related to acetabular component and femoral head. The patients were divided into +IPI and −IPI group according to the presence of IPI. Radiological evaluations were performed including femoral morphology, stem positioning, and collar protrusion length (CPL). Multivariate regression analysis was performed to assess the risk factors for IPI. Results At a minimum follow-up of 1 year, IPI was observed in 15 hips (7.3%). Dorr type C proximal femur was found in nine hips (60%) in the +IPI group and in 28 hips in the −IPI group (14.7%, p < 0.001). The mean stem anteversion in the +IPI group was significantly greater than that in the −IPI group (19.1° vs. 15.2°, p < 0.001), as well as the mean CPL (2.6 mm vs. − 0.5 mm, p < 0.001). The increased stem anteversion (OR = 1.745, p = 0.001) and CPL (OR = 13.889, p = 0.001) were potential risk factors for IPI. Conclusions The incidence of IPI after THA is higher than expected when using a collared femoral prosthesis. Among the factors related to collared femoral prosthesis, excessively increased stem anteversion and prominent collar protrusion are independent predictors for IPI. In addition, high risk of IPI should be carefully considered in Dorr type C bone, despite that femoral morphology is not a predictive factor. Level of evidence Level IV, clinical cohort studyhttp://link.springer.com/article/10.1186/s13018-020-01787-3Iliopsoas impingementHipArthroplastyCollared femoral prosthesisComplicationRisk factor |
| spellingShingle | Jiandi Qiu Xiurong Ke Shanxi Chen Liben Zhao Fanghui Wu Guojing Yang Lei Zhang Risk factors for iliopsoas impingement after total hip arthroplasty using a collared femoral prosthesis Journal of Orthopaedic Surgery and Research Iliopsoas impingement Hip Arthroplasty Collared femoral prosthesis Complication Risk factor |
| title | Risk factors for iliopsoas impingement after total hip arthroplasty using a collared femoral prosthesis |
| title_full | Risk factors for iliopsoas impingement after total hip arthroplasty using a collared femoral prosthesis |
| title_fullStr | Risk factors for iliopsoas impingement after total hip arthroplasty using a collared femoral prosthesis |
| title_full_unstemmed | Risk factors for iliopsoas impingement after total hip arthroplasty using a collared femoral prosthesis |
| title_short | Risk factors for iliopsoas impingement after total hip arthroplasty using a collared femoral prosthesis |
| title_sort | risk factors for iliopsoas impingement after total hip arthroplasty using a collared femoral prosthesis |
| topic | Iliopsoas impingement Hip Arthroplasty Collared femoral prosthesis Complication Risk factor |
| url | http://link.springer.com/article/10.1186/s13018-020-01787-3 |
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