The Impact of Varying Femoral Head Length on Hip External Rotation During Posterior-approach Total Hip Arthroplasty
Background: Prior investigations of total hip arthroplasty (THA) have studied the effects of prosthetic femoral head size and stem offset on hip range of motion (ROM), impingement risk, and overall hip stability to optimize the return to activities of daily living. However, the relationship between...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | Arthroplasty Today |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344122002497 |
| _version_ | 1797924706577285120 |
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| author | Seong J. Jang, BA Christopher Jones, PhD, MBBS (Hons) Kate Shanaghan, BS David J. Mayman, MD Alejandro Gonzalez Della Valle, MD Peter Keyes Sculco, MD |
| author_facet | Seong J. Jang, BA Christopher Jones, PhD, MBBS (Hons) Kate Shanaghan, BS David J. Mayman, MD Alejandro Gonzalez Della Valle, MD Peter Keyes Sculco, MD |
| author_sort | Seong J. Jang, BA |
| collection | DOAJ |
| description | Background: Prior investigations of total hip arthroplasty (THA) have studied the effects of prosthetic femoral head size and stem offset on hip range of motion (ROM), impingement risk, and overall hip stability to optimize the return to activities of daily living. However, the relationship between femoral head length and hip ROM, specifically external rotation (ER), has not been evaluated. The aim of our study was to intraoperatively assess how femoral head length affects hip ROM during a posterior approach THA. Methods: Thirty-two patients undergoing a primary elective THA through a posterior approach were prospectively included. After final femoral stem insertion, femoral head trials were performed using the targeted head length, followed by the shorter (−3.0 to −3.5 mm) and longer (+3.0 to +4.0 mm) head length configurations. At each length, hip ER was measured using an intraoperative goniometer from an imageless navigation system. ER values across the three head lengths were compared using a repeated-measures analysis of variance and paired t-tests. Results: Varying femoral head lengths demonstrated a statically significant and reproducible effect on intraoperative ER range (analysis of variance; P < .001) in each patient. An increased femoral head length (mean 3.4 mm) significantly decreased (P < .001) ER range by 10.8 ± 3.3° while a shortened femoral head length (mean 3.5 mm) significantly increased (P < .001) the ER ROM by 6.0 ± 3.8°. Conclusions: The results of this study demonstrate the sensitivity of hip ROM to incremental changes in femoral head length. As ER is important for activities of daily living, inadvertent lengthening should be avoided. |
| first_indexed | 2024-04-10T15:05:16Z |
| format | Article |
| id | doaj.art-592bc7da92bb4cb390ed76fde4b88693 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-04-10T15:05:16Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-592bc7da92bb4cb390ed76fde4b886932023-02-15T04:28:23ZengElsevierArthroplasty Today2352-34412023-02-0119101072The Impact of Varying Femoral Head Length on Hip External Rotation During Posterior-approach Total Hip ArthroplastySeong J. Jang, BA0Christopher Jones, PhD, MBBS (Hons)1Kate Shanaghan, BS2David J. Mayman, MD3Alejandro Gonzalez Della Valle, MD4Peter Keyes Sculco, MD5Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA; Corresponding author. Seong J. Jang, Department of Orthopedic Surgery, Hospital for Special Surgery, 1300 York Avenue, New York, NY 10065, USA. Tel.: +1 212 606 1771.Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USADepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USADepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USADepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USADepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USABackground: Prior investigations of total hip arthroplasty (THA) have studied the effects of prosthetic femoral head size and stem offset on hip range of motion (ROM), impingement risk, and overall hip stability to optimize the return to activities of daily living. However, the relationship between femoral head length and hip ROM, specifically external rotation (ER), has not been evaluated. The aim of our study was to intraoperatively assess how femoral head length affects hip ROM during a posterior approach THA. Methods: Thirty-two patients undergoing a primary elective THA through a posterior approach were prospectively included. After final femoral stem insertion, femoral head trials were performed using the targeted head length, followed by the shorter (−3.0 to −3.5 mm) and longer (+3.0 to +4.0 mm) head length configurations. At each length, hip ER was measured using an intraoperative goniometer from an imageless navigation system. ER values across the three head lengths were compared using a repeated-measures analysis of variance and paired t-tests. Results: Varying femoral head lengths demonstrated a statically significant and reproducible effect on intraoperative ER range (analysis of variance; P < .001) in each patient. An increased femoral head length (mean 3.4 mm) significantly decreased (P < .001) ER range by 10.8 ± 3.3° while a shortened femoral head length (mean 3.5 mm) significantly increased (P < .001) the ER ROM by 6.0 ± 3.8°. Conclusions: The results of this study demonstrate the sensitivity of hip ROM to incremental changes in femoral head length. As ER is important for activities of daily living, inadvertent lengthening should be avoided.http://www.sciencedirect.com/science/article/pii/S2352344122002497Total hip arthroplastyExternal rotationFemoral head lengthHip stabilityRange of motionPosterior approach |
| spellingShingle | Seong J. Jang, BA Christopher Jones, PhD, MBBS (Hons) Kate Shanaghan, BS David J. Mayman, MD Alejandro Gonzalez Della Valle, MD Peter Keyes Sculco, MD The Impact of Varying Femoral Head Length on Hip External Rotation During Posterior-approach Total Hip Arthroplasty Arthroplasty Today Total hip arthroplasty External rotation Femoral head length Hip stability Range of motion Posterior approach |
| title | The Impact of Varying Femoral Head Length on Hip External Rotation During Posterior-approach Total Hip Arthroplasty |
| title_full | The Impact of Varying Femoral Head Length on Hip External Rotation During Posterior-approach Total Hip Arthroplasty |
| title_fullStr | The Impact of Varying Femoral Head Length on Hip External Rotation During Posterior-approach Total Hip Arthroplasty |
| title_full_unstemmed | The Impact of Varying Femoral Head Length on Hip External Rotation During Posterior-approach Total Hip Arthroplasty |
| title_short | The Impact of Varying Femoral Head Length on Hip External Rotation During Posterior-approach Total Hip Arthroplasty |
| title_sort | impact of varying femoral head length on hip external rotation during posterior approach total hip arthroplasty |
| topic | Total hip arthroplasty External rotation Femoral head length Hip stability Range of motion Posterior approach |
| url | http://www.sciencedirect.com/science/article/pii/S2352344122002497 |
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