Optimal combined anteversion range for obtaining a wider range of motion without prosthetic impingement after total hip arthroplasty: a three-dimensional analysis study
Abstract Background Obtaining a larger theoretical range of motion (ROM) is crucial to avoid prosthetic impingement after total hip arthroplasty (THA); however, no reports have examined the permissible range values of combined anteversion (CA) satisfying targeted ROM without prosthetic impingement....
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-022-03112-6 |
| _version_ | 1798006895208824832 |
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| author | Ryo Hidaka Kenta Matsuda Masaki Nakamura Shigeru Nakamura Hirotaka Kawano |
| author_facet | Ryo Hidaka Kenta Matsuda Masaki Nakamura Shigeru Nakamura Hirotaka Kawano |
| author_sort | Ryo Hidaka |
| collection | DOAJ |
| description | Abstract Background Obtaining a larger theoretical range of motion (ROM) is crucial to avoid prosthetic impingement after total hip arthroplasty (THA); however, no reports have examined the permissible range values of combined anteversion (CA) satisfying targeted ROM without prosthetic impingement. This retrospective study aimed to evaluate the possible postoperative CA extent that would allow meeting target ROM criteria according to Yoshimine’s theory using computed tomography (CT)-based three-dimensional motion analysis after THA. Methods This study included 114 patients (133 hips) who underwent cementless primary THA using a CT-based navigation system and implants (oscillation angle ≥ 135°). Implant positions were determined using Yoshimine's CA formula. Postoperative evaluation was conducted using a three-dimensional templating software for CT data. The postoperative Yoshimine’s and Widmer’s CA was calculated, and the difference between the target and postoperative values was defined as the error of Yoshimine’s CA and Widmer’s CA. Prosthetic ROM was assessed by Yoshimine’s stringent criteria for activities of daily living. Based on fulfilling these criteria, all patients were divided into the ROM (+) and ROM (−) groups. Evaluation items were compared between the two groups. Results There were 111 and 22 hips in the ROM (+) and ROM (−) groups, respectively. A significant difference was noted in the absolute error of Yoshimine’s and Widmer’s CA between the two groups. Using receiver operating characteristic analysis, threshold values of 6.0 (higher values indicate greater disability; sensitivity 90.9%, specificity 72.1%) for the absolute Yoshimine’s CA difference (area under the curve [AUC] 0.87, P < 0.01) and 6.9 (higher values indicate greater disability; sensitivity 68.2%, specificity 88.3%) for the absolute Widmer’s CA difference (AUC 0.83, P < 0.01) were predictors in the ROM (−) group. Conclusions The target range of Yoshimine’s CA (90.8° ± 6.0°) and Widmer’s CA values (37.3° ± 6.9°) was crucial in implant orientation for obtaining theoretical ROM without prosthetic impingement after THA. |
| first_indexed | 2024-04-11T13:01:39Z |
| format | Article |
| id | doaj.art-711c3678adb0494dbc81087f968b75d7 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:01:39Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-711c3678adb0494dbc81087f968b75d72022-12-22T04:22:54ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-04-0117111010.1186/s13018-022-03112-6Optimal combined anteversion range for obtaining a wider range of motion without prosthetic impingement after total hip arthroplasty: a three-dimensional analysis studyRyo Hidaka0Kenta Matsuda1Masaki Nakamura2Shigeru Nakamura3Hirotaka Kawano4Department of Orthopaedic Surgery, Teikyo University School of MedicineDepartment of Orthopaedic Surgery, Teikyo University School of MedicineDepartment of Orthopaedic Surgery, Toranomon HospitalDepartment of Orthopaedic Surgery, Teikyo University Mizonokuchi HospitalDepartment of Orthopaedic Surgery, Teikyo University School of MedicineAbstract Background Obtaining a larger theoretical range of motion (ROM) is crucial to avoid prosthetic impingement after total hip arthroplasty (THA); however, no reports have examined the permissible range values of combined anteversion (CA) satisfying targeted ROM without prosthetic impingement. This retrospective study aimed to evaluate the possible postoperative CA extent that would allow meeting target ROM criteria according to Yoshimine’s theory using computed tomography (CT)-based three-dimensional motion analysis after THA. Methods This study included 114 patients (133 hips) who underwent cementless primary THA using a CT-based navigation system and implants (oscillation angle ≥ 135°). Implant positions were determined using Yoshimine's CA formula. Postoperative evaluation was conducted using a three-dimensional templating software for CT data. The postoperative Yoshimine’s and Widmer’s CA was calculated, and the difference between the target and postoperative values was defined as the error of Yoshimine’s CA and Widmer’s CA. Prosthetic ROM was assessed by Yoshimine’s stringent criteria for activities of daily living. Based on fulfilling these criteria, all patients were divided into the ROM (+) and ROM (−) groups. Evaluation items were compared between the two groups. Results There were 111 and 22 hips in the ROM (+) and ROM (−) groups, respectively. A significant difference was noted in the absolute error of Yoshimine’s and Widmer’s CA between the two groups. Using receiver operating characteristic analysis, threshold values of 6.0 (higher values indicate greater disability; sensitivity 90.9%, specificity 72.1%) for the absolute Yoshimine’s CA difference (area under the curve [AUC] 0.87, P < 0.01) and 6.9 (higher values indicate greater disability; sensitivity 68.2%, specificity 88.3%) for the absolute Widmer’s CA difference (AUC 0.83, P < 0.01) were predictors in the ROM (−) group. Conclusions The target range of Yoshimine’s CA (90.8° ± 6.0°) and Widmer’s CA values (37.3° ± 6.9°) was crucial in implant orientation for obtaining theoretical ROM without prosthetic impingement after THA.https://doi.org/10.1186/s13018-022-03112-6Activities of daily livingArthroplastyHip prosthesisJoint dislocationPolyethyleneX-ray computed tomography |
| spellingShingle | Ryo Hidaka Kenta Matsuda Masaki Nakamura Shigeru Nakamura Hirotaka Kawano Optimal combined anteversion range for obtaining a wider range of motion without prosthetic impingement after total hip arthroplasty: a three-dimensional analysis study Journal of Orthopaedic Surgery and Research Activities of daily living Arthroplasty Hip prosthesis Joint dislocation Polyethylene X-ray computed tomography |
| title | Optimal combined anteversion range for obtaining a wider range of motion without prosthetic impingement after total hip arthroplasty: a three-dimensional analysis study |
| title_full | Optimal combined anteversion range for obtaining a wider range of motion without prosthetic impingement after total hip arthroplasty: a three-dimensional analysis study |
| title_fullStr | Optimal combined anteversion range for obtaining a wider range of motion without prosthetic impingement after total hip arthroplasty: a three-dimensional analysis study |
| title_full_unstemmed | Optimal combined anteversion range for obtaining a wider range of motion without prosthetic impingement after total hip arthroplasty: a three-dimensional analysis study |
| title_short | Optimal combined anteversion range for obtaining a wider range of motion without prosthetic impingement after total hip arthroplasty: a three-dimensional analysis study |
| title_sort | optimal combined anteversion range for obtaining a wider range of motion without prosthetic impingement after total hip arthroplasty a three dimensional analysis study |
| topic | Activities of daily living Arthroplasty Hip prosthesis Joint dislocation Polyethylene X-ray computed tomography |
| url | https://doi.org/10.1186/s13018-022-03112-6 |
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