Computer simulation of optimal lipped polyethylene liner orientation against prosthetic impingement
Abstract Background Lipped or elevated acetabular liners are to improve posterior stability and are widely used in hip arthroplasty. However, concerns of increasing impingement exist when using such liners and optimal orientation of the elevated rim remains unknown. We aimed to identify the impact o...
| 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 |
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| Online Access: | https://doi.org/10.1186/s13018-022-03093-6 |
| _version_ | 1811184975207202816 |
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| author | Yi Hu Xianhao Zhou Hua Qiao Zhenan Zhu Huiwu Li Jingwei Zhang |
| author_facet | Yi Hu Xianhao Zhou Hua Qiao Zhenan Zhu Huiwu Li Jingwei Zhang |
| author_sort | Yi Hu |
| collection | DOAJ |
| description | Abstract Background Lipped or elevated acetabular liners are to improve posterior stability and are widely used in hip arthroplasty. However, concerns of increasing impingement exist when using such liners and optimal orientation of the elevated rim remains unknown. We aimed to identify the impact of lipped liner on the range of motion (ROM) before impingement and propose its optimal orientation. Methods An isochoric three-dimensional model of a general hip-replacement prosthesis was generated, and flex-extension, add-abduction and axial rotation were simulated on a computer. The maximum ROM of the hip was measured before the neck impinged on the liner. Different combinations of acetabular anteversion angles ranging from 5 to 30 degrees, and lipped liner orientations from posterior to anterior were tested. Results When acetabular anteversion was 10 or 15 degrees, placing the lip of the liner in the posterosuperior of the acetabulum allowed satisfactory ROM in all directions. When acetabular anteversion was 20 degrees, extension and external rotation were restricted. Adjusting the lip to the superior restored satisfactory ROM. When acetabular anteversion was 25 degrees, only placing the lip into the anterosuperior could increase extension and external rotation to maintain satisfactory ROM. Conclusions This study showed that optimal lipped liner orientation should depend on acetabular anteversion. When acetabular anteversion was smaller than 20 degrees, placing lip in the posterior allowed an optimally ROM. When acetabular anteversion was greater than 20 degrees, adjusting lip to the anterior allowed a comprehensive larger ROM to avoid early impingement. |
| first_indexed | 2024-04-11T13:21:37Z |
| format | Article |
| id | doaj.art-8bf3b84305b448a0af278bee3796e1f0 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:21:37Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-8bf3b84305b448a0af278bee3796e1f02022-12-22T04:22:11ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-04-011711610.1186/s13018-022-03093-6Computer simulation of optimal lipped polyethylene liner orientation against prosthetic impingementYi Hu0Xianhao Zhou1Hua Qiao2Zhenan Zhu3Huiwu Li4Jingwei Zhang5Department of Orthopaedics, Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopaedics, Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopaedics, Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopaedics, Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopaedics, Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopaedics, Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineAbstract Background Lipped or elevated acetabular liners are to improve posterior stability and are widely used in hip arthroplasty. However, concerns of increasing impingement exist when using such liners and optimal orientation of the elevated rim remains unknown. We aimed to identify the impact of lipped liner on the range of motion (ROM) before impingement and propose its optimal orientation. Methods An isochoric three-dimensional model of a general hip-replacement prosthesis was generated, and flex-extension, add-abduction and axial rotation were simulated on a computer. The maximum ROM of the hip was measured before the neck impinged on the liner. Different combinations of acetabular anteversion angles ranging from 5 to 30 degrees, and lipped liner orientations from posterior to anterior were tested. Results When acetabular anteversion was 10 or 15 degrees, placing the lip of the liner in the posterosuperior of the acetabulum allowed satisfactory ROM in all directions. When acetabular anteversion was 20 degrees, extension and external rotation were restricted. Adjusting the lip to the superior restored satisfactory ROM. When acetabular anteversion was 25 degrees, only placing the lip into the anterosuperior could increase extension and external rotation to maintain satisfactory ROM. Conclusions This study showed that optimal lipped liner orientation should depend on acetabular anteversion. When acetabular anteversion was smaller than 20 degrees, placing lip in the posterior allowed an optimally ROM. When acetabular anteversion was greater than 20 degrees, adjusting lip to the anterior allowed a comprehensive larger ROM to avoid early impingement.https://doi.org/10.1186/s13018-022-03093-6Range of motionElevated linerImpingementTotal hip arthroplastyOrientationComputer simulation |
| spellingShingle | Yi Hu Xianhao Zhou Hua Qiao Zhenan Zhu Huiwu Li Jingwei Zhang Computer simulation of optimal lipped polyethylene liner orientation against prosthetic impingement Journal of Orthopaedic Surgery and Research Range of motion Elevated liner Impingement Total hip arthroplasty Orientation Computer simulation |
| title | Computer simulation of optimal lipped polyethylene liner orientation against prosthetic impingement |
| title_full | Computer simulation of optimal lipped polyethylene liner orientation against prosthetic impingement |
| title_fullStr | Computer simulation of optimal lipped polyethylene liner orientation against prosthetic impingement |
| title_full_unstemmed | Computer simulation of optimal lipped polyethylene liner orientation against prosthetic impingement |
| title_short | Computer simulation of optimal lipped polyethylene liner orientation against prosthetic impingement |
| title_sort | computer simulation of optimal lipped polyethylene liner orientation against prosthetic impingement |
| topic | Range of motion Elevated liner Impingement Total hip arthroplasty Orientation Computer simulation |
| url | https://doi.org/10.1186/s13018-022-03093-6 |
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