Which Safe Zone Is Safe in Total Hip Arthroplasty? The Effect of Bony Impingement
“Safe zones” for cup position are currently being investigated in total hip arthroplasty (THA). This study aimed to evaluate the impact of bony impingement on the safe zone and provide recommendations for cup position in THA. CT scans were performed on 123 patients who underwent a cementless THA. Us...
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| Format: | Article |
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MDPI AG
2022-05-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/5/812 |
| _version_ | 1797498636648579072 |
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| author | Markus Weber Frederik von Kunow Moritz Innmann Matthias Meyer Max Thieme Seth Jerabek Tobias Renkawitz |
| author_facet | Markus Weber Frederik von Kunow Moritz Innmann Matthias Meyer Max Thieme Seth Jerabek Tobias Renkawitz |
| author_sort | Markus Weber |
| collection | DOAJ |
| description | “Safe zones” for cup position are currently being investigated in total hip arthroplasty (THA). This study aimed to evaluate the impact of bony impingement on the safe zone and provide recommendations for cup position in THA. CT scans were performed on 123 patients who underwent a cementless THA. Using the implant data and bone morphology from the CT scans, an impingement detection algorithm simulating range of motion (ROM) determined the presence of prosthetic and/or bony impingement. An impingement-free zone of motion was determined for each patient. These zones were then compared across all patients to establish an optimized impingement-free “safe zone”. Bony impingement reduced the impingement-free zone of motion in 49.6% (61/123) of patients. A mean reduction of 23.4% in safe zone size was observed in relation to periprosthetic impingement. The superposition of the safe zones showed the highest probability of impingement-free ROM with cup position angles within 40–50° of inclination and 20–30° of anteversion in relation to the applied cup and stem design of this study. Virtual ROM simulations identified bony impingement at the anterosuperior acetabular rim for internal rotation at 90° of flexion and at the posteroinferior rim for adduction as the main reasons for bony impingement. |
| first_indexed | 2024-03-10T03:36:10Z |
| format | Article |
| id | doaj.art-e72f8364af8042c5a051c9e68de8480f |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-10T03:36:10Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-e72f8364af8042c5a051c9e68de8480f2023-11-23T11:45:11ZengMDPI AGJournal of Personalized Medicine2075-44262022-05-0112581210.3390/jpm12050812Which Safe Zone Is Safe in Total Hip Arthroplasty? The Effect of Bony ImpingementMarkus Weber0Frederik von Kunow1Moritz Innmann2Matthias Meyer3Max Thieme4Seth Jerabek5Tobias Renkawitz6Faculty of Medicine, University of Regensburg, 93053 Regensburg, GermanyDepartment of Orthopedic and Trauma Surgery, Barmherzige Brueder Regensburg Medical Center, 93049 Regensburg, GermanyDepartment of Orthopaedics, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Orthopedic Surgery, University of Regensburg, 93077 Bad Abbach, GermanyDepartment of Orthopedic Surgery, University of Regensburg, 93077 Bad Abbach, GermanyOrthopaedic Surgery, Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY 10021, USADepartment of Orthopaedics, Heidelberg University Hospital, 69120 Heidelberg, Germany“Safe zones” for cup position are currently being investigated in total hip arthroplasty (THA). This study aimed to evaluate the impact of bony impingement on the safe zone and provide recommendations for cup position in THA. CT scans were performed on 123 patients who underwent a cementless THA. Using the implant data and bone morphology from the CT scans, an impingement detection algorithm simulating range of motion (ROM) determined the presence of prosthetic and/or bony impingement. An impingement-free zone of motion was determined for each patient. These zones were then compared across all patients to establish an optimized impingement-free “safe zone”. Bony impingement reduced the impingement-free zone of motion in 49.6% (61/123) of patients. A mean reduction of 23.4% in safe zone size was observed in relation to periprosthetic impingement. The superposition of the safe zones showed the highest probability of impingement-free ROM with cup position angles within 40–50° of inclination and 20–30° of anteversion in relation to the applied cup and stem design of this study. Virtual ROM simulations identified bony impingement at the anterosuperior acetabular rim for internal rotation at 90° of flexion and at the posteroinferior rim for adduction as the main reasons for bony impingement.https://www.mdpi.com/2075-4426/12/5/812total hip arthroplastybony impingementcombined anteversionsafe zone |
| spellingShingle | Markus Weber Frederik von Kunow Moritz Innmann Matthias Meyer Max Thieme Seth Jerabek Tobias Renkawitz Which Safe Zone Is Safe in Total Hip Arthroplasty? The Effect of Bony Impingement Journal of Personalized Medicine total hip arthroplasty bony impingement combined anteversion safe zone |
| title | Which Safe Zone Is Safe in Total Hip Arthroplasty? The Effect of Bony Impingement |
| title_full | Which Safe Zone Is Safe in Total Hip Arthroplasty? The Effect of Bony Impingement |
| title_fullStr | Which Safe Zone Is Safe in Total Hip Arthroplasty? The Effect of Bony Impingement |
| title_full_unstemmed | Which Safe Zone Is Safe in Total Hip Arthroplasty? The Effect of Bony Impingement |
| title_short | Which Safe Zone Is Safe in Total Hip Arthroplasty? The Effect of Bony Impingement |
| title_sort | which safe zone is safe in total hip arthroplasty the effect of bony impingement |
| topic | total hip arthroplasty bony impingement combined anteversion safe zone |
| url | https://www.mdpi.com/2075-4426/12/5/812 |
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