Abstract
Background
Surface replacement arthroplasty aims to re-create normal hip biomechanics; however
the pathoanathomy of the hip, prosthetic component design, surgical technique and
other factors may have a significant impact on the range of motion restoration attained
following surface replacement arthroplasty. However, there is paucity of information
on the effect of such factors.
Methods
A computerized three-dimensional hip model was created from preoperative computerized
tomography images of a patient who was scheduled for a surface replacement arthroplasty.
The effects of the femoral component size, translation and orientation on the range
of motion were analysed as was the effect of increasing the seating depth and modification
of the version of the acetabular component.
Findings
Increasing the femoral component size led to global improvement in range of motion
while translation increased range of motion in one direction but reduced it in the
opposite direction. Change in the femoral component orientation had minimal effects
on range of motion in comparison to the effect of changes in the version of the acetabular
component. Increasing the seating depth of the acetabulum only caused reduced range
of motion in internal rotation in 90° flexion.
Interpretation
To restore hip range of motion, surgeons performing surface replacement arthroplasty
should aim to reproduce the natural femoral head–neck offset. Although increasing
the femoral component size may achieve this, more acetabular bone will be resected.
Knowing the specific zones of impingement of each arc of movement, selective translation
of the femoral component or femoral neck osteoplasty can restore femoral neck offset
in more critical areas without affecting acetabular bone stock. Over deepening of
the acetabulum or leaving rim osteophytes should also be avoided to prevent impingement.
Keywords
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Article info
Publication history
Published online: September 17, 2007
Accepted:
July 11,
2007
Received:
April 19,
2007
Identification
Copyright
© 2007 Published by Elsevier Inc. All rights reserved.
