Highlights
- •Femoral offset and stem anteversion substantially affects flexion and internal rotation.
- •Increased femoral offset can also increase the range of motion of external rotation.
- •Increased stem anteversion has a negative effect on the range of motion of external rotation.
- •Femoral offset and stem anteversion are not independent but mutually confounding to the ROM (Read-Only Memory).
Abstract
Background
Femoral offset and anteversion have been reported to affect the incidence of dislocation
following bipolar hemiarthroplasty, although the magnitudes of contributions of the
femoral offset and stem anteversion on dislocation, both singly and in combination
is not fully understood.
Methods
Using the CT data of 61 patients (61 hips), including 30 male and 31 female who underwent
bipolar hemiarthroplasty, three-dimensional dynamic motion analysis was performed
using a modular implant that enabled adjustment of femoral offset and stem anteversion
independently. The pattern of impingement and relationship between femoral offset/stem
anteversion and range of motion were evaluated using the software.
Findings
We found that a higher femoral offset and stem anteversion correlate with a greater
range of motion of flexion and internal rotation. Furthermore, an increased femoral
offset has a great effect on increasing range of motion of flexion than stem anteversion,
and increased both femoral offset and stem anteversion have fewer effect on the flexion,
whereas increasing stem anteversion has a great impact on internal rotation than offset,
especially in the case with lower femoral anteversion. However, a higher stem anteversion
decrease the range of motion of external rotation, whereas a higher femoral offset
leads to an increased range of motion of external rotation.
Interpretation
We demonstrated that both a higher femoral offset and stem anteversion substantially
affected the range of motion in flexion, internal rotation and external rotation.
However, these are not independent, but rather mutually confounding, the surgeons
should consider retaining femoral/anterior offset in bipolar hemiarthroplasty.
Keywords
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Article info
Publication history
Published online: September 27, 2022
Accepted:
September 23,
2022
Received:
February 12,
2022
Identification
Copyright
© 2022 Published by Elsevier Ltd.
