Agreement Between Proximal Femoral Geometry and Component Design in Total Hip Arthroplasty: Implications for Implant Choice

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• 作者：Christoph K. Boese ; MD^a ; ; Jens Dargel ; MD^a ; Janine Jostmeier^a ; Peer Eysel ; MD^a ; Michael Frink ; MD^b ; Philipp Lechler ; MD^b
• 关键词：total hip arthroplasty ; femoral offset ; neck-shaft angle ; preoperative templating ; joint replacement
• 刊名：The Journal of Arthroplasty
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：31
• 期：8
• 页码：1842-1848
• 全文大小：1592 K

文摘

The present study aimed to analyze the agreement between proximal femoral geometry of adult hips and femoral component design in total hip arthroplasty.

Methods

Anatomical femoral offset (FO_Anat) and the anatomical neck-shaft angle (NSA_Anat) of 800 adult hips were measured by computed tomography scans, and anatomical femoral neck height (FH_Anat) was calculated. Corresponding best-fit implants of the most common hip system (standard, high offset and varus variant) were identified for each hip. Finally, the precision of the best possible anatomic reconstruction was assessed.

Results

The mean FO_Anat was 38.0 mm (range: 19.8-57.9 mm, standard deviation [SD]: 6.4 mm), the mean NSA_Anat was 130.8° (range: 107.1°-151.9°; SD: 6.5°), and the mean FH_Anat was 32.6 mm (range: 14.4-52.0 mm; SD: 5.5 mm). In 450 (56.3%) hips, the standard variant was identified to be the best-fit implant, followed by the varus (n = 282, 35.3%) and the high offset (n = 68, 8.5%) variants. The mean minimal distance from the best-fit implant was 4.5 mm (range: 0.1-20.2 mm, SD: 3.4 mm). Excellent agreement (distance: <2 mm) between hip anatomy and best-fit implant was found in 203 (25.4%) hips, combined excellent and acceptable agreement (distance: <6 mm) in 569 (71.1%) hips, whereas 213 (28.9%) hips were graded as poor (distance: ≥6 mm).

Conclusion

The present study revealed a mismatch between proximal femoral anatomy of a relevant proportion of adult hips and implant geometry of the most common femoral component in total hip arthroplasty.