Effect of changes of femoral offset on abductor and joint reaction forces in total hip arthroplasty.

Details

Serval ID
serval:BIB_EA3C7DEBBBAA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Effect of changes of femoral offset on abductor and joint reaction forces in total hip arthroplasty.
Journal
Archives of orthopaedic and trauma surgery
Author(s)
Rüdiger H.A., Guillemin M., Latypova A., Terrier A.
ISSN
1434-3916 (Electronic)
ISSN-L
0936-8051
Publication state
Published
Issued date
11/2017
Peer-reviewed
Oui
Volume
137
Number
11
Pages
1579-1585
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Anatomical reconstruction in total hip arthroplasty (THA) allows for physiological muscle function, good functional outcome and implant longevity. Quantitative data on the effect of a loss or gain of femoral offset (FO) are scarce. The aim of this study was to quantitatively describe the effect of FO changes on abductor moment arms, muscle and joint reactions forces.
THA was virtually performed on 3D models built from preoperative CT scans of 15 patients undergoing THA. Virtual THA was performed with a perfectly anatomical reconstruction, a loss of 20% of FO (-FO), and a gain of 20% of FO (+FO). These models were combined with a generic musculoskeletal model (OpenSim) to predict moment arms, muscle and joint reaction forces during normal gait cycles.
In average, with -FO reconstructions, muscle moment arms decreased, while muscle and hip forces increased significantly (p < 0.001). We observed the opposite with +FO reconstructions. Gluteus medius was more affected than gluteus minimus. -FO had more effect than +FO. A change of 20% of FO induced an average change 8% of abductor moment arms, 16% of their forces, and 6% of the joint reaction force.
To our knowledge, this is the first report providing quantitative data on the effect of FO changes on muscle and joint forces during normal gait. A decrease of FO necessitates an increase of abductor muscle force to maintain normal gait, which in turn increases the joint reaction force. This effect underscores the importance of an accurate reconstruction of the femoral offset.

Keywords
Arthroplasty, Replacement, Hip, Cohort Studies, Computer Simulation, Femur/diagnostic imaging, Femur/surgery, Hip Joint/diagnostic imaging, Hip Joint/surgery, Humans, Imaging, Three-Dimensional, Muscle, Skeletal/diagnostic imaging, Muscle, Skeletal/surgery, Range of Motion, Articular, Tomography, X-Ray Computed, Arthroplasty, Femoral offset, Hip, Joint force, Moment arm, Muscle, Patient-specific musculoskeletal modeling
Pubmed
Web of science
Create date
05/10/2017 10:30
Last modification date
20/08/2019 16:12
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