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- Title
Influence of femoral bowing on range of motion after total hip arthroplasty.
- Authors
Akiyama, Keisuke; Shibuya, Takaaki
- Abstract
<bold>Purpose: </bold>The influence of physiologic femoral bowing on range of motion (ROM) after total hip arthroplasty (THA) remains unknown. The purpose of this study was to investigate the morphology of the femur in patients who underwent THA, and to analyze the influence of femoral bowing on ROM due to implant impingement after THA.<bold>Methods: </bold>The ROM was calculated from 100 hips in 90 patients who underwent THA using computed tomography data with a 3D dynamic analysis software. Lateral and anterior bowing angles of the femur were measured. A modular implant (Modulus system, Lima Corporate, Villanova di San Daniele del Friuli, Italy) was used for simulation. In all subjects, cup inclination, anteversion, and stem anteversion were set to 40°, 15°, and 30°, respectively. Multiple linear regression analyses were performed to assess the relationship between the morphology of the femur and ROM.<bold>Results: </bold>Lateral bowing of the femur was demonstrated to be significantly correlated with age (r = 0.361, p < 0.001) and female sex (r = 0.315, p = 0.001). Lateral bowing of the femur was significantly positively correlated with flexion and internal rotation (Int-R) with 90° flexion. Anterior bowing was significantly associated with decreasing flexion, decreasing Int-R with 90° flexion and increasing Int-R with 45° flexion and 15° adduction.<bold>Conclusions: </bold>A ROM-optimized cup position cannot be calculated from femoral stem anteversion values alone; therefore, when surgeons position the cup in relation to the femoral stem anteversion, the influence of femoral bowing may also require consideration.
- Subjects
ITALY; BOWING of stringed instruments; TOTAL hip replacement; RANGE of motion of joints; FEMUR injuries; BONE mechanics; COMPUTED tomography; FEMUR surgery; HIP surgery; ARTIFICIAL joints; COMPUTER simulation; FEMUR
- Publication
International Orthopaedics, 2018, Vol 42, Issue 8, p1795
- ISSN
0341-2695
- Publication type
journal article
- DOI
10.1007/s00264-017-3732-7