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- Title
Arthroplasty for femoral neck fractures is at risk for under restoration of lateral femoral offset.
- Authors
Shah, Harsh N; Barrett, Andrew A; Finlay, Andrea K; Arora, Prerna; Bellino, Michael J; Bishop, Julius A; Gardner, Michael J; Miller, Matthew D; Huddleston 3rd, James I; Maloney, William J; Goodman, Stuart B; Amanatullah, Derek F
- Abstract
Purpose: The aim of the study was to determine the restoration of hip biomechanics through lateral offset, leg length, and acetabular component position when comparing non-arthroplasty surgeons (NAS) to elective arthroplasty surgeons (EAS). Methods: 131 patients, with a femoral neck fracture treated with a THA by 7 EAS and 20 NAS, were retrospectively reviewed. 2 blinded observers measured leg-length discrepancy, femoral offset, and acetabular component position. Multivariate logistic regression models examined the association between the surgeon groups and restoration of lateral femoral, acetabular offset, leg length discrepancy, acetabular anteversion, acetabular position, and component size, while adjusting for surgical approach and spinal pathology. Results: NAS under-restored 4.8 mm of lateral femoral offset (43.9 ± 8.7 mm) after THA when compared to the uninjured side (48.7 ± 7.1 mm, p = 0.044). NAS were at risk for under-restoring lateral femoral offset when compared to EAS (p = 0.040). There was no association between lateral acetabular offset, leg length, acetabular position, or component size and surgeon type. Conclusions: Lateral femoral offset is at risk for under-restoration after THA for femoral neck fractures, when performed by surgeons that do not regularly perform elective THA. This indicates that lateral femoral offset is an under-appreciated contributor to hip instability when performing THA for a femoral neck fracture. Lateral femoral offset deserves as much attention and awareness as acetabular component position since a secondary analysis of our data reveal that preoperative templating and intraoperative imaging did not prevent under-restoration.
- Subjects
LEG physiology; NECK physiology; HIP joint physiology; ELECTIVE surgery; TOTAL hip replacement; ORTHOPEDIC surgery; FEMUR head; SURGEONS; RETROSPECTIVE studies; LEG length inequality; COMPARATIVE studies; PSYCHOSOCIAL factors; DESCRIPTIVE statistics; BIOMECHANICS; FEMORAL neck fractures
- Publication
Hip International, 2024, Vol 34, Issue 1, p134
- ISSN
1120-7000
- Publication type
Article
- DOI
10.1177/11207000231169914