In vivo kinematics,component alignment and hardware variables influence on the liner-to-neck clearance during chair-rising after total hip arthroplasty |
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| Institution: | 1. Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan;2. Department of Biorobotics, Faculty of Engineering, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka, 813-8583, Japan;3. Department of Creative Engineering, National Institute of Technology, Kitakyushu College, 5-20-1 Shii, Kokuraminami-ku, Kitakyushu, Fukuoka, 802-0985, Japan;1. Boston University Medical Center, 850 Harrison Ave, D2N, Boston, MA 02118, USA;2. Harborview Medical Center, University of Washington, WA, USA;3. Department of Orthopedic Surgery, Penn Medicine, PA, USA;4. McGovern Medical School at UTHealth, Houston, TX, USA;1. Division of Geriatric Medicine, McMaster University, St Peter''s Hospital, GERAS Centre, Hamilton, ON L8M 1W9, Canada;1. Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, 2-36-2, Ebaradai, Sakura City, Chiba, 285-8765, Japan;2. Department of Orthopedics Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan;3. Department of Orthopedics Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan;1. Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan;2. Department of Anesthesia, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan |
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| Abstract: | BackgroundThere is an interest in quantifying dynamic hip kinematics before and after total hip arthroplasty (THA) during chair-rising: one of daily life activities.MethodsThe study consisted of 21 patients who underwent unilateral total hip arthroplasty for symptomatic osteoarthritis. We obtained continuous radiographs using a flat-panel X-ray detector while the participants rose from chair. We assessed the pre and postoperative hip joint's movements using three-dimensional-to-two-dimensional model-to-image registration techniques. We also measured minimum liner-to-neck distances at maximum hip flexion and extension as anterior and posterior liner-to-neck distances, respectively. Multivariate analyses were applied to determine which factors were associated with liner-to-neck distances.ResultsThe cup inclination, cup anteversion, and stem anteversion averaged 37.4°, 23.1°, and 30.1°, respectively. Significantly larger maximum hip flexion angle (72°) was found during chair-rising after THA compared to that before THA (63°, P < 0.01). The anterior pelvic tilt at the maximum hip flexion after THA (3° of anterior tilt) was significantly (P < 0.05) anterior compared to that before THA (1° of posterior tilt). The anterior and posterior liner-to-neck distances averaged 12.3 mm and 8.1 mm, respectively, with a significant difference (P < 0.01). No liner-to-neck contact was found in any hips. In multivariate analysis, the hip flexion angle, cup inclination, stem anteversion and head diameter were significantly associated with the anterior liner-to-neck distance (P < 0.05), the hip extension angle, cup anteversion, neck length and with or without elevated rim were significantly associated with the posterior liner-to-neck distance (P < 0.05, 0.01, 0.05, 0.01, respectively).ConclusionThis study indicates that well-positioned THA provide increased range of hip flexion with sufficient anterior liner-to-neck clearance during chair-rising. Dynamic hip kinematics, component position, and hardware variables significantly influenced on the liner-to-neck clearance under weight-bearing conditions. |
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