An in vivo model for intraoperative assessment of impingement and dislocation in total hip arthroplasty |
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Authors: | Tanino Hiromasa Ito Hiroshi Harman Melinda K Matsuno Takeo Hodge W Andrew Banks Scott A |
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Affiliation: | †The BioMotion Foundation, Orthopaedic Research Laboratory, Good Samaritan Medical Center, Palm Beach, Florida;‡Department of Orthopaedic Surgery, Asahikawa Medical College, Asahikawa, Japan; Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, Florida |
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Abstract: | We have developed an intraoperative model to quantify total hip arthroplasty impingement and dislocation mechanics using fluoroscopy and shape-matching techniques. Two patient groups were investigated: group 1 consisted of 12 hips using 28- or 32-mm femoral heads and an anterolateral surgical approach, and group 2 consisted of 17 hips using 22- or 26-mm femoral heads and a posterolateral surgical approach. During intraoperative hip stability testing consisting of extension and external rotation motions, group 1 was more unstable, and prosthetic impingement was the major reason for dislocation. With flexion and internal rotation motions, group 2 was more unstable, and superior-lateral impingement or soft tissue traction was the major reason for dislocation. Intraoperative quantitative assessment of hip mechanics provides a safe and clinically relevant method to characterize potential complications and evolve techniques to prevent them. |
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Keywords: | hip arthroplasty kinematics fluoroscopy dislocation impingement |
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