Restoration of the centre of rotation in primary total hip arthroplasty: the influence of acetabular floor depth and reaming technique.

@article{Meermans2016RestorationOT,
  title={Restoration of the centre of rotation in primary total hip arthroplasty: the influence of acetabular floor depth and reaming technique.},
  author={Geert Meermans and J. van Doorn and J. Kats},
  journal={The bone \& joint journal},
  year={2016},
  volume={98-B 12},
  pages={
          1597-1603
        }
}
AIMS One goal of total hip arthroplasty is to restore normal hip anatomy. [] Key Method Anteroposterior pelvic radiographs were analysed for acetabular floor depth and vertical and horizontal position of the COR. RESULTS Horizontally, the mean medial displacement of the COR was 0.8 mm (standard deviation (sd) 1.4) in the peripheral remaing group and 5.0 mm (sd 3.30) in the standard reaming group (p < 0.001).

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References

SHOWING 1-10 OF 81 REFERENCES

Do We Medialise the Hip Centre of Rotation in Total Hip Arthroplasty? Influence of Acetabular Offset and Surgical Technique

In patients with significant AO, surgeons should pay close attention to the preparation of the acetabulum, and the concept of hip offset cannot be limited to that of the femoral offset.

The Effect of Superior Placement of the Acetabular Component on the Rate of Loosening after Total Hip Arthroplasty. Long-Term Results in Patients Who Have Crowe Type-II Congenital Dysplasia of the Hip*

It is suggested that superior positioning of the acetabular component, even without lateral displacement, leads to increased rates of loosening of the femoral and acetABular components.

The use of the transverse acetabular ligament for determining the orientation of the components in total hip replacement: a randomised controlled trial.

A prospective, randomised, controlled trial of two groups, comprising of 40 patients each, in order to compare freehand introduction of the component with introduction using the transverse acetabular ligament (TAL) as a reference for anteversion.

Fixation method does not affect restoration of rotation center in hip replacements: A single-site retrospective study

The hip rotation center was similarly restored using either the cemented or cementless fixation techniques in this patient cohort, indicating that the fixation technique itself does not interfere with the position of the center of rotation.

Changes of center of rotation and femoral offset in total hip arthroplasty.

The results indicate a potential for better restoring the location of COR and femoral offset when planning and implanting an uncemented THA and free hand technique, and a fair reproducibility of anatomy.

THE EFFECT OF HIP JOINT CENTRE OF ROTATION DISPLACEMENT ON PATIENT FUNCTIONAL OUTCOME FOLLOWING PRIMARY TOTAL HIP REPLACEMENT

A significant relationship was identified between increasing vertical displacement of the HJC and worsening patient functional outcome, which supports current opinion regarding the disadvantageous consequences of a superiorly displaced HJC in terms of survivorship and function.

Are leg length and hip offset comparable after hip resurfacing and cementless total hip arthroplasty?

Leg length is restored by HRA and THA and a difference remains in offset after HRA although the authors attribute this to intentional medialisation of the acetabular cup.
...