Safety range for acute limb lengthening in primary total hip arthroplasty.

Purpose: There is no documented maximum amount that an extremity can be safely lengthened in primary total hip arthroplasty (THA) without neurologic or soft tissue complications. We retrospectively reviewed patients who underwent primary THA with acute limb lengthening and investigated the safety ra...

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Publicado en:International Orthopaedics Vol. 43; no. 9; pp. 2047 - 2057
Autores principales: Kabata, Tamon, Kajino, Yoshitomo, Inoue, Daisuke, Ohmori, Takaaki, Yoshitani, Junya, Ueno, Takuro, Ueoka, Ken, Tsuchiya, Hiroyuki
Formato: Journal Article
Publicado: Springer Nature Sep2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2019
      vid: 43
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00264-018-4158-6
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        atl: Safety range for acute limb lengthening in primary total hip arthroplasty.
      aug:
        au:
          Kabata, Tamon
          Kajino, Yoshitomo
          Inoue, Daisuke
          Ohmori, Takaaki
          Yoshitani, Junya
          Ueno, Takuro
          Ueoka, Ken
          Tsuchiya, Hiroyuki
        affil: Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, 920-8641, Kanazawa, Ishikawa, Japan
      sug:
        subj:
          Bone Lengthening Methods
          Bone Lengthening Adverse Effects
          Arthroplasty, Replacement, Hip Methods
          Osteoarthritis, Hip Surgery
          Hip Dislocation, Congenital Surgery
          Hip Joint Surgery
          Joint Diseases Surgery
          Adult
          Hip Joint
          Bone Lengthening Standards
          Joint Diseases
          Male
          Hip Dislocation, Congenital
          Femur Surgery
          Female
          Middle Age
          Retrospective Design
          Aged, 80 and Over
          Femur
          Osteoarthritis, Hip
          Aged
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged, 80 & over
          Aged: 65+ years
          Male
          Female
      ab: Purpose: There is no documented maximum amount that an extremity can be safely lengthened in primary total hip arthroplasty (THA) without neurologic or soft tissue complications. We retrospectively reviewed patients who underwent primary THA with acute limb lengthening and investigated the safety range for acute limb lengthening in primary THA.Methods: This study included 61 hips in 52 patients who underwent primary THA with acute limb lengthening (more than 2.5 cm) without femoral shortening osteotomy. The amount of lengthening was measured from pre-operative and post-operative X-ray films using computer graphics software, then the ratios of the amount of lengthening to femoral length (L/F ratio = amount of lengthening / femoral shaft length × 100) were calculated. We investigated correlation with nerve and soft tissue complications at operation in regard to this index.Results: The average amount of lengthening was 3.0 cm (2.5 to 4.8). The average L/F ratio was 7.9 (6.2 to 12.9). There were seven nerve complications and two soft tissue complications in the whole series. In all nine complications, eight indicated higher L/F ratios than 8.7. Altogether, 12 hips indicated a higher L/F ratio than 8.7; 66% of them showed neurological or soft tissue problems. ROC curve analysis indicated that the optimal cutoff value of the L/F ratio was 8.7, which predicted acute lengthening-related complications with a sensitivity of 88.9% and a specificity of 92.3% (AUC = 0.88).Conclusion: The patients who underwent THA with acute lengthening of more than 8.7% of femoral shaft length are at high risk of complications caused by acute limb lengthening in primary THA.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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