Stem torsion in total hip replacement.

Background and purpose The clinical results of THR may be improved by correct femoral torsion. We evaluated the stem position by postoperative CT examination in 60 patients. Methods 60 patients requiring total hip arthroplasty were prospectively enrolled in this study. Minimally invasive THR was per...

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Publicado en:Acta Orthopaedica Vol. 81; no. 5; pp. 579 - 583
Autores principales: Sendtner, Ernst, Tibor, Schuster, Winkler, Roman, Wörner, Michael, Grifka, Joachim, Renkawitz, Tobias
Formato: pictorial research tables/charts Journal Article
Publicado: Medical Journals Sweden AB Oct2010
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2010
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      pub: Medical Journals Sweden AB
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        10.3109/17453674.2010.524596
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        atl: Stem torsion in total hip replacement.
      aug:
        au:
          Sendtner, Ernst
          Tibor, Schuster
          Winkler, Roman
          Wörner, Michael
          Grifka, Joachim
          Renkawitz, Tobias
        affil: Department of Orthopedic Surgery, Regensburg University Medical Center, Regensburg
      sug:
        subj:
          Arthroplasty, Replacement, Hip Methods
          Torsion Abnormality Prevention and Control
          Human
          Male
          Female
          Osteoarthritis, Hip Surgery
          Middle Age
          Aged
          Aged, 80 and Over
          Confidence Intervals
          Pelvis Radiography
          Descriptive Statistics
          Sex Factors
          Prospective Studies
          Unpaired T-Tests
          Data Analysis Software
          Intraclass Correlation Coefficient
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background and purpose The clinical results of THR may be improved by correct femoral torsion. We evaluated the stem position by postoperative CT examination in 60 patients. Methods 60 patients requiring total hip arthroplasty were prospectively enrolled in this study. Minimally invasive THR was performed (anterior approach) in a lateral decubitus position and each patient underwent a postoperative CT examination. The position of the stem was evaluated by an independent external institution. Results Stem torsion ranged from -19° retrotorsion to 33° antetorsion. Normal antetorsion (i.e 10-15° according to Tönnis) was present in 5 of 60 patients, so the prevalence of abnormal stem antetorsion was 92% (95% CI: 82-97). We found a stem antetorsion outside the range of 0-25° in 21 of 60 hips. Women had a higher mean stem antetorsion (8.0° (SD 11)) than men (1.5° (SD 10)). Interpretation Postoperative stem antetorsion shows a high variability and is gender-related. We suggest precise assessment of stem antetorsion intraoperatively by means of computer navigation, preparing the femur first. In abnormal stem antetorsion, the cup position can be adjusted using a combined anteversion concept; alternatively, modular femoral components or stems with retroverted or anteverted necks ('retrostem') could be used.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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