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What is the tolerated width of periacetabular osteophytes to avoid impingement in cementless THA?: a three-dimensional simulation study.

Abstract：

BACKGROUNDS:Impingement is a risk factor for instability and prosthetic failure following total hip arthroplasty (THA). If the periacetabular osteophytes are not removed at surgery, impingement could occur between the osteophytes and the femoral stem following THA. However, excessive removal of the osteophytes could lead to bleeding from the bone. The aim of our study, therefore, was to locate the site of the impingement and to determine the width of tolerable osteophytes, which does not induce impingement during activities of daily living (ADL), using a three-dimensional simulation. METHODS:On 35 hip models, virtual THA was performed. The acetabular cups were positioned at 45° abduction and 20° anteversion, and the anteversion of femoral stems was 15°. Circular osteophytes with a 30-mm rim were built around the acetabular cup. Fourteen ADL motions were simulated, and the osteophytes were removed until there was no impingement. A clock face was used to map the location and the width of tolerable osteophytes. RESULTS:The impingement mainly occurred in antero-superior and posterior portions around the acetabular cup. Only 4.2-6.2-mm osteophytes were tolerable at the antero-superior portion (12-3 o'clock) and 6.3-7.2-mm osteophytes at the posterior portion (8-10 o'clock) following a total hip arthroplasty. In antero-inferior and postero-superior portions, over-20-mm osteophytes did not induce any impingement. CONCLUSION:Osteophytes in the antero-superior and posterior portion of the acetabulum should be excised during a THA to avoid impingement of the femur-stem construct on the acetabular osteophytes during ADLs.

journal_name

Arch Orthop Trauma Surg

journal_title

Archives of orthopaedic and trauma surgery

authors

Kim JT,Lee J,Lee YK,Ha YC,Won YY,Lee K,Khanduja V,Koo KH

doi

10.1007/s00402-018-2982-1

subject

Has Abstract

pub_date

2018-08-01 00:00:00

pages

1165-1172

issue

8

eissn

0936-8051

issn

1434-3916

pii

10.1007/s00402-018-2982-1

journal_volume

138

pub_type

杂志文章

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