Total hip arthroplasty: the relationship between posterolateral reconstruction, abductor muscle strength, and femoral offset.

PURPOSE: To evaluate the relationship between posterolateral reconstruction, abductor muscle strength, and femoral offset following total hip arthroplasty. METHODS: Of 28 patients (56 limbs) we assessed, 12 underwent posterolateral reconstruction (reconstruction group) and 16 did not (non-reconstruction group). Isometric abductor muscle strength was measured with a handheld dynamometer. Each patient's muscle strength was converted into a force to body weight ratio, and this ratio was used in the comparisons. RESULTS: The reconstruction group showed a higher value in abductor muscle strength than the non-reconstruction group (p<0.05). Significant correlation between abductor muscle strength and femoral offset was found in the reconstruction group (p=0.016; r=0.674). CONCLUSION: Posterolateral reconstruction and appropriate reconstruction of femoral offset following total hip arthroplasty are important to improve the abductor muscle strength.

Cementless total hip arthroplasty using an autograft of the femoral head for marked acetabular dysplasia: case series.

PURPOSE: To assess the short-term outcome of cementless total hip arthroplasty involving an autograft of the femoral head in Japanese patients. METHODS: Cementless total hip arthroplasty with autogenous bone block grafting was performed on 18 hips in 15 patients with marked acetabular dysplasia. The resected femoral head was used as a graft for the superior-lateral region of the true acetabulum. Clinical outcome was correlated with the placement of the acetabular component, as revealed in radiographs. RESULTS: The 13 women and 2 men had a mean age of 60.2 years (range, 37.0-73.0 years) at primary surgery and a mean follow-up duration of 3.3 years (range, 2.0-5.3 years). According to the classification of Crowe, 4 hips were in group I, 3 were in group II, one in group III, and 10 in group IV. The mean Harris Hip Score preoperatively was 45.7 (range, 19-69) and that at follow-up was 82.5 (range, 44-100). All 15 cases showed a good clinical outcome. There were no major intra-operative complications in this series. The grafted bones united in all patients. Two patients need surgical revision because the lateral insertion of the acetabular component resulted in loosening of it. CONCLUSION: Medial insertion of the acetabular component provides satisfactory short-term outcomes. Lateral insertion of the acetabular component during total hip arthroplasty should be avoided in patients with marked acetabular dysplasia.

Difference in hip prosthesis femoral offset affects hip abductor strength and gait characteristics during obstacle crossing.

The purpose of this article is to determine if individuals with high rather than low femoral offset of a total hip arthroplasty achieve improved hip abductor muscle strength and thus improved their ability to step over an obstacle safely. These outcomes will help surgeons decide whether increasing the femoral offset helps a patient's physical function.

Intraoperative limb length measurement in total hip arthroplasty.

In order to evaluate the efficacy of intraoperative measurement of limb length inequality (LLI), we performed a prospective study on 64 patients who underwent unilateral total hip arthroplasty. The patients were divided into 2 groups. In Group I, the LLI was evaluated by the Shuck test, and in Group II by intraoperative measurement using a Steinman pin and an adjustable caliper. Preoperative LLIs assessed on radiographs averaged 1.18 cm in Group I and 0.37 cm in Group II.