Change in Axial Rotation of the Femur in the Resting Supine Position Following Total Hip Arthroplasty. 2018

Keisuke Uemura, and Masaki Takao, and Hidetoshi Hamada, and Takashi Sakai, and Nobuhiko Sugano
Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Stem anteversion in the setting of total hip arthroplasty (THA) is usually measured by referencing the posterior condylar line (PCL). However, stem anteversion may not express the functional torsion of the femur if a consistent horizontal tilt in the PCL is observed after THA. Herein, the horizontal tilt of the PCL at the resting neutral position of the hip was retrospectively measured in 53 THA patients from three computed tomography (CT) datasets: (i) preoperative (preop-CT), (ii) 3 weeks after THA (1st postop-CT), and (iii) more than 2 years after THA (2nd postop-CT). Factors including sex, surgical approach, change in femoral anteversion, leg length, leg lateral length, and pelvic sagittal tilt, were analyzed to determine if they were predictors for the rotational change in PCL, and the number of cases in which the horizontal tilt of the PCL remained within 10° in the three CT images was calculated. Comparing the preop-CT to the 1st postop-CT demonstrated that the PCL underwent internal rotation by (mean ± standard deviation) 13.1° ± 8.6°; only leg lateralization was significantly correlated to the change in PCL (β = 0.278, P = 0.046). Comparing the preop-CT to the 2nd postop-CT demonstrated that the PCL was internally rotated by 9.7° ± 9.3°; no factors were correlated to the change in PCL. There were only 12 hips (23%) in which the horizontal tilt of the PCL remained within 10°. In conclusion, the PCL in the resting position was internally rotated shortly after THA and remained internally rotated from the preoperative position at two or more years following THA. Thus, stem anteversion measured by referencing the PCL may not represent functional torsion of the femur.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D005260 Female Females
D005269 Femur The longest and largest bone of the skeleton, it is situated between the hip and the knee. Trochanter,Greater Trochanter,Lesser Trochanter,Femurs,Greater Trochanters,Lesser Trochanters,Trochanter, Greater,Trochanter, Lesser,Trochanters,Trochanters, Greater,Trochanters, Lesser
D006621 Hip Joint The joint that is formed by the articulation of the head of FEMUR and the ACETABULUM of the PELVIS. Acetabulofemoral Joint,Acetabulofemoral Joints,Hip Joints,Joint, Acetabulofemoral,Joint, Hip,Joints, Acetabulofemoral,Joints, Hip
D006622 Hip Prosthesis Replacement for a hip joint. Femoral Head Prosthesis,Femoral Head Prostheses,Hip Prostheses,Prostheses, Femoral Head,Prostheses, Hip,Prosthesis, Femoral Head,Prosthesis, Hip
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D015207 Osteoarthritis, Hip Noninflammatory degenerative disease of the hip joint which usually appears in late middle or old age. It is characterized by growth or maturational disturbances in the femoral neck and head, as well as acetabular dysplasia. A dominant symptom is pain on weight-bearing or motion. Coxarthrosis,Osteoarthritis of the Hip,Osteoarthritis Of Hip,Coxarthroses,Hip Osteoarthritis,Osteoarthritis Of Hips

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