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Inducible Displacements of the Cup and the Femoral Head During Active Range of Motion: Dynamic RSA Studies of Cemented Total Hip Replacements

Journal article
Authors Georgios Digas
Per-Erik Johanson
Johan Kärrholm
Published in Journal of Orthopaedic Research
Volume 31
Issue 11
Pages 1686-1693
ISSN 0736-0266
Publication year 2013
Published at Institute of Clinical Sciences, Department of Orthopaedics
Pages 1686-1693
Language en
Links dx.doi.org/10.1002/jor.22428
Keywords dynamic radiostereometric analysis, femoral head and cup displacement, IN-VIVO DETERMINATION, POLYETHYLENE, ARTHROPLASTY, IMPINGEMENT, SEPARATION, WEAR, LEE JG, 1976, CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, P20
Subject categories Orthopedics

Abstract

We evaluated changes in position of the femoral head relative to the cup and of the cup relative to the pelvis in total hip replacement patients during hip motion 2 years postoperatively. Two patient groups with nine patients in each group were studied. Hip motions, translations of the femoral head center, and cup displacements were recorded with dynamic radiostereometric examination (RSA, 2exposures/s) during abduction in Group 1 and with use of static RSA exposures at increasing flexion of the hip in Group 2. Conventional radiographic examinations were used to evaluate any radiolucent lines around the cups at 2 years. During active abduction the femoral head center moved medially (median 0.04mm) and the cup tilted anteriorly (median 0.09mm). Increments in radiolucent lines at 2 years correlated to medial femoral head penetration, posterior tilt, and retroversion of the cup at 20 degrees of abduction. The extension of radiolucent lines at 2 years showed a positive correlation with proximal inducible displacement of the cup and posterior translation of the femoral head center at maximum hip flexion. Our observations may be of value in understanding the pathogenesis of the loosening process and may be used to facilitate the development of prosthetic designs that optimize hip kinematics. (c) 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31:1686-1693, 2013

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