Médecine

Paramédical

Autres domaines


S'abonner

Is there a role for femoral offset restoration during total hip arthroplasty? A systematic review - 21/04/17

Doi : 10.1016/j.otsr.2016.12.013 
M. De Fine , M. Romagnoli, A. Toscano, A. Bondi, M. Nanni, S. Zaffagnini
 General Orthopaedic Surgery, Rizzoli-Sicilia Department, Rizzoli Orthopaedic Institute, SS 113, km 246, 90011, Bagheria (PA), Italy 

Corresponding author. Rizzoli-Sicilia Department, Rizzoli Orthopaedic Institute, SS 113, km 246, 90011 Bagheria (PA), Italy.

Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.

Connectez-vous pour en bénéficier!

Abstract

Benefits of femoral offset restoration during total hip arthroplasty should be the reduction of bearing surfaces wear, implant loosening and dislocation rates. Modular neck stems ensure offset customization but fretting corrosion and catastrophic failures are well-documented complications. Since clinical evidences are needed to substantiate the effectiveness of femoral offset restoration and promote modular neck choice, we systematically reviewed the literature to ascertain whether femoral offset itself has a proven clinical influence: (1) on bearing surfaces wear, (2) implant loosening, (3) and dislocation rates. A systematic literature screening was conducted to find papers dealing with the influence of femoral offset on wear, dislocation and loosening, including articles with conventional radiographic femoral offset assessment and with comparative design. Observational studies, case reports, instructional course lectures, cadaveric and animal studies as well as biomechanical studies, letters to the editor, surgical techniques or technical notes were all excluded. No limits about publication date were supplied but only papers in English were taken into account. Data were extracted into an anonymous spreadsheet. Offset values, dislocation rates, wear rates, follow-up and surgical approaches were all detailed. Ten manuscripts were finally selected. A statistically significant correlation between femoral offset restoration and the reduction of conventional ultrahigh-molecular-weight polyethylene wear was found in two out of three papers investigating this issue, but no correlations were found between femoral offset and dislocation rates or implant loosening. Femoral offset modification influences ultrahigh-molecular-weight polyethylene liners wear, but no correlation was found with dislocation rates or implant loosening. Advantages on wear can be counterbalanced by the use of hard bearing surfaces or highly cross-linked polyethylene liners, besides the availability of larger femoral heads improving implant stability further reduces the importance of femoral offset restoration by means of modularity. We believe that efforts in restoring femoral offset during total hip arthroplasty do not translate into tangible clinical profits and consequently, we do not advise the routinely usage of modular neck stems in total hip arthroplasty. Level of evidence: level III, systematic review of case-control studies.

Le texte complet de cet article est disponible en PDF.

Keywords : Femoral Offset, Total hip arthroplasty, Loosening, Wear, Dislocation


Plan


© 2017  Elsevier Masson SAS. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 103 - N° 3

P. 349-355 - mai 2017 Retour au numéro
Article précédent Article précédent
  • Acetate templating on calibrated standing digital radiograph improves accuracy of preoperative templating for total hip arthroplasty
  • Q. Wang, J. Xiao, L. Zhu, X. Zhao, Z. Liu, J. Wang, Y. Qin
| Article suivant Article suivant
  • Postoperative infections after excision of neurogenic heterotopic ossifications at the hip: Risk factors and causative organisms
  • L. Gatin, F. Genêt, A. Dinh, P. Denormandie

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement ou un achat à l’unité.

Déjà abonné à cette revue ?

;

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.