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Does High Hip Center Decrease Range of Motion in Total Hip Arthroplasty? A Computer Simulation Study.

Keisuke Komiyama1, Yasuharu Nakashima1, Masanobu Hirata1

  • 1Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

The Journal of Arthroplasty
|April 13, 2016
PubMed
Summary
This summary is machine-generated.

Elevating the hip center in total hip arthroplasty improves bone coverage but reduces hip flexion and internal rotation. An optimal vertical center of rotation (V-COR) of approximately 35 mm balances range of motion and coverage in hip dysplasia.

Keywords:
computer simulationhigh hip centerhip dysplasiarange of motiontotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering
  • Radiology

Background:

  • Achieving adequate bone coverage for cementless acetabular cups is crucial in hip dysplasia.
  • The impact of elevated hip center placement on postoperative range of motion (ROM) requires investigation.

Purpose of the Study:

  • To evaluate the effect of a higher hip center on postoperative ROM in total hip arthroplasty (THA) for hip dysplasia.
  • To determine the optimal vertical center of rotation (V-COR) for balancing bone coverage and ROM.

Main Methods:

  • Computer software analysis of ROM and bone coverage in 32 patients with hip dysplasia (Crowe type II/III).
  • Vertical repositioning of the acetabular cup in 5-mm increments to assess V-COR.
  • Defined required ROM (flexion ≥110°, IR ≥30°, extension ≥30°, external rotation ≥30°) and cup center-edge angle (Cup-CE ≥0°).

Main Results:

  • Only 40.6% achieved adequate bone coverage (Cup-CE ≥0°) at the anatomic hip center.
  • Peak bone coverage (90.6% Cup-CE ≥0°) occurred at V-COR of 30-35 mm.
  • Higher V-COR decreased flexion and internal rotation but increased extension and external rotation; 35 mm V-COR was the cutoff for flexion and IR.

Conclusions:

  • Elevating the hip center improves acetabular cup bone coverage in hip dysplasia.
  • Increased V-COR negatively impacts hip flexion and internal rotation.
  • An acceptable V-COR of approximately 35 mm (20 mm above true hip center) balances ROM and bone coverage.