Computerized Virtual Surgery Demonstrates Where Acetabular Rim Osteophytes Most Reduce Range of Motion Following Total Hip Arthroplasty

HSS Journal: Volume 9 Issue 3

Sebastian Rodriguez-Elizalde, MD,
Department of Orthopaedic Surgery, Hospital for Special Surgery

Alyssa M. Yeager, BA,
Department of Orthopaedic Surgery, Hospital for Special Surgery

Bheeshma Ravi, MD,
Division of Orthopaedic Surgery, Department of Surgery, University of Toronto 

Joseph Lipman, MS
Director of Biomechanics, Hospital for Special Surgery


Eduardo A. Salvati, MD

Attending Orthopaedic Surgeon, Hospital for Special Surgery
Clinical Professor of Surgery (Orthopaedics), Hospital for Special Surgery

Geoffrey H. Westrich, MD

Associate Attending Orthopedic Surgeon, Hospital for Special Surgery
Research Director of Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery
Assistant Scientist, Hospital for Special Surgery
Co-Chairman, Complex Case Review Panel, Hospital for Special Surgery
Associate Professor of Clinical Orthopedic Surgery, Weill Cornell Medical College

Abstract

Background:
Acetabular osteophytes are common findings during total hip arthroplasty (THA).

Purpose:
This study was designed to determine the extent to which osteophytes may limit range of motion (ROM) and in which locations impingement is likely to occur if osteophytes are not removed during surgery.

Methods: Computer-aided design was used to compare ROM of a modern hip implant in four cadaver models with and without 10-mm acetabular rim osteophytes added. A clock face, with 12 o’clock at the superior pole of the right acetabulum, was used to map impingement.

Results:
The osteophyte model limited ROM in flexion (101° v. 113°, p#=#0.03), 90° of flexion with internal rotation (16.7° v. 31.6°, p = 0.01), and external rotation (30.4° v. 49.5°, p = 0.01). Impingement occurred between 7 and 8 o’clock in external rotation and 1 and 2 o’clock in the other two motions.

Conclusions: Osteophytes in these positions have the greatest impact on ROM and should be removed during THA.

This article appears in HSS Journal: Volume 9 Issue 3.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.


^ Back to Top
Request an Appointment