Proximal Femoral Asymmetry in Japanese Patients before Total Hip Arthroplasty

6 pages•Published: October 26, 2019

Maximilian C. M. Fischer, Kunihiko Tokunaga, Masashi Okamoto and Klaus Radermacher

Abstract

Templating is an important and established step in the preoperative planning process of total hip arthroplasty (THA) in order to select the size and position of the implant. In severely arthritic cases, the unaffected contralateral side is sometimes used as a reference to reconstruct morphological parameters of the planned implantation (ipsilateral) side, for example the femoral offset, the leg length or the antetorsion. Recent studies have shown that a significant side-to-side asymmetry of important proximal femoral parameters already exists in healthy subjects questioning the validity of the contralateral side as a reference. However, if preoperative asymmetry is larger than asymmetry in healthy subjects, preoperative planning can still make use of the contralateral side to target a postoperative result within the range of physiological asymmetry. Therefore, the specific objective of this study was to quantify the preoperative side-to-side asymmetry of five important morphological parameters of the proximal femur. Significant side-to- side differences between the ipsilateral side and the contralateral side were detected for the antetorsion, the offset, the neck length and the femoral length. The antetorsion is significantly higher for the ipsilateral side whereas offset, neck length and femoral length are significantly smaller. Mean and maximum difference in antetorsion is almost twice as high for the THA patients in comparison to healthy subjects. The same trend can be observed for the femoral length, less pronounced also for the caput-collum-diaphyseal angle. The comparison of proximal femoral side-to-side differences for subjects before THA and healthy subjects leads to the conclusion that contralateral templating can be a reasonable basis for THA planning of severely arthritic hips if the contralateral side shows no signs of osteoarthritis or developmental dysplasia.

Keyphrases: preoperative templating, proximal femur, side to side asymmetry, total hip arthroplasty

In: Patrick Meere and Ferdinando Rodriguez Y Baena (editors). CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 3, pages 127-132.

Links:	https://easychair.org/publications/paper/PGvz
	https://doi.org/10.29007/ms33

BibTeX entry

@inproceedings{CAOS2019:Proximal_Femoral_Asymmetry_Japanese,
  author    = {Maximilian C. M. Fischer and Kunihiko Tokunaga and Masashi Okamoto and Klaus Radermacher},
  title     = {Proximal Femoral Asymmetry in Japanese Patients before Total Hip Arthroplasty},
  booktitle = {CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Patrick Meere and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {3},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/PGvz},
  doi       = {10.29007/ms33},
  pages     = {127-132},
  year      = {2019}}

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