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Does body mass index affect restoration of femoral offset, leg length and cup positioning after total hip arthroplasty?: A prospective cohort study
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
Vise andre og tillknytning
2019 (engelsk)Inngår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 20, artikkel-id 422Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: In obese patients, total hip arthroplasty (THA) can be technically demanding with increased perioperative risks. The aim of this prospective cohort study is to evaluate the effect of body mass index (BMI) on radiological restoration of femoral offset (FO) and leg length as well as acetabular cup positioning.

Methods: In this prospective study, patients with unilateral primary osteoarthritis (OA) treated with THA between September 2010 and December 2013 were considered for inclusion. The perioperative plain radiographs were standardised and used to measure the preoperative degree of hip osteoarthritis, postoperative FO, leg length discrepancy (LLD), acetabular component inclination and anteversion.

Results: We included 213 patients (74.5% of those considered for inclusion) with a mean BMI of 27.7 (SD 4.5) in the final analysis. The postoperative FO was improper in 55% and the LLD in 15%, while the cup inclination and anteversion were improper in 13 and 23% of patients respectively. A multivariable logistic regression model identified BMI as the only factor that affected LLD. Increased BMI increased the risk of LLD (OR 1.14, 95% CI 1.04 to 1.25). No other factors included in the model affected any of the primary or secondary outcomes.

Conclusion: Increased BMI showed a negative effect on restoration of post-THA leg length but not on restoration of FO or positioning of the acetabular cup. Age, gender, OA duration or radiological severity and surgeon’s experience showed no relation to post-THA restoration of FO, leg length or cup positioning.

sted, utgiver, år, opplag, sider
BioMed Central, 2019. Vol. 20, artikkel-id 422
Emneord [en]
BMI, Hip arthroplasty, Femoral offset, Leg length discrepancy, Cup positioning
HSV kategori
Identifikatorer
URN: urn:nbn:se:umu:diva-151712DOI: 10.1186/s12891-019-2790-yISI: 000485277400001PubMedID: 31510993Scopus ID: 2-s2.0-85072113263OAI: oai:DiVA.org:umu-151712DiVA, id: diva2:1246961
Tilgjengelig fra: 2018-09-10 Laget: 2018-09-10 Sist oppdatert: 2019-11-13bibliografisk kontrollert
Inngår i avhandling
1. Radiological measurements in total hip arthroplasty
Åpne denne publikasjonen i ny fane eller vindu >>Radiological measurements in total hip arthroplasty
2018 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Every year, about 1 million patients worldwide and 20000 patients in Sweden undergo total hip arthroplasty (THA). This type of operation is considered a successful, safe and cost-effective procedure to regain mobility and restore hip joint function in patients suffering from severe hip joint disease or trauma. The main goals of the operation are to relief the pain, improve quality of life (QoL) and to restore the biomechanical forces around the hip with appropriate femoral offset (FO), leg length and proper component position and orientation. The radiographic preoperative planning and postoperative evaluation of these parameters require good validity, interobserver reliability and intraobserver reproducibility. Most patients are satisfied after THA, although this treatment still has its complications. About 10 % of THA patients report persistent pain and suboptimal functional outcome and QoL at long-term follow-up. The absolute number of dissatisfied patients is expected to rise given the increase in the annual number of THA performed. Therefore, every effort should be made to investigate factors that possibly influence THA outcome. The data available about the influence of preoperative radiological severity and symptom duration of OA on the outcome of THA are scarce and contradictory. Further studies even needed to evaluate the effect of obesity on post-operative THA radiological measurements

Abstract [sv]

Varje år opereras ungefär 1 miljon patienter runt om i världen och 20,000 patienter i Sverige med en total höftledsprotes (THA). Höftledsprotesoperation anses vara en av de mest framgångsrika, säkra och kostnadseffektiva kirurgiska åtgärderna med ett syfte att smärtlindra, återställa rörligheten och förbättra livskvaliteten. Höftleden drabbas av artros, åldersrelaterad sjukdom som orsakar destruktion av leden. Vid operation med THA är det viktigt att återställa de biomekaniska krafterna runt höftleden med en adekvat så kallad femoral offset (FO), avståndet mellan höftens rörelsecentrum och mitten av bäckenet, postoperativ benlängdsskillnad (BLS) och ett tillfredsställande komponentläge. Den preoperativa planeringen och den postoperativa röntgenbedömningen av dessa parametrar kräver god tillförlitlighet, det vill säga validitet och reproducerbarhet både mellan olika bedömare och vid upprepade mätningar av samma bedömare. Således är radiologiska mätningar före och efter THA oerhört viktiga för att få bästa resultat efter THA. Det finns inte tillräckligt med information i litteraturen om effekten av den preoperativa radiologiska artrosgraden och symptomduration av artrosen på utfallet av THA. Dessutom behövs ytterligare forskning för att studera effekten av obesitas på de radiologiska mätningarna efter THA.

sted, utgiver, år, opplag, sider
Umeå: Umeå universitet, 2018. s. 69
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 1983
Emneord
Total hip arthroplasty, leg length discrepancy, femoral offset, WOMAC, quality of life, radiographicmeasurements, Kellgren-Lawrence, duration, acetabular cup, inclination, anteversion, BMI
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-151862 (URN)978-91-7601-943-6 (ISBN)
Disputas
2018-10-12, Lionsalen, byggnad 7, målpunkt Y22, 2 tr, Umeå universitetssjukhus, Umeå, 09:00 (svensk)
Opponent
Veileder
Tilgjengelig fra: 2018-09-21 Laget: 2018-09-14 Sist oppdatert: 2018-11-08bibliografisk kontrollert

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