שנה שפה:

Does Restoration of Leg Length and Femoral Offset Play a Role in Functional Outcome One Year after Hip Hemiarthroplasty?



Dror Lakstein1,3, Zachary Tan2, Orit Wissotzky3, Mustafa Yassin1,3
1 Dept. Orthopaedic surgery, Rabin Medical Center, Golda Campus (Hasharon), Petah-Tikva, Israel
2 Orthopedic surgery, University of Toronto, Toronto, Canada
3 Orthopedic Surgery, Sackler School of Medicine, Tel-Aviv, Israel

Background: The objective of this study was to evaluate the correlation between specific joint biomechanical parameters and 1 year functional outcome scores in elderly patients receiving hemiarthroplasty in the setting of intracapsular hip fractures.

Methods: This is a retrospective, institutional registry based study. 168 hip hemarthroplasties were captured from October 2013 to June 2015. Patients were excluded based on contralateral hip surgery, perioperative complications or inadequate radiographs. 84 patients were alive at one year follow up. We compared mobility and pain scores to radiographically determined variations of leg lengths and femoral offset. We also compared the performance of fellowship trained arthroplasty surgeons to their non-fellowship trained counterparts.

Results: The operated leg was a mean of 1.12 ± 6.8mm longer than the contralateral. leg length discrepancy (LLD) was less than 10 mm in 72 patients. Mean difference in offset between limbs was 0.25 ± 3.3mm. The difference was within 5mm in 79 patients (94%). We found no statistically significant correlation between mobility or pain scores and variations in leg length or offset. We found significantly better performance of the arthroplasty surgeons in restoring leg length but no difference in offset reconstruction or functional benefit for the patient.

Conclusions: Our study was unable to demonstrate a significant relationship between leg length or femoral offset restoration and the patient’s ultimate functional recovery. Arthroplasty surgeons performed better in restoring leg length, but no associated functional advantage was seen.

Flow diagram for included patients  LLD measurmentsFemoral offset measurmentA scatter diagram demonstrating no significant correlation between LLD and loss of mobility status (P=0.08).

The correlation between functional outcome and biomechanical restoration

Comparison of biomechanical restoration and functional outcome of patients operated by arthroplasty surgeons and other surgeons

העלאת קובץ המאמר או המצגת

Dror Lakstein