EFFECT OF FEMORAL OFFSET CHANGE ON PAIN AND FUNCTION AFTER TOTAL HIP ARTHROPLASTY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

XU Boyong , YANG Desheng , AiliRehei , CAO Li.

Department of Orthopaedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P.R.China. Corresponding author: YANG Desheng, E-mail: yangdeshengxj@126.com;

Corresponding author：

Keywords：

Femoral offset; Total hip arthroplasty; Joint pain; Joint function

DOI：

10.7507/1002-1892.20130184

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Objective To investigate the effects of altering the femoral offset after total hip arthroplasty on postoperative pain and function. Methods A total of 162 patients undergoing single total hip arthroplasty between March 2009 and December 2011 met the inclusion criteria. According to difference of femoral offset between operative side and contralateral side, the patients were divided into 3 groups: decreased offset group ( lt; — 5 mm, 30 cases), normal offset group ( — 5-5 mm, 87 cases), and increased offset group ( gt; 5 mm, 45 cases). There was no significant difference in gender, age, and disease duration among 3 groups (P gt; 0.05). The types of femoral stem and head prosthesis were compared among 3 groups. Short Form 12 Health Survey (SF-12) score, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score, and Harris score were used to evaluate the clinical outcomes. Results Standard offset femoral prosthesis was most used, followed by increased offset femoral prosthesis, and decreased offset femoral prosthesis was least in 3 groups. The types of femoral stem and head prosthesis showed no significant difference among 3 groups (P gt; 0.05). The patients were followed up 12-33 months (mean, 25 months). There was no significant difference in SF-12 score among 3 groups at 1 year after operation (P gt; 0.05); there was no significant difference in WOMAC pain and stiffness scores among 3 groups (P gt; 0.05) except WOMAC body function score (P lt; 0.05). According to Harris scoring criteria, the results were excellent in 13 cases, good in 8 cases, fair in 7 cases, and poor in 2 cases in decreased offset group; the results were excellent in 42 cases, good in 34 cases, fair in 9 cases, and poor in 2 cases in normal offset group; the results were excellent in 31 cases, good in 12 cases, and fair in 2 cases in increased offset group; and significant difference was found among 3 groups (Z= — 3.152, P=0.008). Conclusion Increased offset is more conducive to joint functional recovery and pain relief; decreased offset may lead to joint function deterioration and pain aggravation.

Citation： XU Boyong,YANG Desheng,AiliRehei,CAO Li.. EFFECT OF FEMORAL OFFSET CHANGE ON PAIN AND FUNCTION AFTER TOTAL HIP ARTHROPLASTY. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(7): 843-846. doi: 10.7507/1002-1892.20130184 Copy

1.	Brilhault JM, Ries MD. Influence of offset stem couplers in femoral revision knee arthroplasty: a radiographic study. Knee, 2012, 19(2): 112-115.
2.	Wik TS, Enoksen C, Klaksvik J, et al. In vitro testing of the deformation pattern and initial stability of a cementless stem coupled to an experimental femoral head, with increased offset and altered femoral neck angles. Proc Inst Mech Eng H, 2011, 225(8): 797-808.
3.	Chamnongkich S, Asayama I, Kinsey TL, et al. Difference in hip prosthesis femoral offset affects hip abductor strength and gait characteristics during obstacle crossing. Orthop Clin North Am, 2012, 43(5): e48-58.
4.	Brilhault JM, Ries MD. Posteriorly offset femoral component to restore anteroposterior position of the distal femur in revision total knee arthroplasty. J Arthroplasty, 2011, 26(2): 214-217.
5.	Cinotti G, Sessa P, Ripani FR, et al. Correlation between posterior offset of femoral condyles and sagittal slope of the tibial plateau. J Anat, 2012, 221(5): 452-458.
6.	Malhotra R, Kannan A, Kancherla R, et al. Femoral head-neck offset in the indian population: A CT based study. Indian J Orthop, 2012, 46(2): 212-215.
7.	芦北极, 孙俊英, 施勤, 等. 全髋关节成形术后的偏心距测量对临床功能的影响. 中国矫形外科杂志, 2012, 20(14): 1282-1286.
8.	Malviya A, Lingard EA, Malik A, et al. Hip flexion after Birmingham hip resurfacing: role of cup anteversion, anterior femoral head-neck offset, and head-neck ratio. J Arthroplasty, 2010, 25(3): 387-391.
9.	Preininger B, Schmorl K, von Roth P, et al. Femoral offset (3D) in patients without osteoarthritis-index values from 200 hip joints. Open Orthop J, 2012, 6: 578-581.
10.	吕作刚, 孔荣. 股骨偏心距变化可影响髋关节置换后相关并发症的发生. 中国组织工程研究, 2012, 16(13): 2309-2312.
11.	Brilhault JM, Ries MD. Influence of offset stem couplers in femoral revision knee arthroplasty: a radiographic study. Knee, 2011, 19(2): 112-115.
12.	Husby VS, Bjørgen S, Hoff J, et al. Unilateral vs. bilateral total hip arthroplasty—the influence of medial femoral head offset and effects on strength and aerobic endurance capacity. Hip Int, 2010, 20(2): 204-214.

1. Brilhault JM, Ries MD. Influence of offset stem couplers in femoral revision knee arthroplasty: a radiographic study. Knee, 2012, 19(2): 112-115.
2. Wik TS, Enoksen C, Klaksvik J, et al. In vitro testing of the deformation pattern and initial stability of a cementless stem coupled to an experimental femoral head, with increased offset and altered femoral neck angles. Proc Inst Mech Eng H, 2011, 225(8): 797-808.
3. Chamnongkich S, Asayama I, Kinsey TL, et al. Difference in hip prosthesis femoral offset affects hip abductor strength and gait characteristics during obstacle crossing. Orthop Clin North Am, 2012, 43(5): e48-58.
4. Brilhault JM, Ries MD. Posteriorly offset femoral component to restore anteroposterior position of the distal femur in revision total knee arthroplasty. J Arthroplasty, 2011, 26(2): 214-217.
5. Cinotti G, Sessa P, Ripani FR, et al. Correlation between posterior offset of femoral condyles and sagittal slope of the tibial plateau. J Anat, 2012, 221(5): 452-458.
6. Malhotra R, Kannan A, Kancherla R, et al. Femoral head-neck offset in the indian population: A CT based study. Indian J Orthop, 2012, 46(2): 212-215.
7. 芦北极, 孙俊英, 施勤, 等. 全髋关节成形术后的偏心距测量对临床功能的影响. 中国矫形外科杂志, 2012, 20(14): 1282-1286.
8. Malviya A, Lingard EA, Malik A, et al. Hip flexion after Birmingham hip resurfacing: role of cup anteversion, anterior femoral head-neck offset, and head-neck ratio. J Arthroplasty, 2010, 25(3): 387-391.
9. Preininger B, Schmorl K, von Roth P, et al. Femoral offset (3D) in patients without osteoarthritis-index values from 200 hip joints. Open Orthop J, 2012, 6: 578-581.
10. 吕作刚, 孔荣. 股骨偏心距变化可影响髋关节置换后相关并发症的发生. 中国组织工程研究, 2012, 16(13): 2309-2312.
11. Brilhault JM, Ries MD. Influence of offset stem couplers in femoral revision knee arthroplasty: a radiographic study. Knee, 2011, 19(2): 112-115.
12. Husby VS, Bjørgen S, Hoff J, et al. Unilateral vs. bilateral total hip arthroplasty—the influence of medial femoral head offset and effects on strength and aerobic endurance capacity. Hip Int, 2010, 20(2): 204-214.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECT OF FEMORAL OFFSET CHANGE ON PAIN AND FUNCTION AFTER TOTAL HIP ARTHROPLASTY

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