Background: The concept of restoring the femoral offset is well established during hip replacement surgery, but is less well known when treating Garden I or II femoral neck fractures by internal fixation. And yet, the therapeutic aim for these fractures is to restore this native parameter as best possible. The aim of this study was to identify the risk factors for reduction of femoral offset after union of a Garden I or II femoral neck fracture treated by internal fixation.
Hypothesis: After internal fixation of a femoral neck fracture, certain factors may contribute to reducing the femoral offset, which itself has been identified as being responsible for altering the patients' quality of life and functional outcomes.
Materials And Methods: This multicenter study included 193 patients who had a Garden I or II femoral neck fracture treated by cannulated screws or a sliding compression screw-plate. The difference between the femoral offset in the operated hip and that of the contralateral hip was measured in weightbearing patients after the fracture had healed. This difference was the primary outcome measure. Univariate and multivariate analyses were done to look for risk factors contributing to femoral neck shortening.
Results: Based on the univariate analysis, being more than 85 years of age, having a Garden I fracture, and cannulated screw fixation were associated with a significantly greater reduction in the femoral offset. In the multivariate analysis, only Garden I fractures were associated with a greater reduction in femoral offset.
Discussion: Garden I fractures were associated with a greater reduction in the offset, although there was no evidence that this change was related to early weightbearing. By identifying this risk factor, surgeons can optimize the indications given that the treatment of these fractures is still widely debated and there is still no consensus as to the best method.
Level Of Evidence: IV.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.otsr.2024.103967 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Specific approach to total hip arthroplasty in patients with childhood hip disorders sequelae.
World J Orthop
December 2024
Department for Science, Dubai College, Dubai 00000, Dubayy, United Arab Emirates.
Hip arthroplasty in patients with a history of paediatric hip disorders presents a significant challenge for orthopaedic surgeons. These patients are typically younger and have greater functional demands. Therefore, achieving optimal biomechanical conditions is crucial, involving placement of the acetabulum at the ideal centre of rotation and securing a stable femoral component with good offset to preserve abductor muscle function and restore leg length.
View Article and Find Full Text PDFComparing cup placement, leg length, and offset discrepancy after total hip arthroplasty between CT-based robotic arm-assisted and navigation systems.
Bone Jt Open
January 2025
Department of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Toon, Japan.
Aims: Excellent outcomes have been reported following CT-based robotic arm-assisted total hip arthroplasty (rTHA) compared with manual THA; however, its superiority over CT-based navigation THA (nTHA) remains unclear. This study aimed to determine whether a CT-based robotic arm-assisted system helps surgeons perform accurate cup placement, minimizes leg length, and offsets discrepancies more than a CT-based navigation system.
Methods: We studied 60 hips from 54 patients who underwent rTHA between April 2021 and August 2023, and 45 hips from 44 patients who underwent nTHA between January 2020 and March 2021 with the same target cup orientation at the Department of Orthopedic Surgery at Ozu Memorial Hospital, Japan.
A systematic review of short- compared with standard-length Exeter stems in primary total hip arthroplasty.
Bone Joint J
January 2025
Grampian Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, UK.
Aims: The Exeter femoral stem has a cemented, polished taper-slip design, and an excellent track record. The current range includes short-length options for various offsets, but less is known about the performance of these stems. The aim of this study was to compare the survival of short-length stems with standard-length Exeter stems.
View Article and Find Full Text PDFFactors that Determine Pelvic Obliquity in Adults Who Suffered Legg-Calvé-Perthes Disease and the Role of Total Hip Arthroplasty in Its Restoration.
J Arthroplasty
December 2024
Department of Orthopedic Surgery and Traumatology. La Paz University Hospital. Madrid, Spain; La Paz University Hospital. Paseo de la Castellana, 261, 28046, Madrid, Spain.
Background: The purpose of the study was to analyze the appearance of pelvic obliquity before total hip arthroplasty (THA) in adults who have Legg-Calvé-Perthes disease (LCPD) sequelae and its evolution in the first two postoperative years, identifying which factors influence its development.
Methods: The THAs performed between 2012 and 2021 at a single institution in adults who had LCPD during childhood were retrospectively identified. Each case was matched 1:1, based on age at surgery, sex, and body mass index, with a primary THA performed for hip osteoarthritis (primary OA).
Anterior femoral offset is a flawed measurement of patellofemoral overstuffing.
Arch Orthop Trauma Surg
December 2024
Adventist Health Memorial Hospital, Lodi, CA, USA.
Background: Patellofemoral joint (PFJ) issues after total knee arthroplasty (TKA) are becoming a topic of interest once again. Due to the complex three-dimensional shape of the trochlea, various two-dimensional proxy measurements on plain X-rays have been described. One of these measurements is the anterior femoral offset (AFO).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!