de Waard S, Verboom T, Bech NH, Sierevelt IN, Kerkhoffs GM, Haverkamp D. Femoroacetabular offset restoration in total hip arthroplasty; Digital templating a short stem vs a conventional stem. World J Orthop 2022; 13(2): 139-149 [PMID: 35317405 DOI: 10.5312/wjo.v13.i2.139]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Feb 18, 2022; 13(2): 139-149 Published online Feb 18, 2022. doi: 10.5312/wjo.v13.i2.139
Femoroacetabular offset restoration in total hip arthroplasty; Digital templating a short stem vs a conventional stem
Sheryl de Waard, Tom Verboom, Niels Hendrik Bech, Inger N Sierevelt, Gino M Kerkhoffs, Daniël Haverkamp
Sheryl de Waard, Tom Verboom, Niels Hendrik Bech, Inger N Sierevelt, Daniël Haverkamp, Orthopedic Surgery, Xpert Orthopedie Amsterdam, Amsterdam 1101 EA, Netherlands
Gino M Kerkhoffs, Orthopaedic Surgery, Academic Medical Centre, Amsterdam 1105 AZ, Netherlands
Author contributions: de Waard S, Verboom T, Bech NH, Kerkhoffs GM, Haverkamp D drafted the manuscript; de Waard S and Haverkamp D did the measurements; Sierevelt I performed the statistical analysis, de Waard S assisted with data analysis; Sierevelt I, Haverkamp D participated in study design; Kerkhoffs GM and Haverkamp D participated in oversight of the study.
Institutional review board statement: The cohort studies in which the X-rays were chosen from, were reviewed by and approved by the Medical Ethical review committee of the MC Slotervaart hospital in Amsterdam, under registry numbers NL47055.048.13 and NL48211.048.14.
Informed consent statement: All study participants provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: There are no conflict of interest from any of the authors regarding this paper.
Data sharing statement: No additional data are available. For information regarding the used data, contact the corresponding author at s.dewaard21@gmail.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: April 28, 2021 Peer-review started: April 28, 2021 First decision: June 16, 2021 Revised: July 2, 2021 Accepted: January 7, 2022 Article in press: January 7, 2022 Published online: February 18, 2022 Processing time: 295 Days and 9.3 Hours
ARTICLE HIGHLIGHTS
Research background
The following steps that are necessary to take are the postoperative measurements of the short stem to see if the offset can be restored. Also, a pilot study with gait measurements in a case-matched study of patients with either a short or conventional stem will help to define if there is a difference.
Research motivation
If the native offset was > 80 mm, the short stem was better at restoring FAO than the conventional stem in digital templating. This could indicate that there is a specific patient population that could benefit if a short stem with a curve is chosen as femoral stem instead of the conventional stem.
Research objectives
A FAO more than 80mm showed a large failure rate in restoration in the conventional stems, whereas the short stem could restore the offset in all cases. The reliability of all measurements were good between in both inter- as intra-reliability, with no difference in experience.
Research methods
Digital templating in a standardized X-ray of the hip were used from two ongoing cohorts, varying in hip anatomy. Orthoview was used as digital templating program. Pre-templating FAO was measured, as well as post-templating FAO measurements in the short and conventional stem. The results were divided into restored (< 5 mm difference in offset) or not-restored (> 5 mm difference in offset).
Research results
Primary objective was the femoroacetabular offset restoration in all types of hip anatomy between a short and conventional hip stem, where the acetabular component is used as a fixed parameter. Second objectives were the reliability of the measurements.
Research conclusions
As digital templating is a reliable tool for measuring component sizes in total hip arthroplasty, this is used as measurement to see if there is a difference between a short and conventional hip stem in a wide range of hip anatomy.
Research perspectives
Short stems are gaining popularity, as one of the possible advantages is the restoration of offset. Offset restoration improves functional outcome. This could benefit the younger patient population, as they have higher expectations of their total hip arthroplasty in their more active lifestyle.
