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Journal of Orthopaedic Surgery and Research | Abstract | A comparison of Leg Length and Femoral Offset discrepancies in Hip Resurfacing, Large Head Metal-on-Metal and Conventional Total Hip Replacement: a case series.

Research article

A comparison of Leg Length and Femoral Offset discrepancies in Hip Resurfacing, Large Head Metal-on-Metal and Conventional Total Hip Replacement: a case series

Katherine A Herman, Alan J Highcock, John D Moorehead and Simon J Scott

Journal of Orthopaedic Surgery and Research 2011,6:65 doi:10.1186/1749-799X-6-65

Published: 29 December 2011

Abstract (provisional)

Background

A discrepancy in leg length and femoral offset restoration is the leading cause of patient dissatisfaction in hip replacement surgery and has profound implications on patient quality of life. The aim of this study is to compare biomechanical hip reconstruction in hip resurfacing, large-diameter femoral head hip arthroplasty and conventional total hip replacement.

Method

Sixty patient’s post-operative radiographs were reviewed; 20 patients had a hip resurfacing (HR), 20 patients had a Large Head Metal-on-metal (LHM) hip replacement and 20 patients had a conventional small head Total Hip Replacement (THR). The leg length and femoral offset of the operated and unoperated hips were measured and compared.

Results

Hip resurfacing accurately restored hip biomechanics with no statistical difference in leg length (P=0.07) or femoral offset (P=0.95) between the operated and non-operative hips. Overall HR was superior for reducing femoral offset discrepancies where it had the smallest bilateral difference (-0.2 %, P= 0.9). The traditional total hip replacement was least effective at restoring the hip anatomy.

Conclusion

The use of a larger-diameter femoral head in hip resurfacing does not fully account for the superior biomechanical restoration, as LHM did not restore femoral offset as accurately. We conclude that restoration of normal hip biomechanics is best achieved with hip resurfacing.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

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