title: Impingement and stability of total hip arthroplasty versus femoral head resurfacing using a cadaveric robotics model.
abstract: We identified and compared the impingent-free range of motion (ROM) and subluxation potential for native hip, femoral head resurfacing (FHR), and total hip arthroplasty (THA). These constructs were also compared both with and without soft tissue to elucidate the role of the soft tissue. Five fresh-frozen bilateral hip specimens were mounted to a six-degree of freedom robotic manipulator. Under load-control parameters, in vivo mechanics were recreated to evaluate impingement free ROM, and the subluxation potential in two "at risk" positions for native hip, FHR, and THA. Impingement-free ROM of the skeletonized THA was greater than FHR for the anterior subluxation position. For skeletonized posterior subluxations, stability for THA and FHR constructs were similar, while a different pattern was observed for specimens with soft tissues intact. FHR constructs were more stable than THA constructs for both anterior and posterior subluxations. When the femoral neck is intact the joint has an earlier impingement profile placing the hip at risk for subluxation. However, FHR design was shown to be more stable than THA only when soft tissues were intact.
authors.affiliation: Cleveland Clinic Foundation, 9500 Euclid Ave Desk A41 Crile Building, Cleveland, OH 44195, USA.
authors.forename: R W
authors.initials: RW
authors.lastname: Colbrunn
authors.forename: J J
authors.initials: JJ
authors.lastname: Bottros
authors.forename: R S
authors.initials: RS
authors.lastname: Butler
authors.forename: A K
authors.initials: AK
authors.lastname: Klika
authors.forename: T F
authors.initials: TF
authors.lastname: Bonner
authors.forename: C
authors.initials: C
authors.lastname: Greeson
authors.forename: A J
authors.initials: AJ
authors.lastname: van den Bogert
authors.forename: W K
authors.initials: WK
authors.lastname: Barsoum
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002102:Cadaver; D005270:Femur Head / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D004204:Joint Dislocations / Q000453:epidemiology*; D007593:Joint Instability / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D012371:Robotics / Q000379:methods*