title: Inducible displacements of the cup and the femoral head during active range of motion: dynamic RSA studies of cemented total hip replacements.
abstract: We evaluated changes in position of the femoral head relative to the cup and of the cup relative to the pelvis in total hip replacement patients during hip motion 2 years postoperatively. Two patient groups with nine patients in each group were studied. Hip motions, translations of the femoral head center, and cup displacements were recorded with dynamic radiostereometric examination (RSA, 2 exposures/s) during abduction in Group 1 and with use of static RSA exposures at increasing flexion of the hip in Group 2. Conventional radiographic examinations were used to evaluate any radiolucent lines around the cups at 2 years. During active abduction the femoral head center moved medially (median 0.04 mm) and the cup tilted anteriorly (median 0.09 mm). Increments in radiolucent lines at 2 years correlated to medial femoral head penetration, posterior tilt, and retroversion of the cup at 20° of abduction. The extension of radiolucent lines at 2 years showed a positive correlation with proximal inducible displacement of the cup and posterior translation of the femoral head center at maximum hip flexion. Our observations may be of value in understanding the pathogenesis of the loosening process and may be used to facilitate the development of prosthetic designs that optimize hip kinematics.
authors.affiliation: Department of Orthopaedics, General Hospital Xanthi, 67100, Xanthi, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Digas
authors.forename: Per-Erik
authors.initials: PE
authors.lastname: Johansson
authors.forename: Johan
authors.initials: J
authors.lastname: Kärrholm
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements; D005260:Female; D005270:Femur Head / Q000503:physiopathology*; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D059869:Radiostereometric Analysis; D016059:Range of Motion, Articular; D012399:Rotation
chemical_list: D001843:Bone Cements
keywords: dynamic radiostereometric analysis; femoral head and cup displacement