An Intraoperative Technique to Assess Tissue Tension and Leg Length When Aligning the Hip Centre of Rotation With the Acetabulum in Hip Arthroplasties.

Autor:	Al Ani Z; Trauma and Orthopaedics, Peterborough City Hospital, Peterborough, GBR., Sharif K; Trauma & Orthopaedics, Diana, Princess of Wales Hospital, Grimsby, GBR., Verghese SC; Trauma & Orthopaedics, Hinchingbrooke & Peterborough City Hospital, North-West Anglia NHS Foundation Trust, Huntingdon, GBR., Singh S; Lower Limb Arthroplasties, Peterborough City Hospital, Peterborough, GBR., Killampalli VV; Trauma and Orthopaedics, North-West Anglia NHS Foundation Trust, Huntingdon, GBR.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 31; Vol. 16 (7), pp. e65860. Date of Electronic Publication: 2024 Jul 31 (Print Publication: 2024).
DOI:	10.7759/cureus.65860
Abstrakt:	Hip arthroplasties are cost-effective procedures; however, instability and leg length discrepancy are common complications that can lead to higher revision rates and patient dissatisfaction. Preoperative planning aids surgeons in choosing the right offset and neck length before surgery. Nonetheless, intraoperative measures are still necessary due to the differences dictated by the surgical procedure. Several hip trials might be needed to reach the optimum choice of implants. We have introduced a technique that utilizes the trunnion as a reference point to the hip centre of rotation, matching it with the acetabulum centre of rotation after applying the necessary soft tissue tension. This serves as a proximal reference point. Using the trunnion, as opposed to the trial head, allows for a better assessment of tissue tension within the acetabular void, avoiding constraints imposed by the applied trial head. Additionally, determining the acetabulum's centre of rotation is challenging if obscured by the trial head. Matching the two tibial tuberosities indicates the correct leg length, serving as the distal reference point. Both reference points should be considered together to select the right neck length and offset for optimal tissue tension. This technique has been tested on hip arthroplasty patients over five years. All hip surgeons who used this technique agree that it gives a better representation of the tissue tension, easing the challenges when preparing the acetabulum as well as reducing the need for multiple trials. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Research and Development department in Peterborough City Hospital issued approval 409. This retrospective study was approved by the ethical committee in the research development department at Peterborough City Hospital as well as by the quality governance in the Northwest Anglia Foundation Trust. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Al Ani et al.)
Databáze:	MEDLINE
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