![]() ![]() For the external hip adduction moments the literature is not unambiguous as some studies found increased hip loading, whereas other studies did not find an overload for patients after THR.ĭifferences in gait kinematics between hip OA patients after THR and healthy controls can partly explain the differences in the joint moments in the frontal plane. Due to this lateralization of the knee joint load, patients likely have an increased risk for lateral knee osteoarthritis (OA) after THR. ![]() Patients still show a reduced external knee adduction moment in the second half of stance in both the operated leg and the non-operated leg compared to a healthy control group. It is known that the joint loads, expressed as net joint moments, do not return to normal up to 2 years after total hip replacement (THR). This study was retrospectively registered with DRKS (German Clinical Trials Register) under the number DRKS00015053. For surgeons it is important not to create too much of a structural varus alignment by implanting the new hip joint as varus alignment can increase the knee adduction moment and the risk for osteoarthritis of the medial knee compartment. A combination of these radiological leg parameters, especially the varus alignment, and the deviating kinematics explain the joint moments in the frontal plane during gait after total hip replacement surgery. In our patient group the joint moments after total hip replacement did not differ from healthy controls, whereas radiological leg alignment parameters changed significantly after the total hip replacement. The combination with a kinematic parameter (knee range of motion, foot progression angle) increased the predictive value for the knee moments. The hip moment (first half of stance) and the knee moments (first and second half of stance) were mostly determined by the varus/valgus alignment (29% and respectively 36% and 35%). The operated leg showed significantly ( P < 0.05) more varus (1.1°) as well as a larger femoral offset (+ 8 mm) and a larger Hip-Knee-Shaft-Angle (+ 1.3°) after total hip replacement however no significant differences in the joint moments in the frontal plane compared to healthy controls were found. Preoperatively and 1 year postoperatively all patients had biplanar radiographic examinations and 3D gait analysis. MethodsĢ2 unilateral hip osteoarthritis patients who were scheduled for total hip replacement were included in the study. The goal of this study was to determine if total hip replacement surgery affects radiological leg alignment (Hip-Knee-Shaft-Angle, femoral offset, Neck-Shaft-Angle and varus/valgus alignment) and which of these parameters can explain the joint moments, additionally to the gait kinematics. Normal and abnormal follow-up radiographic features are outlined to allow assessment of loosening or impending failure of a prosthesis.Gait kinematics after total hip replacement only partly explain the differences in the joint moments in the frontal plane between hip osteoarthritis patients after hip replacement and healthy controls. A review of the literature provides evidence for the assessment and importance of adequacy of component positioning, and good cementing technique. Follow-up radiographs are assessed for signs of component failure. Assessment of initial radiographs focuses on assessing leg length, acetabular and femoral positioning, and cement mantle adequacy. ![]() Basics of patient positioning for obtaining radiographs, types of prosthesis encountered, and terminology used are covered. This review aims to provide the reader with a systematic approach to analysing the initial postoperative total hip arthroplasty radiograph, and subsequent follow-up films. The authors feel that certainly during orthopaedic surgical training, not enough time is allocated to formal training on the systematic assessment of such radiographs. Orthopaedic surgeons, radiologists, junior surgical trainees, general medical practitioners, and advanced nurse/extended scope practitioners may all be required to interpret these radiographs during clinical practice. Follow-up radiographs can be assessed for signs of component failure. Information gained from the initial radiograph includes assessment of the quality of implantation and hence the likelihood of long term success. A crucial aspect of follow-up for these patients is the assessment of the postoperative radiograph. In 2006 over 55,000 primary total hip replacements were implanted in the UK. ![]()
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