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Restoration of leg length and offset correlates with trochanteric pain syndrome in total hip arthroplasty
Persistent pain around the greater trochanter is a common complication after total hip arthroplasty. Restoration of biomechanics such as leg length, femoral und acetabular offset is crucial in THA. The purpose of this study was to evaluate postoperative differences of these parameters after THA and...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188889/ https://www.ncbi.nlm.nih.gov/pubmed/32345993 http://dx.doi.org/10.1038/s41598-020-62531-9 |
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author | Worlicek, Michael Messmer, Benedikt Grifka, Joachim Renkawitz, Tobias Weber, Markus |
author_facet | Worlicek, Michael Messmer, Benedikt Grifka, Joachim Renkawitz, Tobias Weber, Markus |
author_sort | Worlicek, Michael |
collection | PubMed |
description | Persistent pain around the greater trochanter is a common complication after total hip arthroplasty. Restoration of biomechanics such as leg length, femoral und acetabular offset is crucial in THA. The purpose of this study was to evaluate postoperative differences of these parameters after THA and to analyze their association to greater trochanteric pain syndrome. Furthermore, we aimed to evaluate the clinical relevance of trochanteric pain syndrome compared to patient reported outcome measures. 3D-CT scans of 90 patients were analyzed after minimalinvasive total hip arthroplasty and leg length, femoral and acetabular offset differences were measured. Clinical evaluation was performed three years after THA regarding the presence of trochanteric pain syndrome and using outcome measures. Furthermore, the patients’ expectation were evaluated. Patients with trochanteric pain syndrome showed a higher absolute discrepancy of combined leg length, femoral and acetabular offset restoration compared to the non-operated contralateral side with 11.8 ± 6.0 mm than patients without symptoms in the trochanteric region with 7.8 ± 5.3 mm (p = 0.01). Patients with an absolute deviation of the combined parameters of more than 5 mm complained more frequently about trochanteric symptoms (29.2%, 19/65) than patients with a biomechanical restoration within 5 mm compared to the non-affected contralateral side (8.0%, 2/25, p = 0.03). Clinical outcome measured three years after THA was significantly lower in patients with trochanteric symptoms than without trochanteric pain (p < 0.03). Similarly, fulfillment of patient expectations as measured by THR-Survey was lower in the patients with trochanteric pain (p < 0.005). An exact combined restoration of leg length, acetabular and femoral offset reduces significantly postoperative trochanteric pain syndrome and improves the clinical outcome of the patients. |
format | Online Article Text |
id | pubmed-7188889 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-71888892020-05-04 Restoration of leg length and offset correlates with trochanteric pain syndrome in total hip arthroplasty Worlicek, Michael Messmer, Benedikt Grifka, Joachim Renkawitz, Tobias Weber, Markus Sci Rep Article Persistent pain around the greater trochanter is a common complication after total hip arthroplasty. Restoration of biomechanics such as leg length, femoral und acetabular offset is crucial in THA. The purpose of this study was to evaluate postoperative differences of these parameters after THA and to analyze their association to greater trochanteric pain syndrome. Furthermore, we aimed to evaluate the clinical relevance of trochanteric pain syndrome compared to patient reported outcome measures. 3D-CT scans of 90 patients were analyzed after minimalinvasive total hip arthroplasty and leg length, femoral and acetabular offset differences were measured. Clinical evaluation was performed three years after THA regarding the presence of trochanteric pain syndrome and using outcome measures. Furthermore, the patients’ expectation were evaluated. Patients with trochanteric pain syndrome showed a higher absolute discrepancy of combined leg length, femoral and acetabular offset restoration compared to the non-operated contralateral side with 11.8 ± 6.0 mm than patients without symptoms in the trochanteric region with 7.8 ± 5.3 mm (p = 0.01). Patients with an absolute deviation of the combined parameters of more than 5 mm complained more frequently about trochanteric symptoms (29.2%, 19/65) than patients with a biomechanical restoration within 5 mm compared to the non-affected contralateral side (8.0%, 2/25, p = 0.03). Clinical outcome measured three years after THA was significantly lower in patients with trochanteric symptoms than without trochanteric pain (p < 0.03). Similarly, fulfillment of patient expectations as measured by THR-Survey was lower in the patients with trochanteric pain (p < 0.005). An exact combined restoration of leg length, acetabular and femoral offset reduces significantly postoperative trochanteric pain syndrome and improves the clinical outcome of the patients. Nature Publishing Group UK 2020-04-28 /pmc/articles/PMC7188889/ /pubmed/32345993 http://dx.doi.org/10.1038/s41598-020-62531-9 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Worlicek, Michael Messmer, Benedikt Grifka, Joachim Renkawitz, Tobias Weber, Markus Restoration of leg length and offset correlates with trochanteric pain syndrome in total hip arthroplasty |
title | Restoration of leg length and offset correlates with trochanteric pain syndrome in total hip arthroplasty |
title_full | Restoration of leg length and offset correlates with trochanteric pain syndrome in total hip arthroplasty |
title_fullStr | Restoration of leg length and offset correlates with trochanteric pain syndrome in total hip arthroplasty |
title_full_unstemmed | Restoration of leg length and offset correlates with trochanteric pain syndrome in total hip arthroplasty |
title_short | Restoration of leg length and offset correlates with trochanteric pain syndrome in total hip arthroplasty |
title_sort | restoration of leg length and offset correlates with trochanteric pain syndrome in total hip arthroplasty |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188889/ https://www.ncbi.nlm.nih.gov/pubmed/32345993 http://dx.doi.org/10.1038/s41598-020-62531-9 |
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