Is there any range-of-motion advantage to ...
Document type :
Article dans une revue scientifique
PMID :
Permalink :
Title :
Is there any range-of-motion advantage to using bearings larger than 36 mm in primary hip arthroplasty: A case-control study comparing 36-mm and large-diameter heads
Author(s) :
Delay, C. [Auteur]
Putman, Sophie [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Dereudre, G [Auteur]
Girard, Julien [Auteur]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 [URePSSS]
Lancelier-Bariatinsky, V [Auteur]
Drumez, Elodie [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Migaud, Henri [Auteur]
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]
Putman, Sophie [Auteur]

Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Dereudre, G [Auteur]
Girard, Julien [Auteur]

Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 [URePSSS]
Lancelier-Bariatinsky, V [Auteur]
Drumez, Elodie [Auteur]

Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Migaud, Henri [Auteur]

Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]
Journal title :
Orthopaedics & traumatology, surgery & research
Abbreviated title :
Orthop. Traumatol.-Surg. Res.
Volume number :
102
Pages :
735-740
Publication date :
2016-10-01
ISSN :
1877-0568
English keyword(s) :
Large-diameter head
Rehabilitation
Daily living activities
Range-of-motion
Hip prosthesis
Rehabilitation
Daily living activities
Range-of-motion
Hip prosthesis
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Large-diameter (>36mm) total hip arthroplasty (THA) has developed rapidly since the advent of ceramic-on-ceramic (CoC) bearings and highly cross-linked polyethylene. Theoretically, the increase in diameter reduces the risk ...
Show more >Large-diameter (>36mm) total hip arthroplasty (THA) has developed rapidly since the advent of ceramic-on-ceramic (CoC) bearings and highly cross-linked polyethylene. Theoretically, the increase in diameter reduces the risk of instability, although the advantage of calibers beyond 36mm has not been demonstrated in terms of range-of-motion recovery. We conducted a comparative study with a single prosthesis model to determine whether increasing the caliber beyond 36mm provides: (1) better recovery of range-of-motion, (2) a higher functional score, and (3) reduction of the dislocation rate. Increasing the range-of-motion by increasing the caliber beyond 36mm provides better range-of-motion. We analyzed two consecutive, single-operator cementless THA series performed via the mini posterior approach, which differed only in the bearing system (51 metal-on-metal [MoM] with a mean caliber of 45mm±3.3 [range, 40-54] and 61 CoC with a 36-mm caliber). Both series were comparable preoperatively in terms of age, diagnosis, functional scores, preoperative range-of-motion, body mass index, UCLA activity level, and Charnley score. We compared the joint range of movement at follow-up and the gains in range of movement, onset of dislocation, and functional scores (Oxford, Postel-Merle d'Aubigné [PMA]). The mean overall joint range-of-motion was 254°±39° (range, 150-310°) for an 81°±44° (range, -50 to 180°) gain in the MoM group and 256°±23° (range, 200-280°) for an 84°±40° (range, 0-160°) gain in the CoC group (NS). The MoM group presented the following results: Oxford=13.71±3.66 (range, 12-33) for a gain of 24.82 points±7.9 (range, -1 to 40), PMA=17.75±1.06 (range, 11-18) for a gain of 7.78 points±4.01 (range, 2-15). The CoC group had: Oxford=14.98±4.42 (range, 12-36) for a gain of 24.75 points±6.55 (range, 12-40), PMA 17.66±0.7 (range, 14-18) for a gain of 8 points±3.77 (range, 1-15). None of the gains and scores at follow-up differed significantly between the two groups. No episode of dislocation was identified. The current trend of increasing femoral head diameters beyond 36mm to improve the gains in joint range-of-motion and function is not warranted. The potential side effects of increasing the caliber call for even greater caution in the use of large-diameter heads because our hypothesis has not been confirmed. Case-control study, level III.Show less >
Show more >Large-diameter (>36mm) total hip arthroplasty (THA) has developed rapidly since the advent of ceramic-on-ceramic (CoC) bearings and highly cross-linked polyethylene. Theoretically, the increase in diameter reduces the risk of instability, although the advantage of calibers beyond 36mm has not been demonstrated in terms of range-of-motion recovery. We conducted a comparative study with a single prosthesis model to determine whether increasing the caliber beyond 36mm provides: (1) better recovery of range-of-motion, (2) a higher functional score, and (3) reduction of the dislocation rate. Increasing the range-of-motion by increasing the caliber beyond 36mm provides better range-of-motion. We analyzed two consecutive, single-operator cementless THA series performed via the mini posterior approach, which differed only in the bearing system (51 metal-on-metal [MoM] with a mean caliber of 45mm±3.3 [range, 40-54] and 61 CoC with a 36-mm caliber). Both series were comparable preoperatively in terms of age, diagnosis, functional scores, preoperative range-of-motion, body mass index, UCLA activity level, and Charnley score. We compared the joint range of movement at follow-up and the gains in range of movement, onset of dislocation, and functional scores (Oxford, Postel-Merle d'Aubigné [PMA]). The mean overall joint range-of-motion was 254°±39° (range, 150-310°) for an 81°±44° (range, -50 to 180°) gain in the MoM group and 256°±23° (range, 200-280°) for an 84°±40° (range, 0-160°) gain in the CoC group (NS). The MoM group presented the following results: Oxford=13.71±3.66 (range, 12-33) for a gain of 24.82 points±7.9 (range, -1 to 40), PMA=17.75±1.06 (range, 11-18) for a gain of 7.78 points±4.01 (range, 2-15). The CoC group had: Oxford=14.98±4.42 (range, 12-36) for a gain of 24.75 points±6.55 (range, 12-40), PMA 17.66±0.7 (range, 14-18) for a gain of 8 points±3.77 (range, 1-15). None of the gains and scores at follow-up differed significantly between the two groups. No episode of dislocation was identified. The current trend of increasing femoral head diameters beyond 36mm to improve the gains in joint range-of-motion and function is not warranted. The potential side effects of increasing the caliber call for even greater caution in the use of large-diameter heads because our hypothesis has not been confirmed. Case-control study, level III.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CHU Lille
Univ. Littoral Côte d’Opale
Univ. Artois
Université de Lille
Univ. Littoral Côte d’Opale
Univ. Artois
Université de Lille
Collections :
Research team(s) :
Activité Physique, Muscle, Santé (APMS)
Submission date :
2019-09-24T07:29:43Z
2021-05-17T07:49:27Z
2021-05-17T07:49:27Z