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Improving planning and post-operative assessment for Total Hip Arthroplasty

Benedikt Magnússon, Þröstur Pétursson, Kyle Edmunds, Gígja Magnúsdóttir, Grétar Halldórsson, Halldór Jónsson jr., Paolo Gargiulo
  • Benedikt Magnússon
    Institute for Biomedical and Neural Engineering, Háskólinn í Reykjavík; Department of Clinical Engineering, Landspítali Hospital, Reykjavík, Iceland
  • Þröstur Pétursson
    Department of Systems and Solutions, Landspítali Hospital, Reykjavík, Iceland
  • Kyle Edmunds
    Institute for Biomedical and Neural Engineering, Háskólinn í Reykjavík, Iceland
  • Gígja Magnúsdóttir
    Rehabilitation Clinic Grensás Landspítali Hospital, Reykjavík, Iceland
  • Grétar Halldórsson
    Rehabilitation Clinic Grensás Landspítali Hospital, Reykjavík, Iceland
  • Halldór Jónsson jr.
    Orthopedic Clinic, Landspítali Hospital, Reykjavík; Medical Faculty, University of Iceland, Reykjavík, Iceland
  • Paolo Gargiulo
    Institute for Biomedical and Neural Engineering, Háskólinn í Reykjavík; Department of Science, Landspítali University Hospital, Iceland | paologar@landspitali.is

Abstract

Total Hip Arthroplasty (THA) remains the gold standard of treatment for patients who suffer with a variety of hip-related pathological degeneration or trauma. These patients often exhibit significantly less post-operative pain and an increase in the range of motion of the joint, but there are still relatively common instances of debilitating periprosthetic complications that call into question the method for pre-surgical implant choice. Currently, there are two principal options for THA prostheses: cemented or non cemented. Utilizing the cemented procedure ensures a faster acquisition of adequate implant stability than with the non cemented procedure, but can eventually lead to an increased periprosthetic fracture risk. Non cemented prosthetic stems are more frequently revised within the first few years following THA due to periprosthetic fracture, but non cemented revision surgeries generally result in fewer complications than those of cemented implants. Surgeons typically rely on experience or simple patient metrics such as age and sex to prescribe which implant procedure is optimal, and while this may work for most patients, there is a clear need to analyze more rigoriously patient conditions that correlate to optimal post-THA outcomes. The results from the investigation reported herein indicate that an understanding of how the percent composition and quality of a patient's quadriceps muscle in both healthy and operated legs may be a better indicator for prosthetic choice. Additionally, these data emphasize that the traditional metrics of age and sex inadequately predict changes in quadriceps composition and quality and thereby have comparatively minor utility in determining the patient-appropriate prosthetic type.

Keywords

Total Hip Arthroplasty, Prosthetic selection, Muscle size and quality, Anatomical modeling, Surgical planning

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Submitted: 2014-12-16 12:24:42
Published: 2015-03-11 00:00:00
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Copyright (c) 2015 Benedikt Magnússon, Þröstur Pétursson, Kyle Edmunds, Gígja Magnúsdóttir, Grétar Halldórsson, Halldór Jónsson jr., Paolo Gargiulo

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