Hip Abduction Can Prevent Posterior Edge Loading of Hip Replacements
File(s)
Accepted version
Author(s)
van Arkel, RJ
Modenese, L
Phillips, ATM
Jeffers, JRT
Type
Journal Article
Abstract
Edge loading causes clinical problems for hard-on-hard hip replacements, and edge loading wear scars are present on the majority of retrieved components. We asked the question: are the lines of action of hip joint muscles such that edge loading can occur in a well-designed, well-positioned acetabular cup? A musculoskeletal model, based on cadaveric lower limb geometry, was used to calculate for each muscle, in every position within the complete range of motion, whether its contraction would safely pull the femoral head into the cup or contribute to edge loading. The results show that all the muscles that insert into the distal femur, patella, or tibia could cause edge loading of a well-positioned cup when the hip is in deep flexion. Patients frequently use distally inserting muscles for movements requiring deep hip flexion, such as sit-to-stand. Importantly, the results, which are supported by in vivo data and clinical findings, also show that risk of edge loading is dramatically reduced by combining deep hip flexion with hip abduction. Patients, including those with sub-optimally positioned cups, may be able to reduce the prevalence of edge loading by rising from chairs or stooping with the hip abducted.
Date Issued
2013-06-20
Date Acceptance
2013-03-11
Citation
Journal of Orthopaedic Research, 2013, 31 (8), pp.1172-1179
ISSN
1554-527X
Publisher
Wiley
Start Page
1172
End Page
1179
Journal / Book Title
Journal of Orthopaedic Research
Volume
31
Issue
8
Copyright Statement
This is the peer reviewed version of the following article: van Arkel, R. J., Modenese, L., Phillips, A. T.M. and Jeffers, J. R.T. (2013), Hip abduction can prevent posterior edge loading of hip replacements. J. Orthop. Res., 31: 1172–1179, which has been published in final form at https://dx.doi.org/10.1002/jor.22364 This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Subjects
avoid edge loading
muscles
hip
ceramic-on-ceramic
metal-on-metal
Publication Status
Published