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Hip capsule biomechanics after arthroplasty - the effect of implant, approach and surgical repair

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BJJ - Hip Capsule Biomechanics After Arthroplasty REVISION PROOF FEB 2019.pdfAccepted version1.8 MBAdobe PDFView/Open
Title: Hip capsule biomechanics after arthroplasty - the effect of implant, approach and surgical repair
Authors: Logishetty, K
Van Arkel, RJ
Ng, KC
Muirhead-Allwood, S
Cobb, J
Jeffers, J
Item Type: Journal Article
Abstract: Aims The hip’s capsular ligaments passively restrain extreme range of movement (ROM) by wrapping around the native femoral head/neck. We determined the effect of hip resurfacing arthroplasty (HRA), dual-mobility total hip arthroplasty (DM-THA), conventional THA, and surgical approach on ligament function. Materials and Methods Eight paired cadaveric hip joints were skeletonized but retained the hip capsule. Capsular ROM restraint during controlled internal rotation (IR) and external rotation (ER) was measured before and after HRA, DM-THA, and conventional THA, with a posterior (right hips) and anterior capsulotomy (left hips). Results Hip resurfacing provided a near-native ROM with between 5° to 17° increase in IR/ER ROM compared with the native hip for the different positions tested, which was a 9% to 33% increase. DM-THA generated a 9° to 61° (18% to 121%) increase in ROM. Conventional THA generated a 52° to 100° (94% to 199%) increase in ROM. Thus, for conventional THA, the capsule function that exerts a limit on ROM is lost. It is restored to some extent by DM-THA, and almost fully restored by hip resurfacing. In positions of low flexion/extension, the posterior capsulotomy provided more normal function than the anterior, possibly because the capsule was shortened during posterior repair. However, in deep flexion positions, the anterior capsulotomy functioned better. Conclusion Native head-size and capsular repair preserves capsular function after arthroplasty. The anterior and posterior approach differentially affect postoperative biomechanical function of the capsular ligaments.
Issue Date: Apr-2019
Date of Acceptance: 15-Feb-2019
URI: http://hdl.handle.net/10044/1/67108
DOI: https://dx.doi.org/10.1302/0301-620X.101B4.BJJ-2018-1321.R1
ISSN: 2049-4394
Publisher: British Editorial Society of Bone and Joint Surgery
Start Page: 426
End Page: 434
Journal / Book Title: Bone and Joint Journal
Volume: 101-B
Issue: 4
Copyright Statement: © 2019 The British Editorial Society of Bone & Joint Surgery
Sponsor/Funder: Wellcome Trust
Engineering & Physical Science Research Council (EPSRC)
Engineering & Physical Science Research Council (E
Engineering and Physical Sciences Research Council
Funder's Grant Number: 088844/Z/09/Z
EP/K027549/1
EP/N006267/1
EP/N006267/1
Keywords: Science & Technology
Life Sciences & Biomedicine
Orthopedics
Surgery
DUAL-MOBILITY CUP
RESURFACING ARTHROPLASTY
ACETABULAR COMPONENT
FOLLOW-UP
STABILITY
MOTION
JOINT
DISLOCATION
LIGAMENT
REPLACEMENT
Approach
Capsule
Dual-mobility
Hip arthroplasty
Resurfacing
Stability
Adult
Aged
Arthroplasty, Replacement, Hip
Biomechanical Phenomena
Cadaver
Female
Femur Head
Hip Joint
Hip Prosthesis
Humans
Joint Capsule
Ligaments, Articular
Male
Middle Aged
Range of Motion, Articular
Ligaments, Articular
Femur Head
Hip Joint
Joint Capsule
Humans
Cadaver
Range of Motion, Articular
Arthroplasty, Replacement, Hip
Hip Prosthesis
Adult
Aged
Middle Aged
Female
Male
Biomechanical Phenomena
Publication Status: Published
Online Publication Date: 2019-03-31
Appears in Collections:Mechanical Engineering
Department of Surgery and Cancer
Faculty of Engineering