Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M....
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Transcript of Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M....
![Page 1: Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.](https://reader035.fdocuments.in/reader035/viewer/2022062718/56649eb25503460f94bb96a2/html5/thumbnails/1.jpg)
Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty
by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael J. Morris
J Bone Joint Surg AmVolume 92(16):2737-2752
November 17, 2010
©2010 by The Journal of Bone and Joint Surgery, Inc.
![Page 2: Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.](https://reader035.fdocuments.in/reader035/viewer/2022062718/56649eb25503460f94bb96a2/html5/thumbnails/2.jpg)
Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752
©2010 by The Journal of Bone and Joint Surgery, Inc.
![Page 3: Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.](https://reader035.fdocuments.in/reader035/viewer/2022062718/56649eb25503460f94bb96a2/html5/thumbnails/3.jpg)
Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752
©2010 by The Journal of Bone and Joint Surgery, Inc.
![Page 4: Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.](https://reader035.fdocuments.in/reader035/viewer/2022062718/56649eb25503460f94bb96a2/html5/thumbnails/4.jpg)
Standing evaluation of clinical limb length is performed by measuring the pelvic obliquity and limb length difference.
Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752
©2010 by The Journal of Bone and Joint Surgery, Inc.
![Page 5: Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.](https://reader035.fdocuments.in/reader035/viewer/2022062718/56649eb25503460f94bb96a2/html5/thumbnails/5.jpg)
Supine evaluation of limb length inequality is performed by measuring the distance between the anterior superior iliac spine and the medial malleolus with a tape measure.
Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752
©2010 by The Journal of Bone and Joint Surgery, Inc.
![Page 6: Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.](https://reader035.fdocuments.in/reader035/viewer/2022062718/56649eb25503460f94bb96a2/html5/thumbnails/6.jpg)
Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752
©2010 by The Journal of Bone and Joint Surgery, Inc.
![Page 7: Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.](https://reader035.fdocuments.in/reader035/viewer/2022062718/56649eb25503460f94bb96a2/html5/thumbnails/7.jpg)
Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752
©2010 by The Journal of Bone and Joint Surgery, Inc.
![Page 8: Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.](https://reader035.fdocuments.in/reader035/viewer/2022062718/56649eb25503460f94bb96a2/html5/thumbnails/8.jpg)
Preoperative anteroposterior pelvic radiograph made with the patient supine shows severe erosive arthritis of the right hip.
Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752
©2010 by The Journal of Bone and Joint Surgery, Inc.
![Page 9: Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.](https://reader035.fdocuments.in/reader035/viewer/2022062718/56649eb25503460f94bb96a2/html5/thumbnails/9.jpg)
Preoperative templating can be performed with use of computerized radiology software.
Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752
©2010 by The Journal of Bone and Joint Surgery, Inc.
![Page 10: Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.](https://reader035.fdocuments.in/reader035/viewer/2022062718/56649eb25503460f94bb96a2/html5/thumbnails/10.jpg)
The so-called safe zone for orientation of the acetabular component.
Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752
©2010 by The Journal of Bone and Joint Surgery, Inc.
![Page 11: Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.](https://reader035.fdocuments.in/reader035/viewer/2022062718/56649eb25503460f94bb96a2/html5/thumbnails/11.jpg)
Various methods of restoring offset with use of the femoral stem.
Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752
©2010 by The Journal of Bone and Joint Surgery, Inc.
![Page 12: Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.](https://reader035.fdocuments.in/reader035/viewer/2022062718/56649eb25503460f94bb96a2/html5/thumbnails/12.jpg)
With the patient in a lateral position, the uninvolved lower limb is used to reference limb lengths intraoperatively.
Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752
©2010 by The Journal of Bone and Joint Surgery, Inc.