A COMPARATIVE STUDY BETWEEN INTRAOPERATIVE CLINICAL AND POSTOPERATIVE RADIOLOGICAL MEASUREMENT OF DISTANCE BETWEEN TIP OF GREATER TROCHANTER TO CENTRE OF FEMORAL HEAD IN OPERATED CASES OF HIP ARTHROPLASTY.
Journal Title: INTERNATIONAL JOURNAL OF ADVANCES IN ORTHOPAEDICS - Year 2018, Vol 1, Issue 2
Abstract
BACKGROUND:Hip joint is a polyaxial ball and socket joint. At different stages of gait cycle, joint reaction forces at the hip joint depend on abductor leaver arm which is function of neck length(offset), neck shaft angle and body weight. During Arthroplasty operation of hip, femoral offset measurement and its restoration to anatomical limit is important. In our study we have measured the femoral neck length, between two xed bony points, from the tip of greater trochanter (GT)to the center of the femoral head per-operatively and again post -operatively, from the true size x-ray of the replaced femoral head. We compared this measurement with the postoperative x-ray of normal side hip, to compare, how far normal offset is achieved after operating with various prosthesis (xed bipolar prosthesis and modular prosthesis) available in the Indian scenario. MATERIAL AND METHOD:This is a prospective, observational, comparative study on presentation at in- patient department (IPD). Total 53 patient (22 male and 31 female) above 60 years of age, admitted at our institution Ramakrishna Mission Seva Prathistan (VIMS) in year 2015-16, with intracapsular fracture neck femur of either right or left side where studied. Per-operative measurement was taken during hemiarthroplasty operation using xed bipolar prosthesis or modular prosthesis(cemented/un-cemented) available in the Indian market. Post-operative measurement taken in the true size x-ray of two xed point on the operated and normal side. Limb length measured clinically. The values obtained were compared to establish how far the normal anatomical offset is achieved after hemiarthroplasty operation by using prosthesis manufactured by different companies in India. RESULTS:Intraoperative measurement of distance between tip of GT and center of femoral head correspond with the measurement taken from tip of GT to the prosthetic femoral head. This signies that we have successfully corrected the offset by available prosthesis with correct surgical technique. There is no signicant difference in the postoperative true size x-ray of distance between tip of GT to the center of prosthetic femoral head and the tip of GT with center of femoral head of normal side. CONCLUSION:Our study result shows that by opting correct surgical technique and appropriate neck resection, currently available prosthesis( FBP&MBP) in our country can achieve desired neck offset length in comparison to the normal hip and no signicant limb length discrepancy.
Authors and Affiliations
Dr Sunny Kumar Mallik, Dr Hiranmoy Deb
Keywords
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