Effect of Jumbo cups for total hip arthroplasty revision on femoral offset and hip center of rotation_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Chao ^1,2 , ZHANG Lei ^2△ , CHEN Shuo ² ,  ZHOU Liwu ² ,  ZHAO Jianning ²

1. Clinical College of Medical School of Nanjing University, Nanjing Jiangsu, 210000, P.R.China;
2. Department of Orthopedics, Nanjing General Hospital of Nanjing Military Command, Nanjing Jiangsu, 210002, P.R.China;

Corresponding author：

ZHOU Liwu, Email: zhouliwu2000@sina.com; ZHAO Jianning, Email: zhaojianning.0207@163.com

Keywords：

Jumbo cups; femoral offset; hip center of rotation; total hip arthroplasty revision

DOI：

10.7507/1002-1892.201607089

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Objective To investigate the change of the femoral offset and hip center of rotation (COR) after using Jumbo cups in total hip arthroplasty (THA) revision. Methods The clinical data of 23 patients who underwent THA revision using Jumbo cups between January 2010 and May 2015 were retrospectively analyzed. Morselized bone graft was performed on 8 cases, morselized bone graft combined with structural bone graft on 10 cases. There were 10 males and 13 females, aged 65.4 years on average (range, 51-77 years). The disease duration was 1-24 years (mean, 8.57 years). The reasons for revision included aseptic loosening in 21 cases and periprosthetic infection in 2 cases. The Harris hip score and visual analogue scale (VAS) were 43.04±5.05 and 5.70±0.97 before operation respectively. According to the Paprosky acetabular defect classification, there were 5 cases of type I, 5 cases of type II A, 3 cases of type II B, 6 cases of type II C, and 4 cases of type III A. The X-ray films showed that the femoral offset was (40.65±4.09) mm for normal side and was (44.04±5.08) mm for affected side at preoperation, showing significant difference (t=4.098,P=0.000). Ten patients underwent femoral offset reconstruction (43.48%) but 13 patients did not (56.52%) before operation. The COR was reconstructed in 10 cases (43.48%); COR elevation was observed in 11 cases (47.83%), and COR decline in 2 cases (8.69%) before operation. Results Primary healing of incision was obtained in all patients, with no complication of infection, vascular injury, deep vein thrombosis, dislocation of the joint, or fracture around prosthesis. All the patients were followed up 12-76 months (mean, 22.48 months). The Harris hip score and VAS were 82.09±4.53 and 0.74±0.62 at 1 year after operation respectively, showing significant differences when compared with preoperative scores (t=37.831,P=0.000;t=22.318,P=0.000). The X-ray films showed that the femoral offset was (43.87±3.57) mm for affected side at 1 year after operation, showing no significant difference when compared with preoperative one (t=0.250,P=0.805), but significant difference was found between affected side and normal side (t=5.591,P=0.000). The femoral offset was restored in 16 patients (69.57%) and was not restored in 7 patients (30.43%) after operation. The COR was restored in 15 patients (65.22%) and was not restored in 8 patients (34.78%). Conclusion Using Jumbo cups or combined with morselized or structural bone graft is effective in restoring hip COR and femoral offset at the maximum limit in THA revision, with good short-term outcome and improved stability of acetabular prosthesis.

Citation： YANGChao, ZHANGLei, CHENShuo, ZHOULiwu, ZHAOJianning. Effect of Jumbo cups for total hip arthroplasty revision on femoral offset and hip center of rotation. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(2): 139-143. doi: 10.7507/1002-1892.201607089 Copy

1.	Barlow BT, Boles JW, Lee YY, et al. Short-term outcomes and complications after rejuvenate modular total hip arthroplasty revision. J Arthroplasty, 2016, 31(4): 857-862.
2.	Bjarnason JA, Reikeras O. Changes of center of rotation and femoral offset in total hip arthroplasty. Ann Transl Med, 2015, 3(22): 355-362.
3.	Ozaki Y, Homma Y, Sano K, et al. Small femoral offset is a risk factor for lateral femoral cutaneous nerve injury during total hip arthroplasty using a direct anterior opproach. Orthop Traumatol Surg Res, 2016, 102(8): 1043-1047.
4.	Paprosky WG, Perona PG, Lawrence JM. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty, 1994, 9(1): 33-44.
5.	Moore MS, McAuley JP, Young AM, et al. Radiographic signs of osseointegration in porous-coated acetabular components. Clin Orthop Relat Res, 2006, (444): 176-183.
6.	Sakai T, Sugano N, Nishii T, et al. Optimizing femoral anteversion and offset after total hip arthroplasty, using a modular femoral neck system: an experimental study. J Orthop Sci, 2000, 5(5): 489-494.
7.	Bourne RB, Rorabeck CH. Soft tissue balancing: the hip. J Arthroplasty, 2002, 17(4 Suppl 1): 17-22.
8.	牛士贞, 陈继营, 周勇刚, 等. 全髋关节翻修术后髋臼旋转中心变化对髋关节稳定性的影响. 山东医药, 2009, 49(30): 35-36.
9.	Dearborn JT, Harris WH. Acetabular revision arthroplasty using so-called jumbo cementless components: an average 7-year follow-up study. J Arthroplasty, 2000, 15(1): 8-15.
10.	Fan CY, Chen WM, Lee OK, et al. Acetabular revision arthroplasty using jumbo cups: an experience in Asia. Arch Orthop Trauma Surg, 2008, 128(8): 809-813.
11.	王北岳, 周利武, 张志强, 等. 大臼杯在髋臼骨缺损患者的髋关节翻修术中的应用. 中国骨与关节杂志, 2014, 3(6): 419-423.
12.	张志, 高粱斌, 李健, 等. 人工全髋关节翻修术中股骨偏心距重建的实施策略. 中国组织工程研究与临床康复, 2009, 13(52): 10227-10230.
13.	Sakalkale DP, Sharkey PF, Eng K, et al. Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res, 2001, (388): 125-134.
14.	Vendittoli PA, Ganapathi M, Nuno N, et al. Factors affecting hip range of motion in surface replacement arthroplasty. Clin Biomech (Bristol, Avon), 2007, 22(9): 1004-1012.
15.	Woerner M, Weber M, Sendtner E, et al. Soft tissue restricts impingement-free mobility in total hip arthroplasty. Int Orthop, 2016.[Epub ahead of print].
16.	Harrington MA, O'Connor DO, Lozynsky AJ, et al. Effects of femoral neck length, stem size, and body weight on strains in the proximal cement mantle. J Bone Joint Surg (Am), 2002, 84-A(4): 573-579.
17.	Faizan A, Black BJ, Fay BD, et al. Comparison of head center position and screw fixation pptions between a Jumbo cup and an offset center of rotation cup in revision total hip arthroplasty: A computer simulation study. J Arthroplasty, 2016, 31(1): 307-311.
18.	Nwankwo CD, Ries MD. Do jumbo cups cause hip center elevation in revision THA? A radiographic evaluation. Clin Orthop Relat Res, 2014, 472(9): 2793-2798.
19.	Nwankwo C, Dong NN, Heffeman CD, et al. Do jumbo cups cause hip center elevation in revision THA? A computer simulation. Clin Orthop Relat Res, 2014, 472(2): 572-576.
20.	方远, 孙俊英, 查国春, 等. 采用超大生物型臼杯行髋关节翻修术的疗效观察. 中国修复重建外科杂志, 2013, 27(12): 1424-1427.
21.	Odri GA, Padiolleau GB, Gouin FT. Oversized cups as a major risk factor of postoperative pain after total hip arthroplasty. J Arthroplasty, 2014, 29(4): 753-756.
22.	Gustke KA, Levering MF, Miranda MA. Use of jumbo cups for revision of acetabulae with large bony defects. J Arthroplasty, 2014, 29(1): 199-203.
23.	古凌川, 陈光兴, 杨柳, 等. 钽金属Jumbo杯在PaproskyⅡ及Ⅲ型髋臼缺损髋关节翻修中的应用. 第三军医大学学报, 2015, 37(17): 1776-1781.

1. Barlow BT, Boles JW, Lee YY, et al. Short-term outcomes and complications after rejuvenate modular total hip arthroplasty revision. J Arthroplasty, 2016, 31(4): 857-862.
2. Bjarnason JA, Reikeras O. Changes of center of rotation and femoral offset in total hip arthroplasty. Ann Transl Med, 2015, 3(22): 355-362.
3. Ozaki Y, Homma Y, Sano K, et al. Small femoral offset is a risk factor for lateral femoral cutaneous nerve injury during total hip arthroplasty using a direct anterior opproach. Orthop Traumatol Surg Res, 2016, 102(8): 1043-1047.
4. Paprosky WG, Perona PG, Lawrence JM. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty, 1994, 9(1): 33-44.
5. Moore MS, McAuley JP, Young AM, et al. Radiographic signs of osseointegration in porous-coated acetabular components. Clin Orthop Relat Res, 2006, (444): 176-183.
6. Sakai T, Sugano N, Nishii T, et al. Optimizing femoral anteversion and offset after total hip arthroplasty, using a modular femoral neck system: an experimental study. J Orthop Sci, 2000, 5(5): 489-494.
7. Bourne RB, Rorabeck CH. Soft tissue balancing: the hip. J Arthroplasty, 2002, 17(4 Suppl 1): 17-22.
8. 牛士贞, 陈继营, 周勇刚, 等. 全髋关节翻修术后髋臼旋转中心变化对髋关节稳定性的影响. 山东医药, 2009, 49(30): 35-36.
9. Dearborn JT, Harris WH. Acetabular revision arthroplasty using so-called jumbo cementless components: an average 7-year follow-up study. J Arthroplasty, 2000, 15(1): 8-15.
10. Fan CY, Chen WM, Lee OK, et al. Acetabular revision arthroplasty using jumbo cups: an experience in Asia. Arch Orthop Trauma Surg, 2008, 128(8): 809-813.
11. 王北岳, 周利武, 张志强, 等. 大臼杯在髋臼骨缺损患者的髋关节翻修术中的应用. 中国骨与关节杂志, 2014, 3(6): 419-423.
12. 张志, 高粱斌, 李健, 等. 人工全髋关节翻修术中股骨偏心距重建的实施策略. 中国组织工程研究与临床康复, 2009, 13(52): 10227-10230.
13. Sakalkale DP, Sharkey PF, Eng K, et al. Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res, 2001, (388): 125-134.
14. Vendittoli PA, Ganapathi M, Nuno N, et al. Factors affecting hip range of motion in surface replacement arthroplasty. Clin Biomech (Bristol, Avon), 2007, 22(9): 1004-1012.
15. Woerner M, Weber M, Sendtner E, et al. Soft tissue restricts impingement-free mobility in total hip arthroplasty. Int Orthop, 2016.[Epub ahead of print].
16. Harrington MA, O'Connor DO, Lozynsky AJ, et al. Effects of femoral neck length, stem size, and body weight on strains in the proximal cement mantle. J Bone Joint Surg (Am), 2002, 84-A(4): 573-579.
17. Faizan A, Black BJ, Fay BD, et al. Comparison of head center position and screw fixation pptions between a Jumbo cup and an offset center of rotation cup in revision total hip arthroplasty: A computer simulation study. J Arthroplasty, 2016, 31(1): 307-311.
18. Nwankwo CD, Ries MD. Do jumbo cups cause hip center elevation in revision THA? A radiographic evaluation. Clin Orthop Relat Res, 2014, 472(9): 2793-2798.
19. Nwankwo C, Dong NN, Heffeman CD, et al. Do jumbo cups cause hip center elevation in revision THA? A computer simulation. Clin Orthop Relat Res, 2014, 472(2): 572-576.
20. 方远, 孙俊英, 查国春, 等. 采用超大生物型臼杯行髋关节翻修术的疗效观察. 中国修复重建外科杂志, 2013, 27(12): 1424-1427.
21. Odri GA, Padiolleau GB, Gouin FT. Oversized cups as a major risk factor of postoperative pain after total hip arthroplasty. J Arthroplasty, 2014, 29(4): 753-756.
22. Gustke KA, Levering MF, Miranda MA. Use of jumbo cups for revision of acetabulae with large bony defects. J Arthroplasty, 2014, 29(1): 199-203.
23. 古凌川, 陈光兴, 杨柳, 等. 钽金属Jumbo杯在PaproskyⅡ及Ⅲ型髋臼缺损髋关节翻修中的应用. 第三军医大学学报, 2015, 37(17): 1776-1781.

Chinese Journal of Reparative and Reconstructive Surgery

Effect of Jumbo cups for total hip arthroplasty revision on femoral offset and hip center of rotation

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