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General Orthopaedics

Self Compensation of Excessive Anteversion by Osteophytes in Hip Arthritis

International Society for Technology in Arthroplasty (ISTA) 2012 Annual Congress



Abstract

INTRODUCTION

In total hip arthroplasty, preoperative planning is almost indispensable. Moreover, 3-dimensional preoperative planning became popular recently. Anteversion management is one of the most important factors in preoperative planning to prevent dislocation and to obtain better function.

In arthritic hip patients osteophytes are often seen on both femoral head and acetabulum. Especially on femoral head, osteophytes are often seen at posterior side and its surface creates smooth round contour that assumes new joint surface. (Fig. 1). We can imagine new femoral head center tracing that new joint surface.

OBJECTIVES

In the present study, the posterior osteophytes are compared in osteoarthritic patients and other patients.

MATERIALS & METHODS

Anteversion and new anteversion which was reduced by osteophyte formation were assessed in 28 hip CAT scans, (22 arthritic hips, 6 avascular necrotic hips).

RESULTS

Only in arthritic patients, osteophytes on posterior side were observed.

The anteversion was 33.7+/− 13.0 degree in arthritic patients, which was reduce to 29.7+/−13.1 degree. The mean difference was 4.0+/−4.7 degree reduction. In AVN patients the mean anteversion was 21.4 +/− 9.40 in AVN patients. No reduction was observed in AVN patients.

DISCUSSION

Osteophytes are often created to make the biomechanical situation better. This phenomenon is possiblly explained that those posterior osteophytes have been formed for proper reduction of excessive anteversion.