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Total Hip Prostheses in Standing, Sitting and Squatting Positions: An Overview of Our 8 Years Practice Using the EOS Imaging Technology.

Lazennec JY, Rousseau MA, Brusson A, Folinais D, Amel M, Clarke I, Pour AE - Open Orthop J (2015)

Bottom Line: More total hip arthroplasty (THA) is performed worldwide and especially in younger and more active patients compared to earlier decades.Our results will be compared and confronted with the actual literature about this innovative technology.We shall especially emphasize our experience about patients with abnormal posture and the evolution of the subject over time, because the phenomenon of an aging spine is frequently associated with the process of aging hips.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic and Trauma Surgery, Pitié-Salpétrière Hospital, Assistance Publique - Hopitaux de Paris, UPMC, 47-83 Boulevard de l'hôpital, 75013 Paris, France ; BiomechanicsLab (LBM), Arts et Metiers Paris-Tech, Paris, France ; Department of Anatomy, UPMC, 105 Boulevard de l'hôpital, 75013 Paris, France.

ABSTRACT
More total hip arthroplasty (THA) is performed worldwide and especially in younger and more active patients compared to earlier decades. One of the focuses of THA research in the future will be on optimizing the radiological follow-up of these patients using 2D and 3D measurements of implants position while reducing the radiation dose delivered. Low-dose EOS(®) imaging is an innovative slot-scanning radiograph system providing valuable information in patient functional positions (standing, sitting and even squatting positions). EOS has been proven accurate and reliable without significant inconvenience caused by the metallic artifacts of implants. The ability to obtain precise data on implant orientation according to the patient posture opens new perspectives for a comprehensive analysis of the pelvic frontal and sagittal balance and its potential impact on implants function and failures. We report our 8 years experience on our first 300 THA patients using this technology routinely for pre and post op evaluation. Our results will be compared and confronted with the actual literature about this innovative technology. We shall especially emphasize our experience about patients with abnormal posture and the evolution of the subject over time, because the phenomenon of an aging spine is frequently associated with the process of aging hips.

No MeSH data available.


(A, B) EOS comparison before and after THA implantation: modification of pelvic balance in standing or sitting position (17°reduction of SS in standing position, 20° SS reduction in sitting position after THA in pelvic extension or backward pelvic tilt).
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Figure 18: (A, B) EOS comparison before and after THA implantation: modification of pelvic balance in standing or sitting position (17°reduction of SS in standing position, 20° SS reduction in sitting position after THA in pelvic extension or backward pelvic tilt).

Mentions: We used the EOS® 2D images for the follow-up of 48 THA patients including 15 bilateral THA and 11 THA revisions (Figs. 18, 19). In standing position, we did not observe a significant change of sagittal tilt for 28 patients including 4 bilateral THA (group 1). Other patients experienced significant changes for sagittal pelvic orientation (group 2): an increase of SS (> 5°) in 7 cases and a decrease of SS ( >5°) in 13 cases. For sitting position, the group 1 did not experience changes in SS. For the other cases, changes were not related to those in standing position. Despite the postoperative alterations to pelvic orientation that could not be anticipated, none of these patients experienced an instability.


Total Hip Prostheses in Standing, Sitting and Squatting Positions: An Overview of Our 8 Years Practice Using the EOS Imaging Technology.

Lazennec JY, Rousseau MA, Brusson A, Folinais D, Amel M, Clarke I, Pour AE - Open Orthop J (2015)

(A, B) EOS comparison before and after THA implantation: modification of pelvic balance in standing or sitting position (17°reduction of SS in standing position, 20° SS reduction in sitting position after THA in pelvic extension or backward pelvic tilt).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4384273&req=5

Figure 18: (A, B) EOS comparison before and after THA implantation: modification of pelvic balance in standing or sitting position (17°reduction of SS in standing position, 20° SS reduction in sitting position after THA in pelvic extension or backward pelvic tilt).
Mentions: We used the EOS® 2D images for the follow-up of 48 THA patients including 15 bilateral THA and 11 THA revisions (Figs. 18, 19). In standing position, we did not observe a significant change of sagittal tilt for 28 patients including 4 bilateral THA (group 1). Other patients experienced significant changes for sagittal pelvic orientation (group 2): an increase of SS (> 5°) in 7 cases and a decrease of SS ( >5°) in 13 cases. For sitting position, the group 1 did not experience changes in SS. For the other cases, changes were not related to those in standing position. Despite the postoperative alterations to pelvic orientation that could not be anticipated, none of these patients experienced an instability.

Bottom Line: More total hip arthroplasty (THA) is performed worldwide and especially in younger and more active patients compared to earlier decades.Our results will be compared and confronted with the actual literature about this innovative technology.We shall especially emphasize our experience about patients with abnormal posture and the evolution of the subject over time, because the phenomenon of an aging spine is frequently associated with the process of aging hips.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic and Trauma Surgery, Pitié-Salpétrière Hospital, Assistance Publique - Hopitaux de Paris, UPMC, 47-83 Boulevard de l'hôpital, 75013 Paris, France ; BiomechanicsLab (LBM), Arts et Metiers Paris-Tech, Paris, France ; Department of Anatomy, UPMC, 105 Boulevard de l'hôpital, 75013 Paris, France.

ABSTRACT
More total hip arthroplasty (THA) is performed worldwide and especially in younger and more active patients compared to earlier decades. One of the focuses of THA research in the future will be on optimizing the radiological follow-up of these patients using 2D and 3D measurements of implants position while reducing the radiation dose delivered. Low-dose EOS(®) imaging is an innovative slot-scanning radiograph system providing valuable information in patient functional positions (standing, sitting and even squatting positions). EOS has been proven accurate and reliable without significant inconvenience caused by the metallic artifacts of implants. The ability to obtain precise data on implant orientation according to the patient posture opens new perspectives for a comprehensive analysis of the pelvic frontal and sagittal balance and its potential impact on implants function and failures. We report our 8 years experience on our first 300 THA patients using this technology routinely for pre and post op evaluation. Our results will be compared and confronted with the actual literature about this innovative technology. We shall especially emphasize our experience about patients with abnormal posture and the evolution of the subject over time, because the phenomenon of an aging spine is frequently associated with the process of aging hips.

No MeSH data available.