@article{RenkawitzWeberSpringorumetal., author = {Renkawitz, Tobias and Weber, Markus and Springorum, H.-R. and Sendtner, E. and Woerner, Michael and Ulm, K. and Weber, Tim and Grifka, Joachim}, title = {Impingement-free range of motion, cup coverage and early clinical results between femur first navigation and conventional total hip arthroplasty: a randomised controlled trial}, series = {Journal of Bone \& Joint Surgery}, volume = {97-B}, journal = {Journal of Bone \& Joint Surgery}, doi = {10.1302/0301-620X.97B7.34729}, pages = {890 -- 898}, abstract = {We report the kinematic and early clinical results of a patient- and observer-blinded randomised controlled trial in which CT scans were used to compare potential impingement-free range of movement (ROM) and acetabular component cover between patients treated with either the navigated 'femur-first' total hip arthroplasty (THA) method (n = 66; male/female 29/37, mean age 62.5 years; 50 to 74) or conventional THA (n = 69; male/female 35/34, mean age 62.9 years; 50 to 75). The Hip Osteoarthritis Outcome Score, the Harris hip score, the Euro-Qol-5D and the Mancuso THA patient expectations score were assessed at six weeks, six months and one year after surgery. A total of 48 of the patients (84\%) in the navigated 'femur-first' group and 43 (65\%) in the conventional group reached all the desirable potential ROM boundaries without prosthetic impingement for activities of daily living (ADL) in flexion, extension, abduction, adduction and rotation (p = 0.016). Acetabular component cover and surface contact with the host bone were > 87\% in both groups. There was a significant difference between the navigated and the conventional groups' Harris hip scores six weeks after surgery (p = 0.010). There were no significant differences with respect to any clinical outcome at six months and one year of follow-up. The navigated 'femur-first' technique improves the potential ROM for ADL without prosthetic impingement, although there was no observed clinical difference between the two treatment groups.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{WeberDendorferGrifkaetal., author = {Weber, Tim A. and Dendorfer, Sebastian and Grifka, Joachim and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Does Computer-Assisted Femur First THR Improve Musculoskeletal Loading Conditions?}, series = {BioMed Research International}, volume = {2015}, journal = {BioMed Research International}, editor = {Takagi, Michiaki}, doi = {10.1155/2015/625317}, pages = {ID 625317}, abstract = {We have developed a novel, computer-assisted operation method for minimal-invasive total hip replacement (THR) following the concept of "femur first/combined anteversion," which incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position (CAS FF). The purpose of this study is to assess whether the hip joint reaction forces and patient's gait parameters are being improved by CAS FF in relation to conventional THR (CON). We enrolled 60 patients (28 CAS FF/32 CON) and invited them for gait analysis at three time points (preoperatively, postop six months, and postop 12 months). Data retrieved from gait analysis was processed using patient-specific musculoskeletal models. The target parameters were hip reaction force magnitude (hrf), symmetries, and orientation with respect to the cup. Hrf in the CAS FF group were closer to a young healthy normal. Phase-shift symmetry showed an increase in the CAS FF group. Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well. The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome.}, subject = {H{\"u}ftgelenkprothese}, language = {en} }