TY - JOUR A1 - Renkawitz, Tobias A1 - Weber, Markus A1 - Springorum, H.-R. A1 - Sendtner, E. A1 - Woerner, Michael A1 - Ulm, K. A1 - Weber, Tim A1 - Grifka, Joachim T1 - Impingement-free range of motion, cup coverage and early clinical results between femur first navigation and conventional total hip arthroplasty: a randomised controlled trial JF - Journal of Bone & Joint Surgery N2 - 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. KW - combined anteversion KW - computer-assisted orthopaedic surgery KW - THA KW - Hüftgelenkprothese KW - Operationstechnik KW - Computerunterstütztes Verfahren KW - Beweglichkeit Y1 - 2015 U6 - https://doi.org/10.1302/0301-620X.97B7.34729 VL - 97-B SP - 890 EP - 898 ER - TY - JOUR A1 - Weber, Markus A1 - Weber, Tim A. A1 - Woerner, Michael A1 - Craiovan, Benjamin A1 - Worlicek, Michael A1 - Winkler, Sebastian A1 - Grifka, Joachim A1 - Renkawitz, Tobias T1 - The impact of standard combined anteversion definitions on gait and clinical outcome within one year after total hip arthroplasty JF - International Orthopaedics N2 - Different target areas within the concept of combined cup and stem anteversion have been published for total hip arthroplasty (THA). We asked whether component positioning according to eight standard combined anteversion rules is associated with (1) more physiological gait patterns, (2) higher improvement of gait variables and (3) better clinical outcome after THA.In a prospective clinical study, 60 patients received cementless THA through an anterolateral MIS approach in a lateral decubitus position. Six weeks postoperatively, implant position was analysed using 3D-CT by an independent external institute. Preoperatively, six and 12 months postoperatively range of motion, normalized walking speed and hip flexion symmetry index were measured using 3D motion-capture gait analysis. Patient-related outcome measures (HHS, HOOS, EQ-5D) were obtained by an observer blinded to 3D-CT results. Eight combined anteversion definitions and Lewinnek's "safe zone" were evaluated regarding their impact on gait patterns and clinical outcome.Combined cup and stem anteversion according to standard combined anteversion definitions as well as cup placement within Lewinnek's "safe zone" did not influence range of motion, normalized walking speed and/or hip flexion symmetry index six and 12 months after THA. Similarly, increase of gait parameters within the first year after THA was comparable between all eight combined anteversion rules. Clinical outcome measures like HHS, HOOS and EQ-5D did not show any benefit for either of the combined anteversion definitions.Standard combined cup and stem anteversion rules do not improve postoperative outcome as measured by gait analysis and clinical scores within one year after THA. KW - Total hip athroplasty KW - Combined anteversion KW - Outcome KW - Gait analysis KW - Hüftgelenkprothese KW - Bewegungsanalyse KW - Gehen KW - Funktionelle Anatomie Y1 - 2015 U6 - https://doi.org/10.1007/s00264-015-2777-8 VL - 39 IS - 12 SP - 2323 EP - 2333 ER - TY - JOUR A1 - Weber, Tim A. A1 - Dendorfer, Sebastian A1 - Grifka, Joachim A1 - Verkerke, Gijsbertus Jacob A1 - Renkawitz, Tobias ED - Takagi, Michiaki T1 - Does Computer-Assisted Femur First THR Improve Musculoskeletal Loading Conditions? JF - BioMed Research International N2 - 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. KW - Hüftgelenkprothese KW - Operationstechnik KW - Computerunterstütztes Verfahren KW - Bewegungsapparat KW - Mechanische Belastung Y1 - 2015 U6 - https://doi.org/10.1155/2015/625317 VL - 2015 SP - ID 625317 ER - TY - CHAP A1 - Weber, Tim A1 - Dendorfer, Sebastian A1 - Bulstra, Sjoerd K. A1 - Grifka, Joachim A1 - Verkerke, Gijsbertus Jacob A1 - Renkawitz, Tim T1 - Navigated Femur First Total Hip Arthroplasty leads to improved Biomechanical Outcome after surgery T2 - ORS annual meeting, Las Vegas, USA, 2015 Y1 - 2015 ER - TY - CHAP A1 - Weber, Tim A1 - Dendorfer, Sebastian A1 - Grifka, Joachim A1 - Weber, Markus A1 - Wörner, Michael A1 - Dullien, Silvia A1 - Verkerke, Gijsbertus Jacob A1 - Renkawitz, Tobias T1 - Verbessert die computerassistierte Femur First Operationstechnik für die Hüftendoprothetik den muskuloskelettalen Lastfall auf das Hüftgelenk? T2 - DKOU 2015, Deutscher Kongress für Orthopädie und Unfallchirurgie 2015 Y1 - 2015 UR - https://www.researchgate.net/publication/283259007_Verbessert_die_computerassistierte_Femur_First_Operationstechnik_fur_die_Huftendoprothetik_den_muskuloskelettalen_Lastfall_auf_das_Huftgelenk ER - TY - CHAP A1 - Weber, Tim A1 - Renkawitz, Tobias A1 - Bulstra, Sjoerd K. A1 - Grifka, Joachim A1 - Verkerke, Gijsbertus Jacob A1 - Dendorfer, Sebastian T1 - Biomechanics of computer-assisted vs. conventional THR after one year follow up T2 - XXV Congress of the International Society of Biomechanics, Glasgow, UK, 12th-16th July 2015 Y1 - 2015 ER - TY - CHAP A1 - Weber, Tim A1 - Renkawitz, Tobias A1 - Grifka, Joachim A1 - Bulstra, Sjoerd K. A1 - Verkerke, Gijsbertus Jacob A1 - Dendorfer, Sebastian T1 - The musculoskeletal load scenario of computer-assisted Femur-First THR up to one year after surgery T2 - VI International Conference on Computational Bioengineering, Barcelona, Sept. 2015 Y1 - 2015 UR - https://www.researchgate.net/publication/281745827_The_musculoskeletal_load_scenario_of_computer-assisted_Femur-First_THR_up_to_one_year_after_surgery ER -