Elevated Lip Liner Positions Improving Stability in Total Hip Arthroplasty – An Experimental Study

  • Suleman Qurashi Nepean Hospital Harbour City Orthopaedics
  • William Parr Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, Prince of Wales Hospital, University of New South Wales (UNSW), Randwick, NSW, 2031, Australia.
  • Bob Jang Canterbury Hospital
  • William R Walsh Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales clinical school, Prince of Wales Hospital, University of New South Wales (UNSW), Randwick, NSW, 2031, Australia
Keywords: total hip, arthroplasty, dislocation, stability

Abstract

Background: The use of elevated lip polyethylene liners with the acetabular component is relatively common in Total Hip Arthroplasty (THA). Elevated lip liners increase stability of the THA by increasing the jump distance in one direction. However, the elevated lip, conversely, also reduces the primary arc in the opposite direction and leads to early impingement of the neck on the elevated lip, potentially causing instability.
The aim of the present study is to determine the total range of motion of the femoral head component within the acetabular component with the elevated lip liner in different orientations within the acetabular cup.

Methods: We introduce a novel experimental (ex-vivo) framework for studying the effects lip liner orientation on the range of motion of the femoral component. For constant acetabular cup orientation, the elevated lip liner was positioned superiorly and inferiorly. The femoral component range of motion in the coronal, sagittal and axial plane was measured. To avoid any confounding influences of out of plane motion, the femoral component was constrained to move in the tested plane.

Results: This experimental set up introduces a rigorous framework in which to test the effects of elevated lip liner orientations on the range of motion of the femoral head component in abduction, adduction, flexion, extension and rotation. The movements of this experimental set-up are directly informative of patient’s maximum potential post-operative range of motion. Initial results show that an inferior placement of the elevated lip increases the effective superior lateral range of motion (abduction) for the femoral component, whilst the anatomy of the patient (i.e. their other leg) prevents the point of femoral component – acetabular lip impingement being reached (in adduction).

Author Biographies

Suleman Qurashi, Nepean Hospital Harbour City Orthopaedics

Department of Orthopaedic Surgery,  Nepean Hospital, NSW, Australia 

 Orthopaedic surgeon
William Parr, Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, Prince of Wales Hospital, University of New South Wales (UNSW), Randwick, NSW, 2031, Australia.
Senior research associate, Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales clinical school, Prince of Wales Hospital, University of New South Wales (UNSW), Randwick, NSW, 2031, Australia
Bob Jang, Canterbury Hospital

Department of Orthopaedic Surgery, Canterbury Hospital, NSW, Australia 

Orthopaedic Registrar

William R Walsh, Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales clinical school, Prince of Wales Hospital, University of New South Wales (UNSW), Randwick, NSW, 2031, Australia
Professor, Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales clinical school, Prince of Wales Hospital, University of New South Wales (UNSW), Randwick, NSW, 2031, Australia

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Published
2018-01-15
How to Cite
Qurashi, S., Parr, W., Jang, B., & Walsh, W. R. (2018). Elevated Lip Liner Positions Improving Stability in Total Hip Arthroplasty – An Experimental Study. Reconstructive Review, 7(4). https://doi.org/10.15438/rr.7.4.195
Section
Original Article