Broach Handle Offset and Impact Acceleration During Femoral Preparation for Total Hip Arthroplasty
Investigation was performed at the Rhode Island Hospital Orthopedic Foundation Laboratory, Providence, Rhode Island. At the time of the investigation, all authors were members of the Department of Orthopaedic Surgery within the Warren Alpert Medical School of Brown University.
The direct anterior approach for minimally invasive total hip arthroplasty has become increasingly popular.  Preparation of the femoral canal using this approach can be technically challenging. Instrumentation of the femur involves a posteromedial capsular release, extension and external rotation of the operative leg and elevation of the femur anteriorly. Curved offset femoral broaches have been specifically designed to safely prepare the femoral canal through this single incision. [2,3] The objective of this study was to evaluate the amount of impact force generated and thus transferred to the proximal femur using a variety of curved single-offset broach handles compared to a traditional straight handled broach handle. The amount of acceleration transmitted through the femur could then be correlated to the number of impacts on the broach handle and thus operative time as well as trauma to the surrounding tissue.
Kennon RE, Keggi JM, Wetmore RS, et al. Total hip arthroplasty through a minimally invasive anterior surgical approach. J Bone Joint Surg Am 2003; 85-A(Suppl 4):39.
Matta JM, Shahrdar C, Ferguson T. Single-incision anterior approach for total hip arthroplasty on an orthopaedic table. Clin Orthop Relat Res 2005; 441:115.
Nogler M, Krismer M, Hozack WJ, Merritt P, Rachbauer F, Mayr E. A Double Offset Broach Handle for Preparation of the Femoral Cavity in Minimally Invasive Direct Anterior Total Hip Arthroplasty. J Arthroplasty 2006; 21(8):1206-8.
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Copyright (c) 2014 Stephen Kayiaros MD, Lee Eric Rubin, MD, Alison Biercevicz, PhD, Richard Limbird, MD, David Paller, PhD
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