achieving stability and lower-limb length in total hip arthroplasty by keith r. berend, scott m....

Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty

by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael J. Morris

J Bone Joint Surg AmVolume 92(16):2737-2752

November 17, 2010

©2010 by The Journal of Bone and Joint Surgery, Inc.

Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752

©2010 by The Journal of Bone and Joint Surgery, Inc.

Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752

©2010 by The Journal of Bone and Joint Surgery, Inc.

Standing evaluation of clinical limb length is performed by measuring the pelvic obliquity and limb length difference.

Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752

©2010 by The Journal of Bone and Joint Surgery, Inc.

Supine evaluation of limb length inequality is performed by measuring the distance between the anterior superior iliac spine and the medial malleolus with a tape measure.

Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752

©2010 by The Journal of Bone and Joint Surgery, Inc.

Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752

©2010 by The Journal of Bone and Joint Surgery, Inc.

Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752

©2010 by The Journal of Bone and Joint Surgery, Inc.

Preoperative anteroposterior pelvic radiograph made with the patient supine shows severe erosive arthritis of the right hip.

Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752

©2010 by The Journal of Bone and Joint Surgery, Inc.

Preoperative templating can be performed with use of computerized radiology software.

Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752

©2010 by The Journal of Bone and Joint Surgery, Inc.

The so-called safe zone for orientation of the acetabular component.

Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752

©2010 by The Journal of Bone and Joint Surgery, Inc.

Various methods of restoring offset with use of the femoral stem.

Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752

©2010 by The Journal of Bone and Joint Surgery, Inc.

With the patient in a lateral position, the uninvolved lower limb is used to reference limb lengths intraoperatively.

Keith R. Berend et al. J Bone Joint Surg Am 2010;92:2737-2752

©2010 by The Journal of Bone and Joint Surgery, Inc.