THE EFFECT OF ANTERIOR INFERIOR ILIAC SPINE ANATOMY ON THE RANGE OF MOTION TO IMPINGEMENT IN TOTAL HIP ARTHROPLASTY

Simon Williams; Alison Jones; Ruth Wilcox; Graham Isaac; Alison Traynor; Tim Board; Sophie Williams

doi:10.1302/1358-992X.2021.2.042

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THE EFFECT OF ANTERIOR INFERIOR ILIAC SPINE ANATOMY ON THE RANGE OF MOTION TO IMPINGEMENT IN TOTAL HIP ARTHROPLASTY

The British Orthopaedic Research Society (BORS) Annual Meeting 2020, held online, 7–8 September 2020.

Simon Williams
Alison Jones
Ruth Wilcox
Graham Isaac
Alison Traynor
Tim Board
Sophie Williams

THE EFFECT OF ANTERIOR INFERIOR ILIAC SPINE ANATOMY ON THE RANGE OF MOTION TO IMPINGEMENT IN TOTAL HIP ARTHROPLASTY

Williams S, Jones A, Wilcox R, et al. THE EFFECT OF ANTERIOR INFERIOR ILIAC SPINE ANATOMY ON THE RANGE OF MOTION TO IMPINGEMENT IN TOTAL HIP ARTHROPLASTY. Orthop Procs. 2021;103-B(SUPP_2):42-42. doi:10.1302/1358-992X.2021.2.042

Williams, Simon, et al. “THE EFFECT OF ANTERIOR INFERIOR ILIAC SPINE ANATOMY ON THE RANGE OF MOTION TO IMPINGEMENT IN TOTAL HIP ARTHROPLASTY.” Orthopaedic Proceedings, vol. 103-B, no. SUPP_2, 2021, pp. 42-42., https://doi.org/10.1302/1358-992X.2021.2.042

Williams, S., Jones, A., Wilcox, R., Isaac, G., Traynor, A., Board, T., & Williams, S. (2021). THE EFFECT OF ANTERIOR INFERIOR ILIAC SPINE ANATOMY ON THE RANGE OF MOTION TO IMPINGEMENT IN TOTAL HIP ARTHROPLASTY. Orthopaedic Proceedings, 103-B(SUPP_2), 42-42. https://doi.org/10.1302/1358-992X.2021.2.042

Williams, S., Jones, A., Wilcox, R., Isaac, G., Traynor, A., Board, T. et al. (2021) “THE EFFECT OF ANTERIOR INFERIOR ILIAC SPINE ANATOMY ON THE RANGE OF MOTION TO IMPINGEMENT IN TOTAL HIP ARTHROPLASTY.” Orthopaedic Proceedings, 103-B(SUPP_2), pp. 42-42. Available at: https://doi.org/10.1302/1358-992X.2021.2.042

Williams, Simon, Alison Jones, Ruth Wilcox, Graham Isaac, Alison Traynor, Tim Board, and Sophie Williams. “THE EFFECT OF ANTERIOR INFERIOR ILIAC SPINE ANATOMY ON THE RANGE OF MOTION TO IMPINGEMENT IN TOTAL HIP ARTHROPLASTY.” Orthopaedic Proceedings 103-B, no. SUPP_2 (2021): 42-42. https://doi.org/10.1302/1358-992X.2021.2.042

Williams S, Jones A, Wilcox R, Isaac G, Traynor A, Board T, et al. THE EFFECT OF ANTERIOR INFERIOR ILIAC SPINE ANATOMY ON THE RANGE OF MOTION TO IMPINGEMENT IN TOTAL HIP ARTHROPLASTY. Orthop Procs. 2021 Mar 1;103-B(SUPP_2):42-42. https://doi.org/10.1302/1358-992X.2021.2.042

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Abstract

Objectives

Impingement in total hip replacements (THRs), including bone-on-bone impingement, can lead to complications such as dislocation and loosening. The aim of this study was to investigate how the location of the anterior inferior iliac spine (AIIS) affected the range of motion before impingement.

Methods

A cohort of 25 CT scans (50 hips) were assessed and nine hips were selected with a range of AIIS locations relative to the hip joint centre. The selected CT Scans were converted to solid models (ScanIP) and THR components (DePuy Synthes) were virtually implanted (Solidworks). Flexion angles of 100⁰, 110⁰, and 120⁰ were applied to the femur, each followed by internal rotation to the point of impingement. The lateral, superior and anterior extent of the AIIS from the Centre of Rotation (CoR) of the hip was measured and its effect on the range of motion was recorded.

Results

There was found to be a significant (p<0.05) inverse relationship between the ROM of the THR and the lateral measure of the AIIS. Of the three measures, the lateral AIIS measure showed the strongest relationship with ROM to impingement (R=0.73) with the anterior and superior measures resulting in R values of 0.41 and 0.56 respectively. For every millimetre lateral the AIIS location, there was typically a loss of 1.2° of range of motion. With increasing lateralisation, the AIIS was positioned more directly over the femur, thereby reducing the ROM in the THR during high flexion positions. No soft tissue was included in the models which would have affected the ROM.

Conclusions

The results from this study have shown that the lateral measure of the AIIS could be a predictor for bone-on-bone impingement. To build confidence, wider study of AIIS location variation is needed, as well as analysis under impingement prone activities of daily living.

Declaration of Interest

(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.