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Kim and Ko: Comparison of the lever arm changes in the Charnley total hip arthroplasty
Original Article

J Korean Orthop Assoc 1974;9(1):27-33.

Published online: 1 March 1974

DOI: https://doi.org/10.4055/jkoa.1974.9.1.27

Comparison of the lever arm changes in the Charnley total hip arthroplasty

Young-Yong Kim, M.D., Chul-Un Ko, M. D.

Y. Y. Kim Orthopeadic Clinic, Busan

Copyright © 1974 The Korean Orthopaedic Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A study of the lever arm changes of 33 total hip replacements of Charnley type, done from May 1972 to February 1974, revealed a significant change of ratio following the operation.
Three cases could not be measured because of poor axis of the preoperative radiogram.
The unilateral group A of II Charnley low friction series resulted in a preoperative ratio range from 1.30:1 to 2.10:1 with an average of 1.70:1
The postoperative ratio varied from 1.03 to 1.38 with an average of 1.26.
Group B consisting of 6 bilateral Charnley cases resulted in a preoprative ratio range from 1.39 to 1.81 with an average of 1.58. The postoperative ratio varied from 1.01 to 1.46 with an average of 1.24.
Group C comprised 7 cases of the assessment of low friction arthroplasty in old tuberculous hips. In these cases it was impossible to measure the preoperative ratio range because of old destruction and distortion of the femoral head. Therefore the normal side of the opposite hip was traced for comparison. The healthy hip of the preoperative ratio range was from 1.36 to 1.70 with an average of 1.56.
The postoperative ratio of the affected hip varied from 1.05 to 1.43 with an average of 1.24.
The size of the acetabular angle (Sharp) and depth of the acetabulum is added as a preoperative guidence when performing surgery.
In addition 2 cases of a McKee-Farrar series are included comparison with this study.

References

1. Charnley J.The classic arthroplasty of thasop new operation. Clin. Orthop. 95(4):1973.
2. Sharp I.K.Acetabular dysplasia, The acetabular angle. J, Bone Joint Surg. 43B(268):1961.
3. Charnley J., Zoran Cupic. The nine and ten year results of the low-friction arthroplasty of the hip, Cli. Orthop. 95(9):1973.

Table 1
Roentgenographic Classfication of hips
Upper Pole Grade I   Joint space narrow or absent, at upper pole.   Femora-1 head spherical or only very slightly flattened at upper pole.   Moderate osteoporosis. Upper Pole, Grade II   Head appreciably flattened by wear at upper pole   Osteophytosis medially with some lateral displacement of head.   Shenton’s line intact. Upper Pole, Grade III   Gross loss of head substance at upper pole.   Secondary subluxation indicated by breaking of Shenton’s line. Medial Pole   Gross joint space at upper pole but narrow, or absent medially.   No bulging of pelvic aspect of acetabulum. Protrusio Acctabuli   Classical appearances with bulging of medial wall of acetabulum.
Table 2
Case Distribution
Diagnosis Affected hip Age Sex
Group A (Unilateral)      
1. Fresh femoral neck fracture right 51 female
2. Fresh femoral neck fracture left 68 female
3. Avascualr necrosis (sequela of femoral neck fracture) left 47 female
4 Avascular necrosis (sequela of femoral Deck fracture) left 40 female
5 Avascular necrosis (sequela of femoral neck fracture) right 23 male
6. Secondary osteoarthritis (sequela of femoral neck fracture) right 65 male
7. Secondary osteoarthritis (sequela of femoral neck fracture) left 56 female
8. Secondary osteoarthritis (sequela of fracture-dislocation’) right 46 male
9. Secondary osteoarthritis (sequela of femoral neck fracture) left 33 male
10. Secondary cateoarthritis (sequela of femoralneck faracture) right 23 male
11. Ankylosing spondylitis left 46 male
Group B〔Bilateral)      
1. Secondary osteoarthritis (sequela of femoral neck fracture) both 67 male
2. Spontaneous ischemia (probably steroid) both 58 female
3. Spontaneous ischemia (probably steroid) both 51 male
4. Spontaneous ischemia (probably alcohol) both 50 male
5. Spontaneous ischemia (probably alcohol) both 41 male
6. Spontaneous ischemia (unnkown) both 36 female
Group C (Tuberculosis)      
1. Healed tuberculosis right 47 female
2. Healed tuberculosis (Had prev. arthrodesis) left 45 male
3. Healed tuberculosis left 39 female
4. Healed tuberculosis right 29 male
5. Healed tuberculosis left 30 male
6. Healed tuberculosis right 28 male
7. Healed tuberculosis right 25 female
Table 3
The Variation due to radiographic distortion
Position Acetabular angle (dgree)
Right left
1 36 40
2 37 41
3 35 39
4 38 37
5 34.5 40
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