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Master Thesis

Évaluation des inégalités de longueurs post prothèse de hanche par voie antérieure sans table orthopédique via le logiciel sterEOS® : à propos des 100 premiers cas

Abstract : Introduction : Total hip arthroplasty is currently well controlled surgery. However the problem of unequal length persists in 25% of cases with a functional impact when it exceeds 10mm. Our hypothesis is that an intervention performed in the supine position without fracture table with two free legs is interesting for a better clinical intraoperative control by malleolar ankle palpation. Material & methods : Descriptive study of a prospective cohort of 97 patients (100 THA), operated between March 2013 and June 2014, through Hueter approach. length inequality were investigated clinically and radiologically. Patients received pre and post operative EOS images to assess inequalities in overall length on 3D reconstruction via SterEOS software. We completed our study with clinical functional scores (WOMAC and SF12) and objectives scores (Harris Hip Score and Postel robin Aubigné ) to research a radio-clinical correlation Results : Clinically, we found 9 patients with inequality <10 mm and one patient with inequality > 10mm requiring compensation by orthopedic insole. Radiologically, anatomic total leg length was correct in 79.76 % of cases. The functional scores were significantly improved after surgery. The results were better when leg lengh discrepancy (LLD) tended to isometry. The age, sex or operated side did not influence the occurrence of LLD. However, without significativity, there was a trend to obesity in patients with leg length discrepancy > 10mm. Discussion : The anterior approach without fracture table, with easy anatomical landmarks (anterior superior iliac spines and internal malleolus ) ease intraoperative control of leg lenght discrepancy, with a good impacts on functionnal results. By measuring the total length of the lower limb, the EOS data provides greater accuracy in assessing inequalities of postoperative length, and confirms the idea that technical rigor is necessary to achieve isometry objective.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01390515
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Submitted on : Wednesday, November 2, 2016 - 10:04:43 AM
Last modification on : Wednesday, August 23, 2017 - 4:41:06 PM
Long-term archiving on: : Friday, February 3, 2017 - 12:54:36 PM

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Morgane Vargas. Évaluation des inégalités de longueurs post prothèse de hanche par voie antérieure sans table orthopédique via le logiciel sterEOS® : à propos des 100 premiers cas. Médecine humaine et pathologie. 2016. ⟨dumas-01390515⟩

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