The Effect of Femoral and Global Offset Restoration on Clinical Outcomes in Total Hip Arthroplasty

Yıl 2026, Cilt: 9 Sayı: 1, 59 - 63, 17.03.2026

Hakan Uslu , Fırat Seyfettinoğlu , Hasan Ulaş Oğur , Osman Ciloglu , Oğuzhan Çiçek , Hakan Çiçek

https://doi.org/10.36516/jocass.1807635

https://izlik.org/JA29YS88BB

Öz

Aim: This study aimed to evaluate the impact of restoring femoral offset (FO), global offset (GO), and leg length discrepancy on clinical outcomes in patients undergoing total hip arthroplasty (THA) for primary coxarthrosis.
Methods: A retrospective review was conducted on 100 patients who underwent THA at Adana City Training and Research Hospital between January 2015 and December 2018. Preoperative and postoperative Harris Hip Score (HHS) and radiological parameters (FO, GO, AO, VU, CDI) were compared. Correlations between postoperative parameters and HHS were analyzed using Spearman’s correlation test.
Results: Among the 100 patients, 60 were male (60%) and 40 were female (40%). Males had significantly higher height and weight (p<0.001), but BMI showed no difference. Preoperatively, intact side measurements were higher compared to the operated side. Postoperatively, the mean Harris Score significantly improved from 54.13 to 86.27 (p<0.001). FO and GO increased, whereas AO decreased. Significant negative correlations were found between postoperative HHS and GO (r=-0.663; p<0.001), FO (r=-0.437; p<0.001), and CDI (r=-0.632; p<0.001).
Conclusion: Restoration of FO, GO, and leg length in THA has a significant effect on postoperative functional outcomes. In particular, accurate GO restoration plays a crucial role in patient satisfaction and functional recovery.

Anahtar Kelimeler

Total hip arthroplasty , femoral offset , global offset , Harris Hip Score , coxarthrosis

Etik Beyan

The study was approved by the Adana City Training and Research Hospital Ethics Committee on 28.08.2019 with meeting number 38 and decision number 541, and was conducted in accordance with the Declaration of Helsinki.

Destekleyen Kurum

yok

Teşekkür

yok

Total Kalça Artroplastisinde Femoral ve Global Ofset Restorasyonunun Klinik Sonuçlara Etkisi

https://izlik.org/JA29YS88BB

Öz

Öz
Giriş: Bu çalışmada primer koksartroz nedeniyle total kalça artroplastisi (TKA) uygulanan hastalarda femoral ofset (FO), global ofset (GO) ve ekstremite uzunluk farkının restorasyonunun klinik sonuçlara etkisi değerlendirildi.
Yöntem: Ocak 2015 – Aralık 2018 tarihleri arasında Adana Şehir Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniğinde TKA uygulanan 100 hasta retrospektif olarak incelendi. Preoperatif ve postoperatif Harris Kalça Skoru (HHS) ile radyolojik parametreler (FO, GO, AO, VU, CDI) karşılaştırıldı. Ayrıca postoperatif parametreler ile HHS arasındaki ilişkiler Spearman korelasyon analizi ile değerlendirildi.
Bulgular: Çalışmaya katılan 60 erkek (%60) ve 40 kadının (%40) boy ve kilo değerleri arasında anlamlı fark saptandı (p<0.001), ancak BMI açısından fark yoktu. Preoperatif dönemde sağlam taraf değerleri opere tarafa göre daha yüksek bulundu. Postoperatif dönemde Harris Skoru anlamlı şekilde artarak 54.13’ten 86.27’ye yükseldi (p<0.001). FO ve GO değerlerinde artış gözlenirken AO değerlerinde azalma saptandı. Postoperatif Harris Skoru ile GO (r=-0.663; p<0.001), FO (r=-0.437; p<0.001) ve CDI (r=-0.632; p<0.001) arasında negatif ve anlamlı korelasyon bulundu.
Sonuç: Total kalça artroplastisinde FO, GO ve bacak uzunluğunun uygun restorasyonu postoperatif fonksiyonel sonuçlar üzerine anlamlı etkiye sahiptir. Özellikle GO’nun doğru şekilde ayarlanması hasta memnuniyeti ve fonksiyonel iyileşmede kritik rol oynamaktadır.

Anahtar Kelimeler

Total kalça artroplastisi , femoral ofset , global ofset , Harris Kalça Skoru , koksartroz

Etik Beyan

Çalışma, Adana Şehir Eğitim ve Araştırma Hastanesi Etik Kurulu’nun 28.08.2019 tarih ve 38 sayılı toplantı ve 541 sayılı kararla onaylanmış olup Helsinki Bildirgesi’ne uygun olarak yürütülmüştür.

Destekleyen Kurum

yok

Teşekkür

yok

Kaynakça

• Dawson J, Linsell L, Zondervan K, Rose P, Randall T, Carr A, Fitzpatrick R. Epidemiology of hip and knee pain and its impact on overall health status in older adults. Rheumatology (Oxford). 2004;43(4):497-504. Crossref
• Nho SJ, Kymes SM, Callaghan JJ, Felson DT. The burden of hip osteoarthritis in the United States: epidemiologic and economic considerations. J Am Acad Orthop Surg. 2013;21(Suppl 1):S1-S6. Crossref
• Lee JM. The Current Concepts of Total Hip Arthroplasty. Hip Pelvis. 2016;28(4):191-200. Crossref
• Sofu H, Şahin V, Gürsu S, Yıldırım T, Issın A, Koçkara N. Cementless Total Hip Arthroplasty in Patients with Crowe Type-4 Developmental Dysplasia. Hip Int. 2013;23(5):472-477. Crossref
• Şendir M, Babadağ K. Total Kalça Protezi Ameliyatı Öncesi Hasta Eğitiminin Ameliyat Sonrası Fiziksel Uyum ve Yaşam Kalitesine Etkisi. Florence Nightingale Hemşirelik Dergisi. 2000;12(46):27-42.
• Papa JA. Clinical Orthopedic Rehabilitation: An Evidence-Based Approach - Third Edition. J Can Chiropr Assoc. 2012;56(3):234.
• Başal Ö, Baykal B, Burç H, Turgay O, Öztürk R. Artrozlar ve Artroplasti & Güncel Artrodez Yaklaşımları Kalça Artroplastileri. Ortopedi ve Spor Yaralanmaları Asistan Kitabı. 2015.
• Bilgici A, Kuru Ö, Gündüz Ö, Alaylı G. Correlation Between Pain And Physical And Psychosocial Disability In Elderly Osteoarthritis Patients. Turk J Geriatr. 2000;3:22-25.
• İnal S, Subaşı F, Mungan-Ay S, Uzun S, Alpkaya U, Hayran O, Akarcay V. Yaşlıların fiziksel kapasitelerinin ve yaşam kalitelerinin değerlendirilmesi. Turk J Geriatr. 2003;6(3):95-99.
• Slavica J, Zotovic M, Luka B, Jandric S, Nožica T. Assessment of quality of life of patients with total hip arthroplasty. Am J Phys Med Rehabil. 2006;85(3):288. Crossref
• Bachmeier CJ, March LM, Cross MJ, Lapsley HM, Tribe KL, Courtenay BG, et al. A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthritis Cartilage. 2001;9(2):137-146. Crossref
• Lecerf G, Fessy MH, Philippot R, Massin P, Giraud F, Flecher X, Girard J, Mertl P, Marchetti E, Stindel E. Femoral offset: anatomical concept, definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol Surg Res. 2009;95(3):210-219. Crossref
• Can F. Total kalça artroplastisi rehabilitasyonu. TOTBİD Dergisi. 2013;12:292-308. Crossref
• Goldstein DH, Ellis J, Brown R, Wilson R, Penning J, Chisom K, et al. Meeting proceedings: recommendations for improved acute pain services. Pain Res Manag. 2004;9(3):123-130. Crossref
• Ferrell BA. Pain management in elderly people. J Am Geriatr Soc. 1991;39(1):64-73. Crossref
• Eid T, Bucknall T. Documenting and implementing evidence-based post-operative pain management in older patients with hip fractures. J Orthop Nurs. 2008;12(2):90-98. Crossref
• Erivan R, Muller AS, Villatte G, Millerioux S, Mulliez A, Boisgard S, Descamps S. Short stems reproduce femoral offset better than standard stems in total hip arthroplasty: a case-control study. Int Orthop. 2020;44(1):45-51. Crossref
• Enke O, Levy YD, Bruce WJ. Accuracy of leg length and femoral offset restoration after total hip arthroplasty with the utilisation of an intraoperative calibration gauge. Hip Int. 2020;30(3):296-302. Crossref
• Snijders TE, van Erp JHJ, de Gast A. Restoring femoral offset and leg length; the potential of a short curved stem in total hip arthroplasty. J Orthop. 2019;16(5):396-399. Crossref
• Mahmood SS, Mukka SS, Crnalic S, Wretenberg P, Sayed-Noor AS. Association between changes in global femoral offset after total hip arthroplasty and function, quality of life, and abductor muscle strength. Acta Orthop. 2016;87(1):36-41. Crossref
• Ji HM, Won SH, Han J, Won YY. Does femoral offset recover and affect the functional outcome of patients with displaced femoral neck fracture following hemiarthroplasty? Injury. 2017;48(6):1170-1174. Crossref
• Aderinto J, Brenkel IJ, Chan P. Weight change following total hip replacement: a comparison of obese and non-obese patients. Surgeon. 2005;3(4):269-272,305. Crossref
• Chee YH, Teoh KH, Sabnis BM, Ballantyne JA, Brenkel IJ. Total hip replacement in morbidly obese patients with osteoarthritis: results of a prospectively matched study. J Bone Joint Surg Br. 2010;92(8):1066-1071. Crossref