Electronic Letters to:

Hip: J. Girard, M. Lavigne, P.-A. Vendittoli, and A. G. Roy Biomechanical reconstruction of the hip: A RANDOMISED STUDY COMPARING TOTAL HIP RESURFACING AND TOTAL HIP ARTHROPLASTY J Bone Joint Surg Br 2006; 88-B: 721-726 [Abstract] [Full text] [PDF]

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Biomechanical reconstruction of the hip

Nick J Little, Benedict A. Rogers, Arshad Khaleel   (9 May 2007)

Biomechanical reconstruction of the hip 9 May 2007
Nick J Little, Specialist Registrar Orthopaedics Rowley Bristow Orthopaedic Unit, St Peters, Chertsey, Benedict A. Rogers, Arshad Khaleel Send letter to journal: Re: Biomechanical reconstruction of the hip njlittle{at}gmail.com Nick J Little, et al.	Sir, We read this paper with interest. We note the hypothesis that surface replacement arthroplasty facilitates more precise biomechanical reconstruction of the hip than total hip arthroplasty. It is an excellent example of a well designed prospective randomised study. However, we would like to make the following points regarding the measurement methods. 1. The femoral offset was measured from the centre of rotation to the femoral shaft line. Precise definition of the shaft line is not included and therefore discrepancies can arise between radiographs and observers. Intra- and inter- observer error would help validate these readings. 2. Pelvic and femoral rotation are important in standardising measurements. The authors state that all radiographs were taken with the legs in 15º of internal rotation and rejected if the coccyx was not centred over the symphysis. Can the authors accurately ensure that the femoral shafts are 15º internally rotated from plain radiographs? If not, one can not assume that anteversion is the same in both hips and therefore the offset can not be accurately compared. N. Little MRCS MSc, B. Rogers MA MRCS MSc, A. Khaleel FRCS MSc, Rowley Bristow Orthopaedic Unit, St Peters, Chertsey, UK.