The Effect of Postoperative Femoral Offset on Outcomes After Hip Arthroplasty: A Systematic Review
Authors: Shapira J, Chen SL, Rosinsky PJ, Maldonado DR, Meghpara M, Lall AC, Domb BG
DOI: 10.1016/j.jor.2020.03.034
Background
Proper restoration of femoral offset during total hip arthroplasty (THA) is essential for optimal biomechanics, range of motion, and patient outcomes. This systematic review analyzes how changes in femoral offset (increased, decreased, or restored) affect function, satisfaction, and pain after THA.
Methods
The review evaluated multiple studies measuring postoperative femoral offset and its correlation with patient-reported outcomes (PROs). Both radiographic data and clinical endpoints were analyzed.
Key Findings
- Outcomes were best when femoral offset was restored to preoperative or normal anatomical values.
- Both increased and decreased offset were associated with variable results across studies, but extremes in either direction were generally less favorable.
- Restoration of offset correlated with improved function, gait mechanics, and patient satisfaction.
Conclusions
Maintaining or restoring femoral offset during THA is a critical factor for achieving optimal patient outcomes and minimizing complications such as abductor weakness or impingement.
What Does This Mean for Providers?
During hip arthroplasty, accurate restoration of femoral offset should be a surgical priority. Failure to restore offset may compromise patient outcomes, while tailored adjustments based on individual anatomy can enhance biomechanical function, reduce postoperative complications, and improve satisfaction.