Issue link: https://beckershealthcare.uberflip.com/i/976338
47 Executive Briefing Sponsored by: W ith total hip arthroplasty, one of the main objectives is to provide a stable hip by restoring joint biomechanics. Failure to achieve this goal results in dislocation and may happen regardless of surgical approach. 1 Dislocation after THA is the most common cause for revision hip surgery in the United States. 2 Proper component position and soft tissue tension must be achieved during THA to reduce the risk of dislocation. 3 Intraoperative instability during THA can be addressed by proper restoration of femoral offset. Leg-length equality and acetabular component position are also fundamental considerations in THA for patient satisfaction and prevention of dislocation. 4 Patients with spinal deformities and younger, more active patients, create higher demands on implant components needed to improve functional outcomes and avoid dislocation. This article discusses femoral and acetabular implant selection and how they can optimize offset restoration and improve joint stability with the goal of reducing the risk of dislocation. Femoral Offset & Leg-length Equality One of the differentiating factors of femoral hip stem implants is how they address offset. Femoral stem implants usually offer two offset options to address soft tissue tension. Most of the femoral stem systems medialize the head center along the axial plane, which tightens the hip joint without changing leg length. The amount of offset between a standard and lateralized offset neck normally ranges from 6 mm to 8 mm. Some femoral stem systems lower the head center when offset is added. This changes the leg length and can complicate the intraoperative decision-making process. Other systems may offer a reduced neck option or coxa vara neck option. These options will also shorten the leg and make the intraoperative decision- making process more complex. Leg-length discrepancy in these situations is a major concern in terms of patient satisfaction. While two offset options provide good intraoperative flexibility to restore hip joint biomechanics, there are cases where femoral offset could be compromised. The standard option may be a bit too loose but adding 8 mm of offset may make the joint a bit too tight. When this is the case, less than optimal tensioning may occur. The MasterLoc™ Hip System from Medacta may provide the most comprehensive and straight-forward solution to addressing soft tissue tension. The MasterLoc System offers three offset options within an 11 mm range that do not change leg length. The standard version has less offset to accommodate smaller patients who may have less femoral offset. A lateralized version adds 6 mm of direct offset that does not change leg length. For patients that need more femoral offset, the lateralized plus option is a third offset alternative, which provides an additional 5 mm of offset that does not change leg length. MasterLoc has an unprecedented offset offering that delivers the most intraoperative choices to dial- in femoral offset without compromising leg length. Outpatient THA: Your choice of implants can improve functional outcomes and reduce the risk of dislocation "Patients expectations following total hip replacement have become increasingly more demanding. Return to a pain free lifestyle with no limitations and equal leg lengths are considered the 'norm.'" W