Radiographic Evaluation of Femoral Offset Reconstruction in Hip Arthroplasty: A Retrospective Analysis.

AIM: To investigate the impact of femoral offset (FO) reconstruction on postoperative hip function recovery and complication rates following total hip arthroplasty (THA) via the posterolateral approach.

METHODS

A retrospective analysis was performed on 146 patients who underwent primary unilateral THA between January 2019 and April 2024. Patients were divided into two groups based on whether the postoperative FO difference (≤4 mm vs. >4 mm): the reconstruction group (n = 92) and the control group (n = 54). Baseline characteristics, radiographic parameters, postoperative functional outcomes (Harris Hip Score (HHS), visual analogue scale (VAS) for pain, and gait parameters), complications, and prosthesis failure cases were compared between the groups, accompanied by a representative case analysis.

RESULTS

No significant differences were observed in baseline data between the two groups (p > 0.05). Compared with the control group, the postoperative FO in the reconstruction group was significantly closer to that of the contralateral healthy side (p < 0.05). There were no significant differences in acetabular prosthesis parameters between the two groups (p > 0.05). However, the femoral stem neck-shaft angle in the control group was significantly smaller than in the reconstruction group (p < 0.05). At all postoperative time points, the reconstruction group demonstrated superior outcomes in HHS, VAS, and gait parameters than the control group (p < 0.05). The incidence of complications was significantly lower in the reconstruction group than that in the control group (p < 0.05), whereas no significant difference was found in prosthesis revision rates (p > 0.05). Representative cases indicated that patients who failed to achieve FO reconstruction criteria were more susceptible to postoperative dislocation.

CONCLUSIONS

Precise femoral offset reconstruction contributes to improved postoperative hip function and a reduced risk of complications in THA.