Broach Handle Offset and Impact Acceleration During Femoral Preparation for Total Hip Arthroplasty

I nvestigation was performed at the Rhode Island Hospital Orthopedic Foundation Laboratory, Providence, Rhode Island. At the time of the investigation, all authors were members of the Department of Orthopaedic Surgery within the Warren Alpert Medical School of Brown University. Introduction The direct anterior approach for minimally invasive total hip arthroplasty has become increasingly popular. [1] Preparation of the femoral canal using this approach can be technically challenging.  Instrumentation of the femur involves a posteromedial capsular release, extension and external rotation of the operative leg and elevation of the femur anteriorly.  Curved offset femoral broaches have been specifically designed to safely prepare the femoral canal through this single incision. [2,3] The objective of this study was to evaluate the amount of impact force generated and thus transferred to the proximal femur using a variety of curved single-offset broach handles compared to a traditional straight handled broach handle. The amount of acceleration transmitted through the femur could then be correlated to the number of impacts on the broach handle and thus operative time as well as trauma to the surrounding tissue.