Offset restoration in total hip arthroplasty: Important: A current review

Core Tip

Core Tip: Total hip arthroplasty (THA) requires careful attention to achieve restoration of both the vertical and horizontal offset. The vertical offset is critical to establish the correct limb length; inadequate restoration of vertical offset results in limb length discrepancy and poor clinical outcomes. The horizontal offset plays a role in obtaining optimal abductor tension and function, allowing for normal gait. Failure to achieve normal horizontal offset leads to sub-optimal abductor function, fatigue, limp, increased wear, and possible THA instability. Pre-operative templating and intra-operative execution of this plan allow for offset restoration, appropriate soft-tissue releases, and suitable implant selection, which ultimately results in hip center restoration and recreation of normal hip biomechanics.