Error of intraoperative measurement of stem anteversion is decreased by measuring in neutral hip position during total hip arthroplasty

IF 1.5 4区 医学 Q3 ORTHOPEDICS Journal of Orthopaedic Science Pub Date : 2024-09-01 DOI:10.1016/j.jos.2023.08.008
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Abstract

Background

Intraoperative stem anteversion, which is the angle between the lower leg axis and the trial-stem axis with hip flexion and adduction, is generally evaluated by the surgeon's visual estimation during total hip arthroplasty (THA). However, the conventional approach can be influenced by knee osteoarthritis or uncertain surgeon's observation point. Therefore, we developed a new method for measuring the stem anteversion angle in the neutral hip position using an original rod attached to the trial-stem perpendicular to the long axis and parallel to the stem neck. This study aimed to assess the accuracy of our method in comparison with the conventional method of measuring intraoperative stem anteversion angle.

Methods

We measured the intraoperative stem anteversion angle in consecutive 106 hips of 106 patients who underwent cementless primary THA with a tapered wedge stem. Absolute error in the stem anteversion angle was expressed as the difference between intraoperative (common vs. neutral hip positions) and postoperative computed tomography measurements, i.e., true stem anteversion. Additionally, we investigated the factors affecting these errors.

Results

The absolute error of measurement was significantly smaller in the neutral hip position than in the common position (3.0° ± 2.5° vs. 8.0° ± 3.9°; p < 0.0001). The factor associated with the error was advanced knee osteoarthritis in the common position, whereas it was not statistically significant in the neutral hip position.

Conclusions

This study suggests that the error in the intraoperative measurement of stem anteversion is decreased by measuring in the neutral hip position during THA.

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在全髋关节置换术中保持髋关节中立位进行测量,可减少术中测量髋干内翻的误差
背景在全髋关节置换术(THA)中,通常由外科医生目测评估术中髋关节柄内翻,即髋关节屈曲和内收时小腿轴线与试行髋关节柄轴线之间的角度。然而,传统方法可能会受到膝关节骨关节炎或外科医生观察点不确定的影响。因此,我们开发了一种新方法,在髋关节中立位时使用一根原始杆测量茎干内翻角,该杆与试验茎干的长轴垂直,与茎干颈平行。本研究旨在评估我们的方法与测量术中柄内翻角的传统方法相比的准确性。方法我们测量了连续106例使用锥形楔形柄进行无骨水泥初级THA的患者的术中柄内翻角。柄内翻角度的绝对误差表示为术中(普通髋关节位置与中立髋关节位置)和术后计算机断层扫描测量值之间的差异,即真正的柄内翻。此外,我们还研究了影响这些误差的因素。结果髋关节中立位测量的绝对误差明显小于普通位(3.0° ± 2.5° vs. 8.0° ± 3.9°;p < 0.0001)。在普通体位中,与误差相关的因素是晚期膝关节骨性关节炎,而在中立髋位中,该因素无统计学意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Orthopaedic Science
Journal of Orthopaedic Science 医学-整形外科
CiteScore
3.00
自引率
0.00%
发文量
290
审稿时长
90 days
期刊介绍: The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
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