{"title":"Error of intraoperative measurement of stem anteversion is decreased by measuring in neutral hip position during total hip arthroplasty","authors":"","doi":"10.1016/j.jos.2023.08.008","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p><span>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 </span>total hip arthroplasty<span> (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.</span></p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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°; <em>p</em><span> < 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.</span></p></div><div><h3>Conclusions</h3><p>This study suggests that the error in the intraoperative measurement of stem anteversion is decreased by measuring in the neutral hip position during THA.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1235-1241"},"PeriodicalIF":1.5000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Science","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0949265823002178","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
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.
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.