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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2020

Open Access 01-12-2020 | Osteoarthrosis | Research article

A simple angle-measuring instrument for measuring cemented stem anteversion during total hip arthroplasty

Authors: Ryo Mitsutake, Hiromasa Tanino, Yasuhiro Nishida, Masaru Higa, Hiroshi Ito

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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Abstract

Background

During total hip arthroplasty (THA), the accurate placement of the femoral components is an important determinant of the success of the procedure. This study assessed the accuracy of cemented stem placement using a new angle-measuring instrument. The primary objective was to investigate the accuracy of the intraoperative measurements of cemented stem anteversion obtained using the angle-measuring instrument. Our secondary objective was to evaluate the accuracy of stem positioning performed using the angle-measuring instrument.

Methods

We compared the intraoperative stem anteversion measurements obtained using the angle-measuring instrument with postoperative stem anteversion measurements obtained using computed tomography in 149 hips (measurement accuracy). We also compared the target angle and postoperative stem anteversion in 105 hips (implantation accuracy).

Results

The mean amount of intraoperative stem anteversion was 37.9° ± 10.1°, and the mean amount of postoperative stem anteversion was 37.0° ± 10.4°. The mean measurement accuracy was 0.9° ± 6.1°, and the absolute measurement accuracy was 4.9° ± 3.7°. The correlation coefficient for the relationship between the intraoperative and postoperative stem anteversion measurements was 0.824 (p = 0.000). The mean amount of target angle was 37.4° ± 7.6°, and the mean amount of postoperative stem anteversion was 35.9° ± 9.1°. The mean implantation accuracy was 1.4° ± 5.6°, and the mean absolute implantation accuracy was 4.3° ± 3.6°. The correlation coefficient for the relationship between the target angle and postoperative stem anteversion was 0.795 (p = 0.000).

Conclusions

The angle-measuring instrument measured intraoperative stem anteversion accurately, and cemented stem was implanted accurately during THA with the angle-measuring instrument.
Literature
1.
Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978;60(2):217–20.CrossRef
2.
Kristiansen B, Jørgensen L, Hölmich P. Dislocation following total hip arthroplasty. Arch Orthop Trauma Surg. 1985;103(6):375–7.CrossRef
3.
Kummer FJ, Shah S, Iyer S, DiCesare PE. The effect of acetabular cup orientations on limiting hip rotation. J Arthroplast. 1999;14(4):509–13.CrossRef
4.
Patil S, Bergula A, Chen PC, Colwell CW Jr, D'Lima DD. Polyethylene wear and acetabular component orientation. J Bone Joint Surg Am. 2003;85-A(Suppl 4):56–63.CrossRef
5.
Widmer KH, Zurfluh B. Compliant positioning of total hip components for optimal range of motion. J Orthop Res. 2004;22(4):815–21.CrossRef
6.
Yoshimine F. The safe-zones for combined cup and neck anteversions that fulfill the essential range of motion and their optimum combination in total hip replacements. J Biomech. 2006;39(7):1315–23.CrossRef
7.
Mayeda BF, Haw JG, Battenberg AK, Schmalzried TP. Femoral-Acetabular Mating: The Effect of Femoral and Combined Anteversion on Cross-Linked Polyethylene Wear. J Arthroplast. 2018;33(10):3320–4.CrossRef
8.
Digioia AM 3rd, Jaramaz B, Plakseychuk AY, Moody JE Jr, Nikou C, Labarca RS, Levison TJ, Picard F. Comparison of a mechanical acetabular alignment guide with computer placement of the socket. J Arthroplast. 2002;17(3):359–64.CrossRef
9.
Dorr LD, Malik A, Wan Z, Long WT, Harris M. Precision and bias of imageless computer navigation and surgeon estimates for acetabular component position. Clin Orthop Relat Res. 2007;465:92–9.PubMed
10.
Ecker TM, Tannast M, Murphy SB. Computed tomography-based surgical navigation for hip arthroplasty. Clin Orthop Relat Res. 2007 Dec;465:100–5.PubMed
11.
Tanino H, Nishida Y, Mitsutake R, Ito H. Portable Accelerometer-Based Navigation System for Cup Placement of Total Hip Arthroplasty: A Prospective, Randomized, Controlled Study. J Arthroplast. 2020;35(1):172–7.CrossRef
12.
Hirasawa N, Matsubara M, Ishii K, Hagio S, Okuda N, Sekiya I, Muneta T. Effect of CT slice thickness on accuracy of implant positioning in navigated total hip arthroplasty. Comput Aided Surg. 2010;15(4–6):83–9.CrossRef
13.
Hirata M, Nakashima Y, Ohishi M, Hamai S, Hara D, Iwamoto Y. Surgeon error in performing intraoperative estimation of stem anteversion in cementless total hip arthroplasty. J Arthroplast. 2013;28(9):1648–53.CrossRef
14.
Fukunishi S, Nishio S, Fujihara Y, Okahisa S, Takeda Y, Fukui T, Yoshiya S. Accuracy of combined anteversion in image-free navigated total hip arthroplasty: stem-first or cup-first technique? Int Orthop. 2016;40(1):9–13.CrossRef
15.
Fujihara Y, Fukunishi S, Fukui T, Nishio S, Okahisa S, Takeda Y, Kurosaka K, Yoshiya S. Use of the G-guide for Measuring Stem Antetorsion During Total Hip Arthroplasty. Orthopedics. 2016;39(2):e271–5.CrossRef
16.
Lee YK, Kim JW, Kim TY, Ha YC, Koo KH. Validity of the intra-operative measurement of stem anteversion and factors for the erroneous estimation in cementless total hip arthroplasty using postero-lateral approach. Orthop Traumatol Surg Res. 2018;104(3):341–6.CrossRef
17.
Kitada M, Nakamura N, Iwana D, Kakimoto A, Nishii T, Sugano N. Evaluation of the accuracy of computed tomography-based navigation for femoral stem orientation and leg length discrepancy. J Arthroplast. 2011;26(5):674–9.CrossRef
18.
Dorr LD, Wan Z, Malik A, Zhu J, Dastane M, Deshmane P. A comparison of surgeon estimation and computed tomographic measurement of femoral component anteversion in cementless total hip arthroplasty. J Bone Joint Surg Am. 2009;91(11):2598–604.CrossRef
19.
Domb BG, Redmond JM, Louis SS, Alden KJ, Daley RJ, LaReau JM, Petrakos AE, Gui C, Suarez-Ahedo C. Accuracy of Component Positioning in 1980 Total Hip Arthroplasties: A Comparative Analysis by Surgical Technique and Mode of Guidance. J Arthroplast. 2015;30(12):2208–18.CrossRef
20.
Ito H, Hirayama T, Tanino H, Matsuno T, Minami A. Tight fit technique in primary hybrid total hip arthroplasty for patients with hip dysplasia. J Arthroplast. 2007;22(1):57–64.CrossRef
21.
Tanino H, Sato T, Nishida Y, Mitsutake R, Ito H. Hip stability after total hip arthroplasty predicted by intraoperative stability test and range of motion: a cross-sectional study. BMC Musculoskelet Disord. 2018;19(1):373.CrossRef
22.
Wines AP, McNicol D. Computed tomography measurement of the accuracy of component version in total hip arthroplasty. J Arthroplast. 2006;21(5):696–701.CrossRef
23.
Reikerås O, Gunderson RB. Components anteversion in primary cementless THA using straight stem and hemispherical cup: a prospective study in 91 hips using CT-scan measurements. Orthop Traumatol Surg Res. 2011;97(6):615–21.CrossRef
24.
Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494–502.CrossRef
25.
Woerner M, Sendtner E, Springorum R, Craiovan B, Worlicek M, Renkawitz T, Grifka J, Weber M. Visual intraoperative estimation of cup and stem position is not reliable in minimally invasive hip arthroplasty. Acta Orthop. 2016;87(3):225–30.CrossRef
26.
Lum ZC, Coury JG, Cohen JL, Dorr LD. The Current Knowledge on Spinopelvic Mobility. J Arthroplast. 2018;33(1):291–6.CrossRef
27.
D'Lima DD, Urquhart AG, Buehler KO, Walker RH, Colwell CW Jr. The effect of the orientation of the acetabular and femoral components on the range of motion of the hip at different head-neck ratios. J Bone Joint Surg Am. 2000;82(3):315–21.CrossRef
28.
Argenson JN, Ryembault E, Flecher X, Brassart N, Parratte S, Aubaniac JM. Three-dimensional anatomy of the hip in osteoarthritis after developmental dysplasia. J Bone Joint Surg (Br). 2005;87(9):1192–6.CrossRef
29.
30.
Danoff JR, Bobman JT, Cunn G, Murtaugh T, Gorroochurn P, Geller JA, Macaulay W. Redefining the Acetabular Component Safe Zone for Posterior Approach Total Hip Arthroplasty. J Arthroplast. 2016;31(2):506–11.CrossRef
31.
Jolles BM, Zangger P, Leyvraz PF. Factors predisposing to dislocation after primary total hip arthroplasty: a multivariate analysis. J Arthroplast. 2002;17(3):282–8.CrossRef
32.
Nakashima Y, Hirata M, Akiyama M, Itokawa T, Yamamoto T, Motomura G, Ohishi M, Hamai S, Iwamoto Y. Combined anteversion technique reduced the dislocation in cementless total hip arthroplasty. Int Orthop. 2014;38(1):27–32.CrossRef
Metadata
Title
A simple angle-measuring instrument for measuring cemented stem anteversion during total hip arthroplasty
Authors
Ryo Mitsutake
Hiromasa Tanino
Yasuhiro Nishida
Masaru Higa
Hiroshi Ito
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-3142-7

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