The Accuracy of Acetabular Component Position Using a Novel Method to Determine Anteversion

Boettner, Friedrich; Zingg, Matthieu; Waldstein, Wenzel; Faschingbauer, M.; Kasparek, Michael S.

doi:10.1016/j.arth.2016.10.004

Cited by 18 publications

(22 citation statements)

References 25 publications

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“…The current paper presents the in vitro validation of the technique. Its in vivo accuracy has been recently published and supports the conclusion of the current paper …”

Section: Discussionsupporting

confidence: 88%

“…Targeted CI and CV angles were respectively within the targeted range in 98–97% of the cases with DAA versus only 86–77% for the posterior approach. In a recent study using a similar design, our method demonstrated comparable results while avoiding perioperative on‐screen measurements …”

Section: Discussionmentioning

confidence: 73%

“…In a recent study using a similar design, our method demonstrated comparable results while avoiding perioperative on-screen measurements. 27 The current paper has the following limitations: (i) The validity of the method was demonstrated under experimental conditions using an opaque synbone model and not in a real surgical setting; (ii) The inclination angle was measured with a dedicated software and not with a protractor; (iii) There is a small chance that the acetabular component could have moved in between measurements. In this study, the cup was securely fixed using a piece of special rubber, and no movements of the acetabular component were observed during the procedure; (iv) The technique relies on neutral position of the pelvis.…”

Section: Discussionmentioning

confidence: 98%

“…Its in vivo accuracy has been recently published and supports the conclusion of the current paper. 27…”

Section: Discussionmentioning

confidence: 99%

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Standardized fluoroscopy‐based technique to measure intraoperative cup anteversion

Zingg¹,

Boudabbous²,

Hannouche³

et al. 2017

Journal Orthopaedic Research

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Direct anterior approach (DAA) with the patient lying supine has facilitated the use of intraoperative fluoroscopy and allows for standardized positioning of the patient. The current study presents a new technique to measure acetabular component anteversion using intraoperative fluoroscopy. The current paper describes a mathematical formula to calculate true acetabular component anteversion based on the acetabular component abduction angle and the c-arm tilt angle (CaT). The CaT is determined by tilting the c-arm until an external pelvic oblique radiograph with the equatorial plane of the acetabular component perpendicular to the fluoroscopy receptor is obtained. CaT is determined by direct reading on the C-arm device. The technique was validated using a radiopaque synbone model comparing the described technique to computed tomography anteversion measurement. The experiment was repeated 25 times. The difference in anteversion between the two measuring techniques was on average 0.2° (range -3.0-3.1). The linear regression coefficients evaluating the agreement between the experimental and control methods were 0.99 (95%CI 0.88-1.10, p < 0.001) and 0.33 (95%CI -1.53-2.20, p = 0.713) for the slope and intercept, respectively. The current study confirms that the described three-step c-arm acetabular cup measuring technique can reproducibly and reliably assess acetabular component anteversion in the supine position, as compared to CT-imaging. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2307-2312, 2017.

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“…The current paper presents the in vitro validation of the technique. Its in vivo accuracy has been recently published and supports the conclusion of the current paper …”

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 98%

“…Its in vivo accuracy has been recently published and supports the conclusion of the current paper. 27…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Standardized fluoroscopy‐based technique to measure intraoperative cup anteversion

Zingg¹,

Boudabbous²,

Hannouche³

et al. 2017

Journal Orthopaedic Research

Self Cite

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“…Component placement is of paramount concern for successful THA, with much attention paid in particular to ideal acetabular component positioning. Optimal positioning of prosthetic components is necessary to successfully achieve the goals of THA, including re-establishment of femoral offset [2,17], restoration of hip biomechanics [18,19], improvement in postoperative stability [20,21], reduction in bearing wear [20,22], and reproduction of appropriate leg lengths [19,23]. In an attempt to optimize component positioning, a number of techniques have been developed, including the utilization of newer technology, such as robotics, computer navigation, and patient-specific positioning systems [24][25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

Does the use of intraoperative fluoroscopy improve postoperative radiographic component positioning and implant size in total hip arthroplasty utilizing a direct anterior approach?

et al. 2020

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Background: The direct anterior approach (DAA) for total hip arthroplasty (THA) has gained recent popularity, with 1 purported benefit being access to intraoperative fluoroscopy. However, there are limited data demonstrating improved component position with the use of intraoperative fluoroscopy. The aim of this study is to compare radiographic implant positioning on 2 consecutive cohorts of patients undergoing DAA THA performed by 1 surgeon either utilizing intraoperative fluoroscopy or not. We hypothesized that there would be no relevant radiographic differences between the cohorts. Methods: Forty-two consecutive patients underwent DAA THA utilizing fluoroscopy (IFC), and 42 consecutive patients then underwent DAA THA without fluoroscopy (NFC). Using preoperative pelvis radiographs and 6-week postoperative pelvis radiographs, acetabular anteversion, inclination, femoral offset, and templated component sizes vs final intraoperatively selected sizes were recorded and compared between cohorts. Results: Acetabular inclination was 45.0 for IFC and 45.6 for NFC (P ¼ .629). Femoral offset difference preoperatively and postoperatively was 0.8 mm for IFC and 1.3 mm for NFC (P ¼ .734). Number of hips within the so-called safe zone was 32 for IFC and 33 for NFC (P ¼ .794). These all demonstrated no significant difference between the cohorts. However, acetabular anteversion was 13.7 for IFC and 11.2 for NFC (P ¼ .02). Conclusions: In this limited series, the routine use of intraoperative fluoroscopy did not improve implant positioning or sizing. This may be surgeon-specific or due to the result of the use of acetabular landmarks to guide placement of the components without fluoroscopy.

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Getting Correct Cup Position with the Anterior Approach: Bony Landmarks Versus x-ray Versus Computer Guidance

Nogler,

Boettner,

Lovell

2022

Anterior Hip Replacement

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The Accuracy of Acetabular Component Position Using a Novel Method to Determine Anteversion

Cited by 18 publications

References 25 publications

Standardized fluoroscopy‐based technique to measure intraoperative cup anteversion

Standardized fluoroscopy‐based technique to measure intraoperative cup anteversion

Does the use of intraoperative fluoroscopy improve postoperative radiographic component positioning and implant size in total hip arthroplasty utilizing a direct anterior approach?

Getting Correct Cup Position with the Anterior Approach: Bony Landmarks Versus x-ray Versus Computer Guidance

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