Use of the G-guide for Measuring Stem Antetorsion During Total Hip Arthroplasty

Fujihara, Yuki; Fukunishi, Shigeo; Fukui, Tomokazu; Nishio, Shoji; Okahisa, Shohei; Takeda, Yu; Kurosaka, Kenji; Yoshiya, Shinichi

doi:10.3928/01477447-20160201-03

Cited by 13 publications

(11 citation statements)

References 17 publications

(18 reference statements)

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“…However, with regard to stem anteversion, there is almost no method for accurately determining the anteversion angle of the stem during surgery apart from computer-assisted navigation. Although the accuracy of stem anteversion using the gravity-guide reported by Fujihara et al is 4.6 ± 4.1, it is necessary to attach the large device to the lower leg, and the procedure is complicated [22]. In addition, it cannot be used with various type of stems, and the accuracy in the OA of the knee on the affected side and in uence of stem placement angle (varus/valgus or exion/extension) is also unknown.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a simple intraoperative stem-anteversion measuring device in total hip arthroplasty

Iwakiri

Ohta

Ohyama

et al. 2020

Preprint

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Background Background: Stem anteversion is important in reducing postoperative complications in total hip arthroplasty (THA). THA utilizing the combined-anteversion theory requires stem anteversion angle (SAA) measurement intraoperatively; however, intraoperative SAA estimation is difficult for surgeons without computer-assisted navigation system. We evaluated the accuracy of the SAA measured intraoperatively using a newly developed device by comparing the three-dimensional measurements using postoperative computed tomography (CT).Materials & Methods In 127 hips in 127 patients who underwent unilateral THA at our hospital, we used our newly developed device that can be easily attached to rasping broach handles for measuring the SAA intraoperatively, which required the addition of the correction angle obtained in the preoperative epicondylar view. Postoperative SAA and its discrepancies from the measured intraoperative SAA with or without adding the correction angle were compared between the groups to evaluate the usefulness of the device.Results The intraoperative SAA measured by the device was 17.93 ± 7.53°. The true SAA measured on postoperative CT was 26.40 ± 9.73°. The discrepancy between the intraoperative SAA and true SAA was 8.94 ± 5.44° (without the correction angle), and 4.93 ± 3.85° (with the correction angle). Accuracy with a discrepancy of <5 degrees was achieved in 77 (60.6%) and <10 degrees was achieved in 113 (89.0%). The accuracy was unaffected by the stem placement angle (varus/valgus, or flexion/extension), or ipsilateral knee osteoarthritis.Conclusion The SAA measuring device, easily attachable to various rasping handles, is useful to measure the intraoperative SAA in a simple, economical, and noninvasive manner during THA.Level of Evidence Therapeutic Level IV.

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Section: Discussionmentioning

confidence: 99%

Efficacy of a simple intraoperative stem-anteversion measuring device in total hip arthroplasty

Iwakiri

Ohta

Ohyama

et al. 2020

Preprint

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“…Several studies have investigated the accuracy of measurements obtained using a goniometer or navigation systems during THA [12][13][14][15][16] (Table 4). They reported that the mean absolute measurement accuracy ranged from 4.5°-7.3°.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have reported the optimal positions for the acetabular components, and the accuracy of acetabular component positioning using free-hand techniques, mechanically guided techniques, or navigation systems have also been investigated [8][9][10][11]. Other studies have examined the accuracy of intraoperative measurements of stem anteversion obtained using a goniometer or navigation systems during THA [12][13][14][15][16]. However, only one CTbased navigation study has reported the accuracy of stem positioning during THA [17].…”

Section: Introductionmentioning

confidence: 99%

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

Mitsutake

Tanino

Nishida

et al. 2020

BMC Musculoskelet Disord

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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.

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“…Therefore, accurate implantation is very important. In recent years, mechanical intraoperative support devices or navigation systems have been used to place implants accurately [3,4].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of acetabular cup implantation, as a function of body mass index and soft-tissue thickness, with a mechanical intraoperative support device: A retrospective observational study

Suzuki

Imai

Hirano

et al. 2020

Preprint

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Background HipCOMPASS, a mechanical intraoperative support device used in total hip arthroplasty (THA), improves the cup-alignment accuracy. However, alignment accuracy in obese patients has not been examined. We aimed to compare the cup-alignment accuracy, using HipCOMPASS, between patients with and without obesity. Methods We retrospectively evaluated 448 consecutive patients who underwent primary THA using HipCOMPASS. We measured the soft-tissue thickness of the anterior-superior iliac spine (ASIS) and pubic symphysis using preoperative computed tomography (CT) images and the difference in cup angle pre- and postoperatively based on the cup-alignment error on CT. We used Pearson coefficients to determine the correlation of body mass index (BMI) and soft-tissue thickness with cup-alignment error. We created receiver operating characteristic (ROC) curves to determine the cutoff value for statistically significant cup-alignment error factors in radiographic inclination and anteversion of ≥ 5°. Results There were significant correlations between the absolute value of radiographic anteversion difference and BMI (r = 0.205), ASIS thickness (r = 0.419), and pubic symphysis thickness (r = 0.434). The absolute value of radiographic inclination difference was significantly correlated with ASIS (r = 0.257) and pubic symphysis thickness (r = 0.202). The ROC curve showed a pubic symphysis thickness of 37.2 mm for a ≥ 5° implantation error in both radiographic inclination and anteversion simultaneously. The cup-alignment error for HipCOMPASS was large in patients whose pubic symphysis thickness was ≥ 37.2 mm on preoperative CT. Conclusion We recommend using methods other than HipCOMPASS, including computed tomography-based navigation systems, in obese patients.

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Use of the G-guide for Measuring Stem Antetorsion During Total Hip Arthroplasty

Cited by 13 publications

References 17 publications

Efficacy of a simple intraoperative stem-anteversion measuring device in total hip arthroplasty

Efficacy of a simple intraoperative stem-anteversion measuring device in total hip arthroplasty

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

Accuracy of acetabular cup implantation, as a function of body mass index and soft-tissue thickness, with a mechanical intraoperative support device: A retrospective observational study

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