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

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 intraoperative and postoperative stem anteversion measurements was 0.824 (p=0.000). Conclusions The angle-measuring instrument is expected to allow cemented stems to be placed accurately, simply, and less invasively during THA and at significant cost savings.

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A Simple Angle-Measuring Instrument for Measuring Cemented Stem Anteversion during Total Hip Arthroplasty

10.21203/rs.2.16544/v2 ◽

2020 ◽

Author(s):

Ryo Mitsutake ◽

Hiromasa Tanino ◽

Yasuhiro Nishida ◽

Masaru Higa ◽

Hiroshi Ito

Keyword(s):

Total Hip Arthroplasty ◽

Correlation Coefficient ◽

Hip Arthroplasty ◽

Measurement Accuracy ◽

Measuring Instrument ◽

Target Angle ◽

Angle Measuring ◽

Cemented Stem ◽

The Mean ◽

The Relationship

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.

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A Simple Angle-Measuring Instrument for Measuring Cemented Stem Anteversion during Total Hip Arthroplasty

10.21203/rs.2.16544/v3 ◽

2020 ◽

Author(s):

Ryo Mitsutake ◽

Hiromasa Tanino ◽

Yasuhiro Nishida ◽

Masaru Higa ◽

Hiroshi Ito

Keyword(s):

Total Hip Arthroplasty ◽

Correlation Coefficient ◽

Hip Arthroplasty ◽

Measurement Accuracy ◽

Measuring Instrument ◽

Target Angle ◽

Angle Measuring ◽

Cemented Stem ◽

The Mean ◽

The Relationship

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.

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To cement or not to cement acetabular cups in total hip arthroplasty: a systematic review and re-evaluation

SICOT-J ◽

10.1051/sicotj/2019032 ◽

2019 ◽

Vol 5 ◽

pp. 35

Author(s):

Frank Van Praet ◽

Michiel Mulier

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

English Literature ◽

Cost Effective ◽

Acetabular Cup ◽

Qualitative Synthesis ◽

Osteoarthritis Of The Hip ◽

Total Hip ◽

Primary Osteoarthritis ◽

Cemented Stem

Introduction: Total Hip Arthroplasty (THA) in the treatment of primary osteoarthritis of the hip has evolved to a very safe and cost-effective intervention with revision rates below 5% after 10 years. To this day, however, controversy remains on whether or not to cement the acetabular cup. Methods: A comprehensive PubMed search of the English literature for studies published between 2007 and 2018 was performed. Studies comparing the clinical (revision rate, functionality), radiological (wear) or economic (cost) differences between cemented (cemented stem with cemented cup) and hybrid (cemented stem with uncemented cup) prostheses for primary osteoarthritis of the hip were identified as eligible. Results: A total of 1032 studies were identified whereof twelve were included for qualitative synthesis. All studies concerning the risk of revision were based on registry data, covering a total of 365,693 cups. Cemented prostheses had a similar or lower risk of revision compared to hybrid prostheses in every study, but performed slightly worse on functionality and quality of life. While cemented prostheses were the cheapest option, hybrids were the most cost-effective. Discussion: The widespread preference for cementless fixation of the acetabulum cannot be explained by a superior survival of cementless or hybrid models. Irrespective of age, cemented fixation of the acetabulum remains the gold standard to which other techniques should be compared.

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Revision of failed total hip arthroplasty with a proximal femoral modular cemented stem

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.82b5.0820684 ◽

2000 ◽

Vol 82-B (5) ◽

pp. 684-688 ◽

Cited By ~ 4

Author(s):

S. A. Crawford ◽

P. D. Siney ◽

B. M. Wroblewski

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Total Hip ◽

Cemented Stem

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Mid-Term Outcomes of Cemented Stem and Subtrochanteric Shortening Derotational Osteotomy in Total Hip Arthroplasty for Crowe IV Developmental Dysplasia

10.21203/rs.3.rs-745383/v1 ◽

2021 ◽

Author(s):

Zhe-Yu Huang ◽

Jing Ling ◽

Zhi-Min Zeng ◽

Zheng-Lin Di ◽

Jun-Hui Zhang ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Cement Leakage ◽

Developmental Dysplasia ◽

Harris Hip Score ◽

Total Hip ◽

Derotational Osteotomy ◽

Femoral Shortening ◽

Cemented Stem ◽

The Mean

Abstract Background Performing total hip arthroplasty (THA) in patients with Crowe IV developmental dysplasia of the hip (DDH) is technically challenging. Subtrochanteric shortening osteotomy is typically required for placing the acetabular component within the anatomic hip center. However, the outcomes of subtrochanteric osteotomy using cemented components are not widely reported. This study aimed to evaluate the outcomes of cemented stem THA with subtrochanteric femoral shortening and transverse derotational osteotomy in patients with Crowe IV DDH.Methods We retrospectively evaluated data of patients with Crowe IV DDH who underwent cemented stem THA with subtrochanteric femoral shortening and transverse derotational osteotomy between 2010 and 2018. Patients who underwent surgery at the hip joint were excluded. Data regarding pre- and postoperative clinical and radiological parameters were collected and reviewed.Results Among 14 patients included (14 hips), the mean age was 60.4 (range, 47–73) years. The mean Harris hip score improved from 40.7 to 87.7. The mean limb length discrepancy reduced from 52 mm to 12.7 mm. No neurologic deficits were noted. The mean osteotomy union time was 10.6 months. Delayed union and postoperative dislocation were observed in one and two patients, respectively. Cement leakage into the osteotomy gap was observed in one patient. No revisions were required. No signs of loosening or migration were observed. Conclusions Cemented stem THA combined with subtrochanteric femoral shortening and transverse derotational osteotomy is safe and effective for the treatment of patients with Crowe IV DDH. The cemented femoral component showed promising mid-term follow up results. However, cement leakage affects bone healing. Osteotomy and cementing should be performed meticulously.Trial Registration: Retrospectively registered

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