Radiological measurement of femoral stem version using a modified Budin method

2013 ◽  
Vol 95-B (7) ◽  
pp. 877-880 ◽  
Author(s):  
Y. K. Lee ◽  
T. Y. Kim ◽  
Y. C. Ha ◽  
B. J. Kang ◽  
K. H. Koo
Keyword(s):  
Femoral Stem ◽  
Radiological Measurement ◽  
Stem Version

scholarly journals Trans-lateral Decubitus Radiograph of the Hip: A New View to Measure the Version of the Femoral Stem

2019 ◽  
Author(s):  
Yong-Chan Ha ◽  
Jun-Il Yoo ◽  
Joong-Mo Ahn ◽  
Young-Kyun Lee ◽  
Yusuhn Kang ◽  
...  
Keyword(s):  
Ct Scan ◽  
Femoral Stem ◽  
Neck Shaft Angle ◽  
Radiological Measurement ◽  
Ct Measurements ◽  
Radiological Measurements ◽  
Shaft Angle ◽  
Lateral Decubitus ◽  
The Mean ◽  
Stem Version

Abstract Background We developed a radiological method, trans-lateral decubitus view, to measure stem version and assessed its reliability as well as the validity.Methods Trans-lateral decubitus view of the hip was a lateral radiograph, which was taken with the patient in lateral decubitus position, hip extension, 90° knee flexion and patella facing forward. In 40 patients, who underwent total hip replacement (THR), a trans-lateral decubitus view and CT scan of the hip were taken. Three observers measured stem neck-shaft angle (α) on hip AP view, and the stem anteversion (β), which was the angle between the axis of stem neck and axis of the femur, on the trans-lateral decubitus view. The stem version (θ) was calculated using the formula; θ = arc ((tan (180°-β) /tan (180°-α)). The intra and inter-observer reliabilities of each measurement were examined. The radiological measurements were compared with those on the CT scan to evaluate their validity.Results The mean stem anteversion on radiological measurement was 23.72° (SD 8.17) and the mean CT measurement was 23.91° (SD 10.25) (p = 0.929). The intra- and interobserver reliabilities of the radiological measurements were 0.934 and 0.931, respectively. Those of CT measurements were 0.941 and 0.942, respectively. When the radiological anteversion was between -30° and 30°, the correlation coefficient between radiological measurements and CT measurements was 0.729 (p = 0.001).Conclusion The trans-lateral decubitus method appears reliable and valid for the measurement of femoral stem version. Trial Registration: NCT02554149 (29 March 2016).

scholarly journals Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Y. Knafo ◽  
F. Houfani ◽  
B. Zaharia ◽  
F. Egrise ◽  
I. Clerc-Urmès ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Preoperative Planning ◽  
Femoral Stem ◽  
Leg Length ◽  
Femoral Offset ◽  
Postoperative Result ◽  
Total Hip ◽  
Planning Software ◽  
Navigated Surgery

Two-dimensional (2D) planning on standard radiographs for total hip arthroplasty may not be sufficiently accurate to predict implant sizing or restore leg length and femoral offset, whereas 3D planning avoids magnification and projection errors. Furthermore, weightbearing measures are not available with computed tomography (CT) and leg length and offset are rarely checked postoperatively using any imaging modality. Navigation can usually achieve a surgical plan precisely, but the choice of that plan remains key, which is best guided by preoperative planning. The study objectives were therefore to (1) evaluate the accuracy of stem/cup size prediction using dedicated 3D planning software based on biplanar radiographic imaging under weightbearing and (2) compare the preplanned leg length and femoral offset with the postoperative result. This single-centre, single-surgeon prospective study consisted of a cohort of 33 patients operated on over 24 months. The routine clinical workflow consisted of preoperative biplanar weightbearing imaging, 3D surgical planning, navigated surgery to execute the plan, and postoperative biplanar imaging to verify the radiological outcomes in 3D weightbearing. 3D planning was performed with the dedicated hipEOS® planning software to determine stem and cup size and position, plus 3D anatomical and functional parameters, in particular variations in leg length and femoral offset. Component size planning accuracy was 94% (31/33) within one size for the femoral stem and 100% (33/33) within one size for the acetabular cup. There were no significant differences between planned versus implanted femoral stem size or planned versus measured changes in leg length or offset. Cup size did differ significantly, tending towards implanting one size larger when there was a difference. Biplanar radiographs plus hipEOS planning software showed good reliability for predicting implant size, leg length, and femoral offset and postoperatively provided a check on the navigated surgery. Compared to previous studies, the predictive results were better than 2D planning on conventional radiography and equal to 3D planning on CT images, with lower radiation dose, and in the weightbearing position.

scholarly journals Femoral Stem Cementation in Hip Arthroplasty: The Know-How of a “Lost” Art

2021 ◽  
Author(s):  
Ahmed K. Emara ◽  
Mitchell Ng ◽  
Viktor E. Krebs ◽  
Michael Bloomfield ◽  
Robert M. Molloy ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Know How

scholarly journals Metal artefact reduction of different alloys with dual energy computed tomography (DECT)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anand John Vellarackal ◽  
Achim Hermann Kaim
Keyword(s):  
Stainless Steel ◽  
Image Quality ◽  
Femoral Stem ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Bony Tissue ◽  
Stem Image ◽  
Metal Artefact ◽  
Artefact Reduction

AbstractTo evaluate the influence of dual-energy CT (DECT) and Virtual monochromatic spectral (VMS) imaging on: (1) the artefact size of geometrically identical orthopaedic implants consisting of three different compositions and (2) the image quality of the surrounding bone, three similar phantoms—each featuring one femoral stem composed of either titanium, chrome-cobalt or stainless steel surrounded by five calcium pellets (200 mg hydroxyapatite/calcium carbonate) to simulate bony tissue and one reference pellet located away from the femoral stem—were built. DECT with two sequential scans (80 kVp and 140 kVp; scan-to-scan technique) was performed, and VMS images were calculated between 40 and 190 keV. The artefact sizes were measured volumetrically by semiautomatic selection of regions of interest (ROIs), considering the VMS energies and the polychromatic spectres. Moreover, density and image noise within the pellets were measured. All three phantoms exhibit artefact size reduction as energy increases from 40 to 190 keV. Titanium exhibited a stronger reduction than chrome-cobalt and stainless steel. The artefacts were dependent on the diameter of the stem. Image quality increases with higher energies on VMS with a better depiction of surrounding structures. Monoenergetic energies 70 keV and 140 keV demonstrate superior image quality to those produced by spectral energies 80 kVp and 140 kVp.

scholarly journals Differences in femoral component subsidence rate after THA using an uncemented collarless femoral stem: full weight-bearing with an enhanced recovery rehabilitation versus partial weight-bearing

2021 ◽  
Author(s):  
Franziska Leiss ◽  
Julia Sabrina Götz ◽  
Matthias Meyer ◽  
Günther Maderbacher ◽  
Jan Reinhard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Enhanced Recovery ◽  
Weight Bearing ◽  
Femoral Stem ◽  
Full Weight Bearing ◽  
Partial Weight Bearing ◽  
Fill Ratio ◽  
Stem Subsidence ◽  
Partial Weight

Abstract Background Femoral component subsidence is a known risk factor for early failure of total hip arthroplasty (THA) using cementless stems. The aim of the study was to compare an enhanced recovery concept with early full weight-bearing rehabilitation and partial weight-bearing on stem subsidence. In addition, the influence of patient-related and anatomical risk factors on subsidence shall be assessed. Methods One hundred and fourteen patients underwent primary cementless THA and were retrospectively analyzed. Sixty-three patients had an enhanced recovery rehabilitation with early full weight-bearing and 51 patients had rehabilitation with partial weight-bearing (20 kg) for 6 weeks. Postoperative subsidence was analyzed on standing pelvic anterior–posterior radiographs after 4 weeks and 1 year. Subsidence was measured in mm. Anatomical and prosthetic risk factors (stem size, canal flare index, canal fill ratio as well as BMI and demographic data) were correlated. Results Femoral stem subsidence rate was significantly higher for the group with an enhanced recovery concept compared to the group with partial weight-bearing at the first radiological follow up after 4 weeks [2.54 mm (SD ± 1.86) vs. 1.55 mm (SD ± 1.80)] and the second radiological follow up after 1 year [3.43 mm (SD ± 2.24) vs. 1.94 (SD ± 2.16)] (p < 0.001, respectively). Stem angulation > 3° had a significant influence on subsidence. Canal flare index and canal fill ratio showed no significant correlation with subsidence as well as BMI and age. Conclusion In the present study, cementless stem subsidence was significantly higher in the group with enhanced recovery rehabilitation compared to partial weight-bearing. Small absolute values and differences were demonstrated and therefore possibly below clinical relevance. Anatomical radiological parameters and anthropometric data did not appear to be risk factors for stem subsidence.

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