Components anteversion in primary cementless THA using straight stem and hemispherical cup: A prospective study in 91 hips using CT-scan measurements - 14/10/11
, R.B. Gunderson
Corresponding author. Tel.: +47 23076013; fax: +47 23076010.
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Summary |
Background |
The recommended range of anteversion of the components in total hip arthroplasty (THA) is between 10 and 30°, but the intraoperative estimation of these versions may be inadequate.
Hypothesis |
The components anteversion in primary cementless THA using straight stem and hemispherical cup is not significantly different from the native anteversion of the hip joint.
Objectives |
To evaluate in a prospective manner the range of anteversion currently achieved in cementless THA.
Patients and methods |
Five senior surgeons operated 91 patients with primary cementless THA. We used a straight press fit stem and a hemispherical press fit cup. We aimed to obtain femoral anteversion of 10 to 30°, acetabular anteversion of 10 to 30° and a global combined anteversion of 25 to 55°. Cup position was checked with an impactor-positioner, and stem position was determined with the knee flexed 90°. In all cases we used elevated liners and 28mm diameter ceramic heads. At 3months postoperatively the component versions were measured using a General Electric LightSpeed Pro 16 (Milwaukee, Wi, USA) with the patient in supine position.
Results |
Femoral component measurements ranged from 17° of retroversion to 60° of anteversion with a mean of 23.0±11.8°. Similarly, acetabular component version ranged from 28° of retroversion to 46° of anteversion with a mean of 18.5±13.7°. There were no correlations to the native femoral and acetabular versions. Only 55 hips (60.4%) were within the accepted range of 25 to 55° of combined anteversion, but none of the cases dislocated during a follow-up of 2years.
Conclusion |
In cementless THA with our operative technique, the intraoperative estimation of femoral and acetabular anteversion, in many cases, resulted to be inadequate in relation to the intended range of 10 to 30° of anteversion.
Level of evidence |
Level III, prospective diagnostic.
Le texte complet de cet article est disponible en PDF.Keywords : Arthroplasty, Component positioning, CT-scan, Hip, Measurement
Plan
Vol 97 - N° 6
P. 615-621 - octobre 2011 Retour au numéro
Article précédent
- Periacetabular cement extrusion in the course of total hip replacement: Incidence and consequences. An analysis from 269 consecutive cemented total hips
- H. d’Astorg, J. Amzallag, A. Poignard, F. RoudotThoraval, J. Allain
- Periprosthetic femoral fractures treated by locked plating: Feasibility assessment of the mini-invasive surgical option. A prospective series of 36 fractures
- M. Ehlinger, P. Adam, A. Di Marco, Y. Arlettaz, B.-K. Moor, F. Bonnomet
Bienvenue sur EM-consulte, la référence des professionnels de santé.