How to Estimate Femoral Stem Anteversion During Direct Anterior Approach Total Hip Arthroplasty
Background: There are various traditional landmarks used to estimate the femoral component version, yet none are widely accepted by direct anterior surgeons. The purpose of this study was to compare bony landmarks easily accessible to direct anterior surgeons and to estimate which one provides the b...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344124000116 |
| _version_ | 1797237997371916288 |
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| author | Peter A. Gold, MD Thomas F. McCarthy, BSE Ilya Borukhov, BSE Jonathan Danoff, MD |
| author_facet | Peter A. Gold, MD Thomas F. McCarthy, BSE Ilya Borukhov, BSE Jonathan Danoff, MD |
| author_sort | Peter A. Gold, MD |
| collection | DOAJ |
| description | Background: There are various traditional landmarks used to estimate the femoral component version, yet none are widely accepted by direct anterior surgeons. The purpose of this study was to compare bony landmarks easily accessible to direct anterior surgeons and to estimate which one provides the best estimate of femoral component anteversion. Methods: A computed tomography database was used to identify 736 left entire-femur computed tomography scans. Seven visible anatomic landmarks were identified using a computer model in which a 45° virtual neck resection was made at 10 mm above the lesser trochanter. Thirteen axes, to reference the femoral stem position, were created between the 7 landmarks. Means and standard deviations (SDs) of angles between each axis and the transepicondylar axis (TEA) were compared for their precision. Results: The traditional lesser trochanter predicted anteversion from the TEA was 34.1° (SD 9.7°). Predicted anteversion from the TEA was 3.3° (SD 8.1°) when aligned from the center of the canal to the middle of the medial calcar; 14.0° (SD 8.1°) from the center of the canal to the anterior 1/3 of the medial calcar; and 24.8° (SD 8.5°) from the center of the canal to the most anterior point on the medial calcar. Conclusions: Compared to the lesser trochanter, 7 axes were more precise (lower SD) when predicting the version. Estimating the femoral component position, via simulated data, using 3 points along the medial calcar is a relatively precise and easily accessible tool for surgeons. |
| first_indexed | 2024-03-07T20:05:32Z |
| format | Article |
| id | doaj.art-e2a0b6376d90465cb238d53da6ce1f42 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-04-24T17:28:38Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-e2a0b6376d90465cb238d53da6ce1f422024-03-28T06:38:10ZengElsevierArthroplasty Today2352-34412024-04-0126101326How to Estimate Femoral Stem Anteversion During Direct Anterior Approach Total Hip ArthroplastyPeter A. Gold, MD0Thomas F. McCarthy, BSE1Ilya Borukhov, BSE2Jonathan Danoff, MD3Department of Orthopedics, Panorama Orthopedic & Spine Center, Golden, CO, USA; Corresponding author. Department of Orthopedics, Panorama Orthopedic & Spine Center, 660 Golden Ridge Rd #250, Golden, CO 80401, USA. Tel.: +1 303 233 1223.Department of Orthopedics, Stryker Orthopaedics, Mahwah, NJ, USADepartment of Orthopedics, Stryker Orthopaedics, Mahwah, NJ, USADepartment of Orthopedics, Northwell Health, Great Neck, NY, USABackground: There are various traditional landmarks used to estimate the femoral component version, yet none are widely accepted by direct anterior surgeons. The purpose of this study was to compare bony landmarks easily accessible to direct anterior surgeons and to estimate which one provides the best estimate of femoral component anteversion. Methods: A computed tomography database was used to identify 736 left entire-femur computed tomography scans. Seven visible anatomic landmarks were identified using a computer model in which a 45° virtual neck resection was made at 10 mm above the lesser trochanter. Thirteen axes, to reference the femoral stem position, were created between the 7 landmarks. Means and standard deviations (SDs) of angles between each axis and the transepicondylar axis (TEA) were compared for their precision. Results: The traditional lesser trochanter predicted anteversion from the TEA was 34.1° (SD 9.7°). Predicted anteversion from the TEA was 3.3° (SD 8.1°) when aligned from the center of the canal to the middle of the medial calcar; 14.0° (SD 8.1°) from the center of the canal to the anterior 1/3 of the medial calcar; and 24.8° (SD 8.5°) from the center of the canal to the most anterior point on the medial calcar. Conclusions: Compared to the lesser trochanter, 7 axes were more precise (lower SD) when predicting the version. Estimating the femoral component position, via simulated data, using 3 points along the medial calcar is a relatively precise and easily accessible tool for surgeons.http://www.sciencedirect.com/science/article/pii/S2352344124000116Total hip arthroplastyFemoral anteversionBony landmarksDirect anterior approach |
| spellingShingle | Peter A. Gold, MD Thomas F. McCarthy, BSE Ilya Borukhov, BSE Jonathan Danoff, MD How to Estimate Femoral Stem Anteversion During Direct Anterior Approach Total Hip Arthroplasty Arthroplasty Today Total hip arthroplasty Femoral anteversion Bony landmarks Direct anterior approach |
| title | How to Estimate Femoral Stem Anteversion During Direct Anterior Approach Total Hip Arthroplasty |
| title_full | How to Estimate Femoral Stem Anteversion During Direct Anterior Approach Total Hip Arthroplasty |
| title_fullStr | How to Estimate Femoral Stem Anteversion During Direct Anterior Approach Total Hip Arthroplasty |
| title_full_unstemmed | How to Estimate Femoral Stem Anteversion During Direct Anterior Approach Total Hip Arthroplasty |
| title_short | How to Estimate Femoral Stem Anteversion During Direct Anterior Approach Total Hip Arthroplasty |
| title_sort | how to estimate femoral stem anteversion during direct anterior approach total hip arthroplasty |
| topic | Total hip arthroplasty Femoral anteversion Bony landmarks Direct anterior approach |
| url | http://www.sciencedirect.com/science/article/pii/S2352344124000116 |
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