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

Ryo Mitsutake, Hiromasa Tanino, Yasuhiro Nishida, Masaru Higa, Hiroshi Ito, Ryo Mitsutake, Hiromasa Tanino, Yasuhiro Nishida, Masaru Higa, Hiroshi Ito

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.

Keywords: Angle-measuring instrument; Cemented stem; Stem anteversion; Total hip arthroplasty.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a The angle-measuring instrument attached to the handle of the femoral broach. b The angle of the angle-measuring instrument. The angle of the angle-measuring instrument was measured as the angle between the gravitational direction and the line running perpendicular to the prosthetic axis under 90° hip flexion, maximum hip adduction, and 90° knee flexion, with the tibia in a vertical position. α° represents the anteversion of the femoral broach and stem. c Anteversion of the femoral broach and stem. When the tibia was placed in a vertical position, the axis passing through the medial and lateral femoral condyles ran perpendicular to the gravitational direction. The anteversion of the femoral broach and stem was determined as the angle between the prosthetic axis and the line running perpendicular to the gravitational direction. The anteversion of the femoral broach and stem reflected the angle between the gravitational direction and the line running perpendicular to the prosthetic axis. α° indicates the anteversion of the femoral broach and stem
Fig. 2
Fig. 2
The correlation between intraoperative and postoperative stem anteversion measurements. The intraoperative stem anteversion measurements exhibited a good correlation with the postoperative stem anteversion measurements (correlation coefficient: γ = 0.824, p = 0.000)
Fig. 3
Fig. 3
The correlation between the target angle and the postoperative stem anteversion measurements. The target angle exhibited a good correlation with the postoperative stem anteversion measurements (correlation coefficient: γ = 0.795, p = 0.000)

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