scholarly journals A simple and convenient method guide to determine the magnification of digital X-rays for preoperative planning in total hip arthroplasty

2012 ◽  
Vol 3 (2) ◽  
pp. 12 ◽  
Author(s):  
Hansjoerg Heep ◽  
Jie Xu ◽  
Christian Löchteken ◽  
Christian Wedemeyer
Keyword(s):  
Hip Replacement ◽  
Body Shape ◽  
Preoperative Planning ◽  
Absolute Error ◽  
X Rays ◽  
Shape Variation ◽  
Digital Templating ◽  
Total Hip ◽  
Rotation Center ◽  
Modified Method

Scaling of anteroposterior digital pelvic Xrays with variable magnification is the premise for accurate preoperative planning of total hip replacement with digital templating. Conn’s method of placing a marker of known diameter beside the thigh at the level of the femur has been reproduced in many studies and confirmed as one of the most accurate methods. But in our experience, it is inconvenient for radiographers and is not well tolerated by some patients. We modified this method by placing a coin on the radiograph plate. One hundred patients who had undergone hip replacement were enrolled in the study and randomly divided into two groups. The actual diameter of the prosthesis head was taken as the gold standard for assessment of the magnification of the coin in Group A. The coin was within a mean of 117.95% (range 114.37- 122.02%) of magnification for male, and 111.71% (range 114.37-120.93%) for female patients. The variation was small and limited, and had no correlation with body shape parameters (i.e. height, weight, BMI). Subsequently, the magnification of the coin was used to correct the measuring scale of the X-rays of the other 50 patients (Group B). Bias did not exceed 1.96 mm during measurement of the prosthesis with a diameter of less than 56 mm, and a range of absolute error of measurements of 56-66 mm (standard deviation, SD, 0.04-3.95 mm). Furthermore, in order to confirm the expressiveness of the modified method, CT scans of another 50 patients were randomly selected. The distance between the rotation center of the hip and the table, which is acknowledged to be a factor which influences magnification of the coin, changed little in response to body shape. Variation in magnification was caused by variation in distance between the rotation center of the hip and the table. The minimal change in distance for patients with different body shape led to easier and more convenient examination, and increased the feasibility of our modified coin method, except in cases where implantation of a very large-sized prosthesis is necessary.

Modification of Pelvic Orientation after Total Hip Replacement in Primary Osteoarthritis

2009 ◽  
Vol 19 (3) ◽  
pp. 257-263 ◽  
Author(s):  
Elhadi Sariali ◽  
Jean Yves Lazennec ◽  
Frederic Khiami ◽  
Michel Gorin ◽  
Yves Catonne
Keyword(s):  
Healthy Volunteers ◽  
Range Of Motion ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Sacral Slope ◽  
X Rays ◽  
Acetabular Anteversion ◽  
Total Hip ◽  
Pelvic Inclination ◽  
Primary Osteoarthritis

The acetabular anteversion angle varies according to the position of the pelvis. The objective goal of our study was to investigate changes in pelvic orientation after total hip replacement for primary osteoarthritis. We studied 89 patients who underwent total hip replacement for primary unilateral osteoarthritis. Lateral pelvic X-rays that included the hips were performed pre-operatively and one year post-operatively. Reference values were calculated by carrying out the same analysis in 100 asymptomatic healthy volunteers. Pelvic orientation was analyzed using the sacral slope. Patients having surgery for osteoarthritis had a decreased pelvic range of motion pre-operatively and post-operatively when compared to healthy volunteers. Post-operatively, this range of motion increased by 3° but remained lower than the norm. Compared to asymptomatic healthy volunteers, patients affected by osteoarthritis had a posterior pelvic extension that decreased post-operatively but did not return to norm. This post-operative pelvic inclination generates a significant decrease in the final cup anteversion and thus may predispose to posterior dislocation. As this post-operative alteration to pelvic orientation cannot be anticipated, computer-aided surgery for cup positioning may not improve the accuracy of the acetabular anteversion in some patients.

Comparison of Digital Templating with Manual Templating for Total hip Replacement

2005 ◽  
Vol 40 (7) ◽  
pp. 929 ◽  
Author(s):  
Ye Yeon Won ◽  
Wen Quen Cui ◽  
Kwang kyoun Kim ◽  
Sung Ho Son
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Digital Templating ◽  
Total Hip

Preoperative planning for total hip replacement, consent, and complications

2011 ◽  
Author(s):  
R.W.J. Carrington
Keyword(s):  
Informed Consent ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Preoperative Planning ◽  
Total Hip ◽  
Comprehensive Knowledge ◽  
The Common

♦ Preoperative planning is essential to achieve successful results after total hip replacement♦ Obtaining informed consent is important for both surgeon and patient♦ The surgeon must have a comprehensive knowledge of the aetiology and treatment of the common associated complications.

Standing or Supine X-Rays after Total Hip Replacement – When is the Safe Zone Not Safe?

2014 ◽  
Vol 24 (6) ◽  
pp. 616-623 ◽  
Author(s):  
John Au ◽  
Diana M. Perriman ◽  
Teresa M. Neeman ◽  
Paul N. Smith
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Safe Zone ◽  
X Rays ◽  
Total Hip

Features of preoperative planning for hip arthroplasty

2021 ◽  
Vol 2 (2) ◽  
pp. 59-64
Author(s):  
B.P. Buryachenko ◽  
◽  
D.I. Vartholomew ◽  
Keyword(s):  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Preoperative Planning ◽  
X Rays ◽  
X Ray ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Digital Planning ◽  
Speed Up

Relevance. Preoperative planning is an integral stage of hip replacement surgery, which reduces the number of complications and improves the accuracy of the installation of endoprosthesis components. Goal. Assess the accuracy of digital preoperative planning using mediCAD® v.6. Material and methods. The study included data from 276 patients with idiopathic coxarthrosis who were treated at the orthopedic department of the Center of Traumatology and Orthopedics of the Main Military Clinical Hospital named after N.N. Burdenko in the period from 2018 to 2020.The patients had X-rays of the pelvis and hip joint in two projections. All patients underwent total hip arthroplasty with cementless endoprostheses. Before surgery, all patients underwent preoperative planning using the mediCAD® v.6 software. After the operation, a control X-ray was performed, followed by an assessment of the obtained images in the same software. The planning accuracy was evaluated by comparing the parameters that were calculated in the program before the operation with the parameters of the installed implants. The results. The conducted study demonstrated the high accuracy of digital preoperative planning. The coincidence of the planned sizes of the acetabular component of the endoprosthesis and a deviation within +/- one size was observed in 93% of patients, femoral — in 84% of patients. Conclusion. Preoperative planning is an integral stage of hip replacement surgery, which allows you to perform the necessary preparation for the intervention. Digital planning allows you to simplify and speed up the process of preparing for an operation and improve the quality of its execution.

Accuracy of Femoral Templating in Reproducing Anatomical Femoral Offset in Total Hip Replacement

2007 ◽  
Vol 17 (3) ◽  
pp. 155-159 ◽  
Author(s):  
H. Davies ◽  
J. Foote ◽  
R.F. Spencer
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Rank Order ◽  
Computer Software ◽  
X Rays ◽  
Femoral Offset ◽  
Total Hip ◽  
Crucial Component ◽  
Best Fitting ◽  
The Uk

Restoration of hip biomechanics is a crucial component of successful total hip replacement. Preoperative templating is recommended to ensure that the size and orientation of implants is optimised. We studied how closely natural femoral offset could be reproduced using the manufacturers' templates for 10 femoral stems in common use in the UK. A series of 23 consecutive preoperative radiographs from patients who had undergone unilateral total hip replacement for unilateral osteoarthritis of the hip was employed. The change in offset between the templated position of the best-fitting template and the anatomical centre of the hip was measured. The templates were then ranked according to their ability to reproduce the normal anatomical offset. The most accurate was the CPS-Plus (Root Mean Square Error 2.0 mm) followed in rank order by: C stem (2.16), CPT (2.40), Exeter (3.23), Stanmore (3.28), Charnley (3.65), Corail (3.72), ABG II (4.30), Furlong HAC (5.08) and Furlong modular (7.14). A similar pattern of results was achieved when the standard error of variability of offset was analysed. We observed a wide variation in the ability of the femoral prosthesis templates to reproduce normal femoral offset. This variation was independent of the seniority of the observer. The templates of modern polished tapered stems with high modularity were best able to reproduce femoral offset. The current move towards digitisation of X-rays may offer manufacturers an opportunity to improve template designs in certain instances, and to develop appropriate computer software.

Comparison of Anatomic Vs. Straight Femoral Stem Design in Total Hip Replacement - Femoral Canal Fill in Vivo

2016 ◽  
Vol 27 (3) ◽  
pp. 241-244 ◽  
Author(s):  
Friso A. de Boer ◽  
Elhadi Sariali
Keyword(s):  
Hip Replacement ◽  
Femoral Stem ◽  
X Rays ◽  
Femoral Canal ◽  
Stem Design ◽  
Total Hip ◽  
Straight Stem ◽  
Satisfactory Outcome ◽  
Central Level

Introduction The femoral canal fill between an anatomic and a straight prosthesis design in cementless total hip arthroplasty (THA) was compared. We hypothesised that the anatomic SPS stem has higher proximal fill and lesser distal fill than the straight stem. Material and methods The femoral canal fill was measured on 3 months routine postoperative x-rays at 5 levels of the stem in 50 consecutive patients, aged 35-83 years, who underwent 56 THA procedures by a single surgeon in this hospital. 22 patients received a straight design Ceramconcept Global stem, 34 patients received an anatomic design Symbios SPS stem. Both anteroposterior (AP) and lateral x-rays were combined to suggest a 3-D measurement. Results On the AP x-rays, the canal fill was significantly higher using the anatomic design stem at the proximal measurement levels, and was significantly higher at the distal levels using the straight stem. With the AP and lateral x-rays combined, the canal fill at the proximal levels was also significantly higher in the anatomic groups, nonsignificantly lower at the central level and significantly lower at the distal levels. Discussion In THA surgery, achieving high fill at the metaphysis of the femur and less fill at the diaphysis has been suggested to result in satisfactory outcome and high stability of the prosthesis. This study demonstrated that, compared to straight stem design, an anatomically designed stem has a significantly higher metaphyseal femoral canal fill.

scholarly journals A new anterolateral surgical approach for total hip replacement

Joints ◽  
2016 ◽  
Vol 04 (03) ◽  
pp. 148-152
Author(s):  
Giovanni Grano ◽  
Maria Pavlidou ◽  
Alberto Todesco ◽  
Augusto Palermo ◽  
Luigi Molfetta
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Case Series ◽  
Hip Dislocation ◽  
Harris Hip Score ◽  
Anterolateral Approach ◽  
X Rays ◽  
Level Of Evidence ◽  
Total Hip

Purpose: the purpose of the present paper is to present the short-term results of a “detachment-free” (DF) anterolateral approach for primary total hip replacement (THR) performed in a large series of patients. Methods: two hundred patients submitted to primary THR were retrospectively reviewed for the present study. In all cases, the surgery was performed using a minimally invasive DF anterolateral approach, which entails no disconnection of tendons and no muscle damage. The study population consisted of 96 men (48%) and 104 women (52%), with an average age of 69.4 years (range 38-75). Clinical and radiographic follow-up was performed after 12 months. Results: the clinical results, evaluated using the Harris Hip Score, were excellent in 95% of the cases and good in 5%; no cases had fair or poor results. X-rays taken at 3, 6 and 12 months after surgery did not show heterotopic ossification, mobilization of the prosthetic components, or hip dislocation. No infections, deep vein thrombosis, or failure of the gluteal muscles were reported. Conclusions: the DF anterolateral approach for THR proved safe and provided effective results at shortterm follow-up. Level of evidence: Level IV, therapeutic case series.

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