Usefulness of a Simple Preoperative Planning Technique using Plain X‐rays for Direct Anterior Approach for Total Hip Arthroplasty
| Autor: | Yanyan Bian, Bin Feng, Xisheng Weng, Huiming Peng, Yiou Wang, Xi Chen, Wenwei Qian, Wei Wang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Acetate templating Arthroplasty Replacement Hip Retrospective analysis Radiography Prosthesis Design Osteoarthritis Hip Patient Care Planning 03 medical and health sciences 0302 clinical medicine lcsh:Orthopedic surgery Prosthesis Fitting Statistical significance medicine Humans Fluoroscopy Orthopedics and Sports Medicine Pelvis Aged Retrospective Studies 030222 orthopedics Reproducibility Clinical Article Preoperative planning medicine.diagnostic_test business.industry Reproducibility of Results Middle Aged lcsh:RD701-811 Leg length discrepancy medicine.anatomical_structure Preoperative Period Clinical Articles Female Total hip arthroplasty Surgery Hip Prosthesis Anterior approach business Nuclear medicine 030217 neurology & neurosurgery |
| Zdroj: | Orthopaedic Surgery Orthopaedic Surgery, Vol 13, Iss 1, Pp 145-152 (2021) |
| ISSN: | 1757-7861 1757-7853 |
| DOI: | 10.1111/os.12854 |
| Popis: | Objective To examine the accuracy, reliability, and reproducibility of a simple preoperative planning technique using plain X‐rays. Methods A retrospective analysis of 96 consecutive cases of primary direct anterior approach (DAA)‐total hip arthroplasty (THA) from July 2015 to December 2018 was performed. The 96 patients included 24 males and 72 females, with an average age of 70 years. The standard AP pelvis radiographs with the patients' hips extended and internally rotated were obtained pre‐ and postoperatively. The preoperative planning was also completed on the standardized AP pelvic radiographs. The prearranged cup positioning was radiologically measured intraoperatively using fluoroscopy. The correct leg length was assessed intraoperatively, which was compared with the preoperative planning. The component positioning was measured by three independent researchers. Two of the researchers completed the measurements three times, and intra‐observer and inter‐observer reliability were calculated. All patients received at least 6 months follow‐up (6 months–4 years). Results In all cases, the median leg length discrepancy (LLD) was 4.4 mm (range 1.6–15.9 mm), and 84 patients had an LLD smaller than 10 mm, of which 58 patients had an LLD of less than 5 mm. None of the patients had a critical LLD of 2 cm or larger. The multivariable logistic regression for LLD (safe range: yes/no) with the co‐variables including gender, ASA classification, type of cup, the surgeon's experience level, and the presence of a total hip arthroplasty (THA) on the contralateral side did not present statistical significance. The median angle of the inclination of the acetabular component (IA) was 42.3° (range: 28.7°–52.2°). Ninety‐one patients were within the defined safe range. The hit ratio for the cup to be within the safe zone was significantly higher for the Pinnacle cups than that for the Continuum cups (P Surgical diagrams for the surgical techniques. A is the schematic of the anatomical approach of DAA. B is the patient's supine position, the buttocks are padded and placed in the flexible part of the operating table. C is the mark of incision on the body surface before operation. D is the schematic diagram of intraoperative posterior capsule release (the green area is the release area). |
| Databáze: | OpenAIRE |
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