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Evaluation of the reproducibility of preoperative three-dimensional computed tomography planning for posterolateral approach total hip arthroplasty

  • Original Article
  • Artificial Skin, Muscle, Bone / Joint, Neuron
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Abstract

The anteversion of the stem is occasionally intentionally changed by the surgeon for patients with smaller femoral neck anteversion during total hip arthroplasty (THA). However, the reproducibility of preoperative planning with increasing anteversion has been rarely assessed. The present study investigated it using two types of stems. This retrospective study included patients who underwent primary posterolateral THA using taper-wedge (TS group; 73 hips) and anatomical (AS group; 70 hips) stems. Characteristics of sex and age were matched in the two groups by propensity score matching. In both groups, the relationship between the preoperative three-dimensional planning and postoperative stem position, and the relationship between postoperative stem position and femoral neck anteversion (FNA) were evaluated. In the TS group, there were no significant differences in average stem anteversion (SA) between preoperative planning and postoperative placement (36.1° ± 7.0° and 36.6° ± 11.1°, respectively: p = 0.651). The absolute error of SA was 8.1° ± 6.4°. In the AS group, the postoperative SA was significantly smaller than the preoperative planning SA (22.7° ± 11.6° and 30.0° ± 9.3°, respectively: p < 0.001). The absolute error of SA was 9.0° ± 5.8°. The postoperative SA was significantly larger than the FNA in the TS group (36.6° ± 11.1° and 26.3° ± 10.9°, respectively: p < 0.001). However, no significant differences between the two were observed in the AS group (23.7° ± 10.1° and 22.7° ± 11.6°, respectively: p = 0.253). The preoperative planning of intentional increasing anteversion did not show high reproducibility with taper-wedge and anatomical stems. The anatomical stem was placed according to the femoral medullary canal regardless of preoperative planning with increased SA.

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Data availability

We have the data used in this study stored in our facility and can disclose it upon request.

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Acknowledgements

This research was supported by Japan Agency for Medical Research and Development (AMED) under Grant Number JP22he0122010.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minami-Kogushi, Ube, 755-8505, Japan

    Takehiro Kaneoka, Takashi Imagama, Tomoya Okazaki, Yuta Matsuki, Takehiro Kawakami, Kazuhiro Yamazaki & Takashi Sakai

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  1. Takehiro Kaneoka
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  2. Takashi Imagama
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  3. Tomoya Okazaki
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  4. Yuta Matsuki
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  6. Kazuhiro Yamazaki
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  7. Takashi Sakai
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Correspondence to Takashi Sakai.

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Kaneoka, T., Imagama, T., Okazaki, T. et al. Evaluation of the reproducibility of preoperative three-dimensional computed tomography planning for posterolateral approach total hip arthroplasty. J Artif Organs (2023). https://doi.org/10.1007/s10047-023-01396-x

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  • DOI: https://doi.org/10.1007/s10047-023-01396-x

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