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Femoral Anteversion in THA and its Lack of Correlation with Native Acetabular Anteversion

  • Symposium: Papers Presented at the Hip Society Meetings 2009
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Several studies support the concept that, for optimum range of motion in THA, the combined femoral and acetabular anteversion should be some constant or fall within some “safe zone.” When using a cementless femoral component, the surgeon has little control of the anteversion of the component since it is dictated by native femoral anteversion. Given this constraint, we asked whether the surgeon should use the native anteversion of the acetabulum as a target for implant position in THA. Forty-six patients scheduled for primary THA underwent CT scanning and preoperative planning using a computer workstation. The native acetabular anteversion and the native femoral anteversion were measured. Prosthetic femoral anteversion was measured on the workstation by three-dimensional templating of a straight-stemmed tapered implant. The mean of the sum of the native acetabular anteversion and native femoral anteversion was 28.9°; however, 17% varied by 10° to 15° and 11% by more than 15°. The mean of native femoral anteversion and prosthetic femoral anteversion was 13.8° (range, −6.1°–32.7°) and 22.5° (range, 1°–39°), respectively. Based on our data, we believe the surgeon should not use the native acetabular anteversion as a target for positioning the acetabular component.

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References

  1. Bargar WL, Bauer A, Borner M. Primary and revision total hip replacement using the Robodoc system. Clin Orthop Relat Res. 1998;354:82–91.

    Article  PubMed  Google Scholar 

  2. Jamali AA, Deuel C, Perreira A, Salgado CJ, Hunter JC, Strong EB. Linear and angular measurements of computer-generated models: are they accurate, valid, and reliable? Comput Aided Surg. 2007;12:278–285.

    Article  PubMed  Google Scholar 

  3. Jamali AA, Mladenov K, Meyer DC, Martinez A, Beck M, Ganz R, Leunig M. Anteroposterior pelvic radiographs to assess acetabular retroversion: high validity of the “cross-over-sign”. J Orthop Res. 2007;25:758–765.

    Article  PubMed  Google Scholar 

  4. Lee YS, Oh SH, Seon JK, Song EK, Yoon TR. 3D femoral neck anteversion measurements based on the posterior femoral plane in ORTHODOC system. Med Biol Eng Comput. 2006;44:895–906.

    Article  PubMed  Google Scholar 

  5. Lucas DH, Scott RB. The Ranawat Sign: a specific maneuver to assess component positioning in total hip arthroplasty. J Orthop Techn. 1994;2:59–61.

    Google Scholar 

  6. Malik A, Maheshwari A, Dorr LD. Impingement with total hip replacement. J Bone Joint Surg Am. 2007;89:1832–1842.

    Article  PubMed  Google Scholar 

  7. Murray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg Br. 1993;75:228–232.

    CAS  PubMed  Google Scholar 

  8. Murtha PE, Hafez MA, Jaramaz B, DiGioia AM 3rd. Variations in acetabular anatomy with reference to total hip replacement. J Bone Joint Surg Br. 2008;90:308–313.

    Article  CAS  PubMed  Google Scholar 

  9. Stem ES, O’Connor MI, Kransdorf MJ, Crook J. Computed tomography analysis of acetabular anteversion and abduction. J Skel Radiol. 2006;35:385–389.

    Article  Google Scholar 

  10. Sugano N, Noble PC, Kamaric E. A comparison of alternative methods of measuring femoral anteversion. J Comput Assist Tomogr. 1998;22:610–614.

    Article  CAS  PubMed  Google Scholar 

  11. Tonnis D, Heinecke A. Current Concepts Review: Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am. 1999;81:1747–1770.

    CAS  PubMed  Google Scholar 

  12. Widmer KH, Zurfluh B. Compliant positioning of total hip components for optimal range of motion. J Orthop Res. 2004;22:815–821.

    Article  PubMed  Google Scholar 

  13. Yoshimine F. The safe-zones for combined cup and neck anteversions that fulfill the essential range of motion and their optimum combination in total hip replacements. J Biomech. 2006;39:1315–1323.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Andrea Hankins, BS, Sutter Institute for Medical Research, for her help in preparing this manuscript.

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Authors and Affiliations

  1. 1020 29th Street, #450, Sacramento, CA, 95816, USA

    William L. Bargar MD

  2. UC Davis Medical Center, Davis, CA, USA

    Amir A. Jamali MD

  3. Department of Orthopaedics, UC Davis, Davis, CA, USA

    Amir H. Nejad BA

Authors
  1. William L. Bargar MD
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  2. Amir A. Jamali MD
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  3. Amir H. Nejad BA
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Corresponding author

Correspondence to William L. Bargar MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at The Sutter Institute for Medical Research and at UC Davis.

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Bargar, W.L., Jamali, A.A. & Nejad, A.H. Femoral Anteversion in THA and its Lack of Correlation with Native Acetabular Anteversion. Clin Orthop Relat Res 468, 527–532 (2010). https://doi.org/10.1007/s11999-009-1040-2

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  • DOI: https://doi.org/10.1007/s11999-009-1040-2

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