Does Intraoperative Fluoroscopy Improve Limb-Length Discrepancy and Acetabular Component Positioning During Direct Anterior Total Hip Arthroplasty?
J Arthroplasty
; 33(9): 2927-2931, 2018 09.
Article
em En
| MEDLINE
| ID: mdl-29853308
ABSTRACT
BACKGROUND:
One potential benefit of the direct anterior approach (DAA) for total hip arthroplasty is the ability to use intraoperative fluoroscopy for acetabular cup positioning and limb-length evaluation. Previous studies comparing the use of fluoroscopy with an anterior approach to a posterior approach have reported conflicting results. To our knowledge, no prior study has compared acetabular cup position and limb-length discrepancy (LLD) using a DAA with and without fluoroscopy.METHODS:
We retrospectively reviewed the charts of 298 patients who underwent direct anterior total hip arthroplasty with or without intraoperative fluoroscopy. All procedures were performed by 2 surgeons who use DAA as their primary approach. Preoperative and 6-week postoperative low anteroposterior pelvis and cross-table lateral radiographs were reviewed by 3 independent surgeons. Acetabular cup inclination, anteversion, and LLD were measured and compared.RESULTS:
Thirty-three patients were excluded for inadequate imaging, leaving 125 patients in the fluoroscopy group and 140 patients in the nonfluoroscopy group. Mean inclination, anteversion, and LLD were 39.4° (95% confidence interval [CI], 38.5°-40.2°), 30.2° (95% CI, 29.2°-31.2°), and 1.1 mm (95% CI, 0.1 mm-2.2 mm) for the fluoroscopy group and 39.9° (95% CI, 39.3°-40.5°), 31.1° (95% CI, 30.0°-32.2°), and 0.8 mm (95% CI, -0.1 mm to 1.6 mm) for the nonfluoroscopy group. There was no significant difference in acetabular inclination (P = .35), anteversion (P = .22), or postoperative LLD (P = .64) between groups.CONCLUSION:
This study found no clinically or statistically significant difference in acetabular inclination, anteversion, or LLD between the fluoroscopy and nonfluoroscopy groups. Both surgeons achieved a similar mean acetabular cup position and an equivalent mean LLD.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fluoroscopia
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Artroplastia de Quadril
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Posicionamento do Paciente
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Prótese de Quadril
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Desigualdade de Membros Inferiores
/
Acetábulo
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article