Abstract
Background
Intraoperative fluoroscopy is beneficial when performing total hip arthroplasty (THA)
via the direct anterior approach; however, image distortion may influence component
placement. A manual gridding system (MGS) and a digital gridding system (DGS) are
commercially available, aimed at visually representing or correcting image distortion.
Therefore, the purpose of this study is to compare component placement accuracy following
direct anterior approach THA when intraoperative fluoroscopy was supplemented with
MGS or DGS.
Methods
A retrospective evaluation of acetabular cup abduction (ABD), leg length discrepancy
(LLD) and global hip offset difference (GHO) was completed for consecutive patients
from 6 week post-THA weight-bearing radiographs. The predefined target LLD and GHO
was <10 mm and ABD target was 45° ± 10°. Differences between MGS and DGS were determined
by independent t-tests.
Results
The MGS (250 patients, 315 hips) and DGS (183 patients, 218 hips) achieved targeted
ABD in 98.7% and 96.8% of cases, respectively, and ABD was significantly lower in
the MGS group (45.14 ± 4.03° and 47.01 ± 4.39°, respectively) (P < .001). Compared to MGS, the DGS group averaged significantly higher GHO (3.64 ±
2.44 and 4.45 ± 2.73 mm, respectively, P = .002) but was not significantly different regarding LLD (2.92 ± 2.55 and 3.19 ±
2.46 mm, respectively, P = .275). No significant group difference was noted for percentage within the targeted
LLD and GHO; however, 93.5% of DGS and 97.6% of MGS achieved all three (P = .031).
Conclusion
The use of both the MGS and DGS resulted in consistent component placement within
the predefined target zone. Although the MGS appeared to be slightly more consistent,
these differences are unlikely to be clinically significant.
Keywords
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Article info
Publication history
Published online: June 23, 2020
Accepted:
June 17,
2020
Received in revised form:
June 16,
2020
Received:
May 18,
2020
Footnotes
Each author certifies that he or she has no commercial associations (eg, consultancies, stockownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.
No author associated with this paper has disclosed any potential or pertinent conflicts which may be perceived to have impending conflict with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2020.06.053.
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