1. Radiographic Assessment of Femoral Stem Torsion in Total Hip Arthroplasty-A Comparison of a Caput-Collum-Diaphyseal Angle-Based Technique With the Budin View.
- Author
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Woerner ML, Weber M, Craiovan BS, Springorum HR, Grifka J, and Renkawitz TF
- Subjects
- Aged, Arthroplasty, Replacement, Hip adverse effects, Diaphyses diagnostic imaging, Female, Femur surgery, Humans, Male, Middle Aged, Observer Variation, Postoperative Period, Prospective Studies, Reproducibility of Results, Tomography, X-Ray Computed methods, Arthroplasty, Replacement, Hip methods, Bone Malalignment diagnostic imaging, Femur diagnostic imaging, Hip Prosthesis, Torsion Abnormality diagnostic imaging
- Abstract
Background: Correct assessment of femoral stem torsion is crucial in total hip arthroplasty (THA). In this study, we aimed to compare a recently published novel method based on anteroposterior (AP) hip radiographs using the projected caput-collum-diaphyseal (CCD) angle (AP CCD) with the modified posteroanterior Budin view., Method: AP radiographs, modified Budin views, and 3-dimensional computed tomography (3D-CT) images were obtained in 30 patients after minimally invasive, cementless THA. Radiographic measurements performed by 4 observers twice in a 6-week interval were compared with 3D-CT measurements. Furthermore, correlations between the radiographic deviation to 3D-CT and patient specific characteristics were evaluated., Results: We found a mean difference of 2.2 ± 6.8° between AP CCD and 3D-CT measurements of femoral stem torsion and -0.5 ± 4.2° between the modified Budin view and 3D-CT. We found a high correlation between mean radiographic and 3D-CT stem torsion (r = 0.78, P < .001 for AP CCD and r = 0.84, P < .001 for Budin view). The observers had excellent agreements within (intraclass correlation coefficient, ≥0.88 for AP CCD and intraclass correlation coefficient, ≥0.94 for Budin view) and between (mean concordance correlation coefficient, ≥0.79 for AP CCD and concordance correlation coefficient, ≥0.86 for Budin view) their radiographic measurements., Conclusion: Both radiographic methods enable a simple orientation and a practical conventional radiographic estimation of stem torsion on hip radiographs after THA. However, CT remains the golden standard for exact estimation of stem torsion., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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