3D CT analysis of combined cup and stem anteversion in cases of cup navigation in hip arthroplasty.

Navigation of the cup in total hip arthroplasty is well analyzed and shows accurate results, reducing cup outliers of Lewinnek's "safe zone." With regard to the combined anteversion of cup and stem, however, a "new" safe zone with a range of 25° to 50° has been published. The aim of this study was to analyze total anteversion (cup and stem) by postoperative 3D computed tomography in isolated cup navigation cases. In 46 patients, the mean combined anteversion was 34.4° (range, 16.3°-57.3°, SD ± 9.3°) with 10 outliers. The mean cup anteversion was 19.5° (range, 11°-27°, SD ± 3.7°). Regarding Lewinnek's "safe zone" (cup only), we observed 5 outliers. An improvement of technique of stem implantation or navigation may reduce outliers of combined anteversion.

[1]  L. Dorr,et al.  A comparison of surgeon estimation and computed tomographic measurement of femoral component anteversion in cementless total hip arthroplasty. , 2009, The Journal of bone and joint surgery. American volume.

[2]  P. Asbach,et al.  Ultrasound-based navigation and 3D CT compared in acetabular cup position. , 2009, Orthopedics.

[3]  L. Dorr,et al.  Combined Anteversion Technique for Total Hip Arthroplasty , 2009, Clinical orthopaedics and related research.

[4]  Aamer Malik,et al.  Precision and Bias of Imageless Computer Navigation and Surgeon Estimates for Acetabular Component Position , 2007, Clinical orthopaedics and related research.

[5]  W. Kumpan,et al.  Accuracy of navigation-assisted acetabular component positioning studied by computed tomography measurements: methods and results. , 2007, The Journal of arthroplasty.

[6]  J. Argenson,et al.  Validation and usefulness of a computer-assisted cup-positioning system in total hip arthroplasty. A prospective, randomized, controlled study. , 2007, The Journal of bone and joint surgery. American volume.

[7]  A. Wines,et al.  Computed tomography measurement of the accuracy of component version in total hip arthroplasty. , 2006, The Journal of arthroplasty.

[8]  M Tingart,et al.  Imageless navigation for insertion of the acetabular component in total hip arthroplasty: is it as accurate as CT-based navigation? , 2006, The Journal of bone and joint surgery. British volume.

[9]  M. Krismer,et al.  Reducing the risk of dislocation after total hip arthroplasty: the effect of orientation of the acetabular component. , 2005, The Journal of bone and joint surgery. British volume.

[10]  B. Zurfluh,et al.  Compliant positioning of total hip components for optimal range of motion , 2004, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[11]  B. Jolles,et al.  Factors predisposing to dislocation after primary total hip arthroplasty: a multivariate analysis. , 2002, The Journal of arthroplasty.

[12]  Branislav Jaramaz,et al.  Comparison of a mechanical acetabular alignment guide with computer placement of the socket. , 2002, The Journal of arthroplasty.

[13]  M. Maruyama,et al.  The Frank Stinchfield Award: Morphologic features of the acetabulum and femur: anteversion angle and implant positioning. , 2001, Clinical orthopaedics and related research.

[14]  D. D’Lima,et al.  The Effect of the Orientation of the Acetabular and Femoral Components on the Range of Motion of the Hip at Different Head-Neck Ratios* , 2000, The Journal of bone and joint surgery. American volume.

[15]  B. Morrey,et al.  Effects of acetabular abduction on cup wear rates in total hip arthroplasty. , 1998, The Journal of arthroplasty.

[16]  K. Soffe,et al.  Effect of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear, and component migration. , 1998, The Journal of arthroplasty.

[17]  L. Dorr,et al.  Structural and cellular assessment of bone quality of proximal femur. , 1993, Bone.

[18]  D. Murray.  The definition and measurement of acetabular orientation. , 1993, The Journal of bone and joint surgery. British volume.

[19]  S. Weinstein,et al.  The natural history and long-term follow-up of Scheuermann kyphosis. , 1993, The Journal of bone and joint surgery. American volume.

[20]  J. Lewis,et al.  Dislocations after total hip-replacement arthroplasties. , 1978, The Journal of bone and joint surgery. American volume.

[21]  B. Mckibbin,et al.  Anatomical factors in the stability of the hip joint in the newborn. , 1970, The Journal of bone and joint surgery. British volume.

[22]  A. Cotten,et al.  Causes of dislocation of total hip arthroplasty. CT study of component alignment. , 1994, The Journal of bone and joint surgery. British volume.

[23]  A. Duquennoy,et al.  CAUSES OF DISLOCATION OF TOTAL HIP ARTHROPLASTY , 1994 .