Zusammenfassung
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 ...
Zusammenfassung
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 degrees between AP CCD and 3D-CT measurements of femoral stem torsion and -0.5 +/- 4.2 degrees 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. (C) 2016 Elsevier Inc. All rights reserved.
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