Abstract
Introduction Generally range of motion (ROM) in total hip arthroplasty (THA) is intraoperatively assessed by eye. Can we assume that visual estimation of ROM is reliable? Methods 60 patients underwent cementless THA in a subgroup analysis of a clinical prospective trial using a minimally invasive anterolateral approach in lateral decubitus position. Four experienced surgeons intraoperatively ...
Abstract
Introduction Generally range of motion (ROM) in total hip arthroplasty (THA) is intraoperatively assessed by eye. Can we assume that visual estimation of ROM is reliable? Methods 60 patients underwent cementless THA in a subgroup analysis of a clinical prospective trial using a minimally invasive anterolateral approach in lateral decubitus position. Four experienced surgeons intraoperatively estimated ROM visually by assessment of the femur relative to the alignment of the patient's pelvis. These estimations were compared with computer navigation measurements. Results We found a mean difference between navigation measurements and intraoperative estimations by eye of -5.6 degrees (+/- 10.9 degrees; -17 degrees to 30 degrees) for flexion, respectively, -0.4 degrees (+/- 10.7 degrees; -24 degrees to 30 degrees) for extension, 8.7 degrees (+/- 9.0 degrees; -10 degrees to 34 degrees) for abduction, 5.9 degrees (+/- 18.3 degrees; -58 degrees to 68 degrees) for external rotation and -5.8 degrees (+/- 12.1 degrees; -38 degrees to 22 degrees) for internal rotation. Multivariate analysis showed no association between the visual accuracy of estimation of ROM and patient characteristics, such as BMI, sex, grade of osteoarthritis and treatment side except for a significant correlation of visual accuracy of estimation of extension and the level of professional experience. Otherwise, the level of professional experience had no impact on the accuracy of estimation of ROM by eye. Conclusions Even the experienced surgeon's intraoperative estimation of ROM by eye is not reliable and differs up to 30 degrees compared to objective measurements in minimally invasive THA. For accurate intraoperative assessment of ROM, the use of technical devices is recommended.
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