Use of a Digital Protractor and a Spirit Level to Determine the Intraoperative Anteversion of Femoral Component during Cemented Hip Hemiarthroplasty: a Prospective Clinical Trial

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Pongkunakorn Anuwat; Palawong Patanapong; Chatmaitri Swist; Phetpangnga Nawakun

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Journal Paper

Paper Information

Journal: Archives of Bone and Joint Surgery Year:2019 | Volume:7 | Issue:4 Page(s): 314-320

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Information Journal Paper

Title

Use of a Digital Protractor and a Spirit Level to Determine the Intraoperative Anteversion of Femoral Component during Cemented Hip Hemiarthroplasty: a Prospective Clinical Trial

Author(s)

Pongkunakorn Anuwat | Palawong Patanapong | Chatmaitri Swist | Phetpangnga Nawakun | Issue Writer Certificate

Keywords

Digital protractor

Femoral stem anteversion

Hip arthroplasty

Spirit level

Abstract

Background: Femoral stem anteversion during Hip arthroplasty is generally estimated by eye intraoperatively and has proven to be different from targeted values. This study aims to determine the accuracy of a novel technique using a Digital protractor and a Spirit level to improve surgeons’ estimation of stem anteversion. Methods: A prospective non-randomized study was conducted among 93 patients with femoral neck fracture who underwent cemented hemiarthroplasty via posterolateral approach. In the control group (N=62), five experienced surgeons assessed stem anteversion related to the posterior femoral condylar plane using visual estimation with a target angle of 15°-25° . In the study group (N=31), another two surgeons assessed stem anteversion with the same target angle by placing a Digital protractor on the femoral stem inserter handle while the assistant held the leg in the truly vertical position, verified by a Spirit level that was attached to the shin with cable ties. Stem anteversion was measured blind, postoperatively, on 2D-CT and compared with the intraoperative results. Results: The mean postoperative anteversion was 22. 4° (-4. 2° to 51. 3° , SD 11. 1° ) in the control group and 23. 0° (16. 0° to 29. 9° , SD 3. 6° ) in the study group (P=0. 810). The study group had more stems positioned in 15°-25° anteversion (71. 0% vs 32. 3%, P=0. 001) and the mean absolute value of surgeon error was-0. 2° (-5. 4° to 7. 0° , SD 3. 0° ). Twentyeight stems of the study group (90. 3%) had an error within 5° . Surgeon overestimation >5° was found in 1 hip (3. 2%) and underestimation >5° was found in 2 hips (6. 4%). Conclusion: Using a Digital protractor and a Spirit level was reliable with high accuracy and precision to improve the intraoperative estimation of cemented stem anteversion.

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APA: Copy

Pongkunakorn, Anuwat, Palawong, Patanapong, Chatmaitri, Swist, & Phetpangnga, Nawakun. (2019). Use of a Digital Protractor and a Spirit Level to Determine the Intraoperative Anteversion of Femoral Component during Cemented Hip Hemiarthroplasty: a Prospective Clinical Trial. THE ARCHIVES OF BONE AND JOINT SURGERY, 7(4), 314-320. SID. https://sid.ir/paper/754390/en

Vancouver: Copy

Pongkunakorn Anuwat, Palawong Patanapong, Chatmaitri Swist, Phetpangnga Nawakun. Use of a Digital Protractor and a Spirit Level to Determine the Intraoperative Anteversion of Femoral Component during Cemented Hip Hemiarthroplasty: a Prospective Clinical Trial. THE ARCHIVES OF BONE AND JOINT SURGERY[Internet]. 2019;7(4):314-320. Available from: https://sid.ir/paper/754390/en

IEEE: Copy

Anuwat Pongkunakorn, Patanapong Palawong, Swist Chatmaitri, and Nawakun Phetpangnga, “Use of a Digital Protractor and a Spirit Level to Determine the Intraoperative Anteversion of Femoral Component during Cemented Hip Hemiarthroplasty: a Prospective Clinical Trial,” THE ARCHIVES OF BONE AND JOINT SURGERY, vol. 7, no. 4, pp. 314–320, 2019, [Online]. Available: https://sid.ir/paper/754390/en

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