Intraoperative Fluoroscopy Improves Component Position During Anterior Hip Arthroplasty

Area of Science:

• Orthopedic Surgery
• Surgical Navigation

Background:

• Acetabular cup positioning is critical for total hip arthroplasty (THA) success.
• Optimizing abduction and anteversion angles reduces dislocation risk and improves implant longevity.
• Anterior approach THA offers potential benefits but requires precise component placement.

Purpose of the Study:

• To evaluate the impact of fluoroscopic guidance on acetabular cup abduction and anteversion alignment in anterior THA.
• To determine if C-arm fluoroscopy improves the accuracy of component positioning within the "safe zone".

Main Methods:

• Retrospective review of 199 patients undergoing primary anterior THA by a single surgeon.
• Comparison of acetabular cup abduction and anteversion angles between a fluoroscopy group (98 patients) and a nonfluoroscopy group (101 patients).
• Analysis of 6-month postoperative anteroposterior pelvis radiographs to measure component angles.

Main Results:

• The fluoroscopy group showed a statistically significant improvement in acetabular cup abduction angles (P=.002).
• No significant difference in acetabular cup anteversion angles was observed between the groups.
• A higher percentage of implants were within the safe zone in the fluoroscopy group (80%) compared to the nonfluoroscopy group (63%).

Conclusions:

• Fluoroscopic guidance may enhance acetabular cup abduction alignment in anterior THA.
• Fluoroscopy is not essential for achieving ideal anteversion placement.
• Utilizing fluoroscopy can increase the likelihood of placing acetabular components within the optimal safe zone.