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Accuracy of the modified Hardinge approach in acetabular positioning
Prateek Goyal1, Adrian Lau1, Richard McCalden1
1From the Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON (Goyal, McCalden, Teeter, Lau, Howard, Lanting); the Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, ON (Teeter)l; and the Surgical Innovation Program, Lawson Health Research Institute, London, ON (Teeter).
Background:
The surgical approach chosen for total hip arthroplasty (THA) may affect the positioning of the acetabular component. The purpose of this study was to examine the accuracy in orienting the acetabular component using the modified Hardinge approach.
Methods:
We used our institutional arthroplasty database to identify patients with primary, press-fit, hemispherical acetabular components of a metal-on-polyethylene THA performed between 2003 and 2011. Patients with radiographs obtained 1-3 years after the index procedure were included for measurement of anteversion and inclination angles. Acceptable values of anteversion and abduction angles were defined as 15° ± 10° and 40° ± 10°, respectively.
Results:
We identified 1241 patients from the database, and the modified Hardinge approach was used in 1010 of the patients included in our analysis. The acetabular component was anteverted in the acceptable zone in 54.1% of patients. The abduction angle was within the defined range in 79.2% of patients. Combined anteversion and abduction angles within the defined zone were present in 43.6% of patients.
Conclusion:
Consistent with studies examining accuracy from other approaches, our study reveals that the modified Hardinge approach was only moderately accurate in positioning the acetabular component in the acceptable zone.
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