Intra-operative digital imaging: assuring the alignment of components when undertaking total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Medical Imaging

Background:

• Accurate component positioning is crucial in total hip arthroplasty (THA) for optimal patient outcomes.
• Deviations in acetabular component positioning, leg length, and femoral offset can lead to complications.

Purpose of the Study:

• To evaluate the impact of intra-operative digital imaging on the accuracy of acetabular component positioning, leg length discrepancy, and femoral offset in THA.
• To compare the incidence of outliers in these parameters with and without intra-operative digital imaging.

Main Methods:

• A retrospective case-control study involving 100 patients undergoing THA (50 with and 50 without intra-operative digital imaging).
• Collection and comparison of radiographic parameters including acetabular inclination and anteversion, leg length discrepancy, and femoral offset.
• Analysis of intra-operative adjustments made based on digital imaging.

Main Results:

• Intra-operative digital imaging led to a significant decrease in leg length discrepancy outliers (20% vs. 52%, p=0.001) and femoral offset inequality (18% vs. 44%, p=0.004).
• A reduction in acetabular inclination outliers was also observed (0% vs. 7%, p=0.023).
• Intra-operative adjustments were made in 86% of cases using digital imaging, primarily for leg length and femoral offset.

Conclusions:

• Intra-operative digital imaging improves the accuracy of component positioning in THA.
• This technology enhances surgical precision for leg length and femoral offset without significant time addition.