[Computed tomographic determination of the anteversion angle. Premises and possibilities]

Area of Science:

• Orthopedic surgery
• Radiology
• Anatomy

Background:

• Femoral anteversion is a critical parameter in hip biomechanics and surgical planning.
• Accurate measurement of femoral anteversion is essential for diagnosing conditions like hip dysplasia and femoroacetabular impingement.
• Existing methods, such as the Rippstein method, have limitations in clinical application and patient positioning.

Purpose of the Study:

• To evaluate the accuracy of computed tomography (CT) in determining femoral anteversion.
• To establish optimal CT imaging conditions for reliable anteversion measurement.
• To compare the accuracy and practicality of CT with the established Rippstein method.

Main Methods:

• Thirty-two macerated femora were examined using CT.
• Specific imaging protocols were developed to ensure the femur's long axis was perpendicular to the image plane.
• Key anatomical landmarks, including femoral condyles and the head-neck junction, were precisely visualized.

Main Results:

• CT demonstrated accuracy comparable to the Rippstein method for measuring femoral anteversion.
• Achieving accuracy with CT requires specific positioning: femur perpendicular to the image plane, clear visualization of maximal condylar configuration, and a plane dividing the femoral neck.
• These CT conditions are more readily achievable than those for the Rippstein method, particularly in immobile patients.

Conclusions:

• Computed tomography is a valid and accurate tool for assessing femoral anteversion.
• Standardized CT protocols, focusing on specific anatomical visualizations and patient positioning, enhance measurement reliability.
• CT offers a practical alternative to the Rippstein method, especially beneficial for patients with limited mobility.