Determining and Achieving Target Limb Length and Offset in Total Hip Arthroplasty Using Intraoperative Digital...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Radiology

Background:

• Accurate limb length and offset restoration in total hip arthroplasty (THA) presents a significant surgical challenge.
• Preoperative planning and intraoperative execution are critical for achieving optimal patient anatomy and function post-THA.
• Existing methods may not consistently address patient-specific goals for limb length and offset.

Purpose of the Study:

• To present a novel method for determining patient-specific target limb length and offset in THA.
• To evaluate the accuracy of achieving these targets using intraoperative digital radiography.
• To assess the clinical outcomes associated with this digital measurement technique.

Main Methods:

• A prospective study included 102 patients undergoing primary THA for unilateral hip osteoarthritis.
• Limb length and offset were measured preoperatively, intraoperatively, and postoperatively using digital pelvic radiographs.
• Intraoperative adjustments were guided by digital radiography to meet patient-derived limb length targets and contralateral offset, with an average follow-up of 4.2 years.

Main Results:

• 100% of patients achieved target limb length within 5 mm; 97.1% achieved target offset within 5 mm.
• Significant differences from contralateral measurements were rare (2.0% for limb length, 2.9% for offset).
• No dislocations or reoperations occurred, with an average Hip disability and Osteoarthritis Outcome Score for Joint Replacement of 95.78.

Conclusions:

• Patient-specific target limb length and offset goals are achievable in most THA cases.
• Intraoperative digital radiography enables precise restoration of limb length and offset, improving surgical accuracy.
• This digital method leads to excellent clinical outcomes and patient satisfaction in unilateral hip osteoarthritis.