Related Experiment Video
Updated: Jan 4, 2026
07:45
The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report
Published on: August 4, 2022
3.7K
New combined anteversion technique in hybrid THA: cup-first procedure with CT-based navigation
Yoshinobu Masumoto1, Shigeo Fukunishi2, Tomokazu Fukui2
1Department of Orthopedic Surgery, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. nobu19850511@gmail.com.
Summary
This study introduces a new cup-first technique for total hip arthroplasty (THA) to achieve optimal combined anteversion (CA) while preventing anterior cup protrusion. The novel approach successfully attained desired CA values and minimized protrusion in hybrid THA procedures.
Area of Science:
- Orthopedic Surgery
- Biomechanical Engineering
- Medical Imaging
Background:
- The standard stem-first combined anteversion (CA) technique in total hip arthroplasty (THA) may lead to anterior cup protrusion due to native femoral anteversion.
- Achieving optimal CA is crucial for hip joint stability and function, but current methods face challenges in preventing acetabular complications.
Purpose of the Study:
- To evaluate a novel cup-first CA technique in hybrid THA for achieving optimal combined anteversion.
- To assess the efficacy of this new technique in avoiding anterior cup protrusion in the acetabulum.
Main Methods:
- A cup-first procedure was employed in 79 hybrid THAs, utilizing a CT-based navigation system for cup positioning.
- Preoperative planning aimed for 20° cup anteversion, prioritizing individual acetabular anatomy for coverage.
- Stem anteversion was determined using Widmer's mathematical formula, and stems were inserted accordingly.
Main Results:
- The mean surgical and postoperative CA values were 34.1° ± 6.0° and 35.1° ± 6.7°, respectively.
- 91.1% of hips achieved a CA within the 25°-50° range.
- Average anterior cup protrusion was minimal (2.0 mm axial, 0.4 mm sagittal), with only 10 hips showing protrusion >5 mm.
Conclusions:
- The new cup-first CA technique in hybrid THA effectively achieves optimal combined anteversion.
- This approach successfully avoids anterior cup protrusion, offering a safer alternative for THA.
