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Achieving Target Cemented Femoral Stem Anteversion Using a 3-Dimensional Model.

Paul Rebgetz1, Tom McCarthy2, Hamish McLaren1

  • 1Orthopaedic Research Unit, School of Mechanical, Medical & Process Engineering, Faculty of Engineering, Queensland University of Technology, The Prince Charles Hospital, Chermside, Queensland, Australia.

Arthroplasty Today
|January 23, 2023
PubMed
Summary
This summary is machine-generated.

This study found that a cemented, collarless hip stem can achieve the target femoral anteversion in most cases. Adjustments can further increase the success rate, optimizing hip biomechanics for patients.

Keywords:
Cemented collarless stemFemoral anteversionRobotics

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Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering
  • Medical imaging

Background:

  • Total hip arthroplasty (THA) aims to restore hip joint function and patient comfort.
  • Optimizing femoral anteversion is crucial for THA biomechanics.
  • Limited data exists on the rotational range of cemented, collarless femoral stems.

Purpose of the Study:

  • To assess the rotational range of a cemented, collarless femoral stem using a CT-based robotic planning platform.
  • To determine the achievable range of femoral anteversion with this implant type.
  • To evaluate the impact of achieving target anteversion on native femoral offset.

Main Methods:

  • Computed tomography (CT) scans of 36 cadaveric hips were analyzed.
  • A robotic planning platform was used to virtually position and rotate a cemented, collarless stem.
  • Rotation limits were defined by cortical contact, with a target anteversion of 10°-20°.

Main Results:

  • The target anteversion range was achieved in 80.5% (29/36) of hips without compromising offset.
  • With minor offset adjustments (mean 2.3 mm), the success rate increased to 91.7% (33/36).
  • The study successfully modeled the rotational capabilities of the stem in a 3D environment.

Conclusions:

  • Target femoral stem anteversion is achievable with cemented, collarless stems in a significant majority of cases.
  • Minor compromises in femoral offset can further enhance the achievement of optimal anteversion.
  • This CT-based modeling approach provides valuable insights for surgical planning in total hip arthroplasty.