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Evaluation of the Accuracy of Intraoperative Femoral Stem Anteversion Using a Mechanical Alignment Guide and a
Yoshinobu Masumoto1,2, Shigeo Fukunishi2, Takuya Nakai2
1Orthopaedic Surgery, Kawasaki Hospital, Kobe, JPN.
Cureus
|January 26, 2026
Summary
Accurate femoral stem anteversion measurement in total hip arthroplasty (THA) is crucial. Intraoperative CT-based navigation offers superior accuracy compared to mechanical guides for measuring stem anteversion, improving THA outcomes.
Area of Science:
- Orthopedic Surgery
- Medical Imaging
- Biomedical Engineering
Background:
- Implant positioning in total hip arthroplasty (THA) significantly impacts longevity, outcomes, and complications.
- Acetabular component accuracy with CT-based navigation is studied, but femoral stem anteversion accuracy needs more research.
Purpose of the Study:
- To compare the accuracy of intraoperative CT-based navigation versus mechanical alignment guides for measuring femoral stem anteversion in THA.
Main Methods:
- 83 patients undergoing primary THA or bipolar hemiarthroplasty were included.
- Femoral stem anteversion was measured simultaneously using CT-based navigation and a mechanical alignment guide.
- Intraoperative measurements were compared to postoperative values using a 3D coordinate system.
Main Results:
- The mechanical alignment guide showed a mean absolute discrepancy of 7.6° ± 5.2° compared to postoperative measurements.
- CT-based navigation demonstrated a significantly lower mean absolute discrepancy of 2.9° ± 3.1° (p = 0.001).
Conclusions:
- Intraoperative CT-based navigation provides more accurate measurements of femoral stem anteversion than mechanical alignment guides.
- Improved accuracy in stem anteversion measurement can lead to better THA outcomes.
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