ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2020
New combined anteversion technique in hybrid THA: cup-first procedure with CT-based navigation.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- CT-based navigation for total hip arthroplasty: a meta-analysis.European journal of medical research · 2023Pooled it
- An algorithm for personalized optimal acetabular cup implant positioning based on bony coverage rate and impingement-free range of motion.Medical & biological engineering & computing · 2026Article
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- Article
- Intraoperative estimation of natural femoral anteversion from proximal femoral osseous orientation during total hip arthroplasty.Journal of orthopaedic surgery and research · 2024Article
- Stem anteversion is not affected by proximal femur geometry in robotic-assisted total hip arthroplasty.Arthroplasty (London, England) · 2024Article
- Characteristic Poses in Ballet in the Case of a Retired Classical Ballerina after Bilateral THA: A Case Report and Review of Literature.Case reports in orthopedics · 2021Article
- Achievement of optimal implant alignment using taper wedge stems with cup-first THA through the MIS antero-lateral approach.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2020Article
- Current concepts in robotic total hip arthroplasty.SICOT-J · 2020Article
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCombined anteversion (CA) technique (stem-first procedure) is generally accepted as the optimal technique to attain an appropriate CA value in total hip arthroplasty (THA). However, cup anteversion is strongly influenced by the native femoral anteversion. Accordingly, anterior protrusion of the cup in the acetabulum might occur. The purpose of the present study is to investigate the achievement of the optimal CA while avoiding anterior cup protrusion and examine the significance of our new CA technique with cup-first procedure in hybrid THA.
methodsSeventy-nine hybrid THAs with the cup-first procedure used a CT-based navigation system for cup positioning. In the preoperative planning, cup anteversion was aimed at approximately 20°. However, in actuality, sufficient cup coverage in the original acetabulum based on individual anatomy is given priority over cup placement based on CT-based planning to ensure adequate cup coverage. The target stem anteversion was determined following Widmer's mathematical formula (37.3 = femoral stem anteversion × 0.7 + cup anteversion). Cemented stem was inserted according to the target stem anteversion angle.
resultsRegarding the assessment of overall alignment, the calculated Widmer's CA values during surgery and postoperative CT evaluation were 34.1° ± 6.0° (range 20.7°-51.2°) and 35.1° ± 6.7° (range 21.6°-50.7°). There were 72 hips (91.1%) within 25°-50° of CA. Cup protrusion length averaged 2.0 mm ± 2.6 mm (0-8.8 mm) in the axial view and 0.4 mm ± 1.0 mm (0-3.6 mm) in the sagittal view. Cup protrusion length of more than 5 mm was indicated in 10 hips, and no hips observed more than 10 mm.
conclusionOur new CA technique (cup-first procedure) with hybrid THA was able to achieve optimal CA value while avoiding anterior cup protrusion.
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