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Can version of the proximal femur be used for CT planning uncemented femoral stems?

Moralidou, Maria; Laura, Anna Di; Henckel, Johann; Hart, Alister J; (2023) Can version of the proximal femur be used for CT planning uncemented femoral stems? Medical Engineering & Physics , 116 , Article 103985. 10.1016/j.medengphy.2023.103985. Green open access

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Abstract

Three-Dimensional Computed Tomography (3D-CT) planning can predict the prosthetic femoral size in uncemented primary Total Hip Arthroplasty (THA). Correct sizing usually results in optimal varus/valgus femoral alignment; however, its effect on the Prosthetic Femoral Version (PFV) is poorly understood. Most 3D-CT planning systems use Native Femoral Version (NFV) to plan PFV. We aimed to assess the relationship between PFV and NFV in primary uncemented THA using 3D-CT analysis. Pre- and post-operative CT data was retrospectively collected from 73 patients (81 hips) undergoing primary uncemented THA with a straight-tapered stem. 3D-CT models were used to measure PFV and NFV. The clinical outcomes were evaluated. The discrepancy between PFV and NFV was low (<5°) in 43%, moderate (5–10°) in 40%, high (10–15°) in 11% and very high (>15°) in 6% of the cases. We found that NFV is not a useable guide for planning PFV. The 95% limits of agreement were both high at 17° and 15°, respectively. Satisfactory clinical outcomes were recorded. The discrepancy was large enough to recommend against the use of NFV for planning PFV when using straight-tapered uncemented stems. Further work should focus on the internal bony anatomy and the influence of stem design when planning uncemented femoral stems.

Type: Article
Title: Can version of the proximal femur be used for CT planning uncemented femoral stems?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.medengphy.2023.103985
Publisher version: https://doi.org/10.1016/j.medengphy.2023.103985
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Total hip arthroplasty, 3D-CT planning, Prosthetic femoral version, Uncemented fixation
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
URI: https://discovery.ucl.ac.uk/id/eprint/10169263
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