Abstract

Reduced limb length discrepancy and more accurate cup positioning are purported benefits of using fluoroscopy for total hip arthroplasty (THA). The authors compared limb length discrepancy and cup position in 200 patients (group I, posterior approach without fluoroscopy; group II, anterior supine approach with fluoroscopy) who underwent primary THA. Mean limb length discrepancy was 2.7 mm (SD, 5.2 mm; range, -9.8 to 20.9 mm) and 0.7 mm (SD, 3.7 mm; range, -11.8 to 10.5 mm) for groups I and II, respectively (P=.002). In group I, 7% of hips had limb length discrepancy greater than 1 cm compared with 3% in group II. Mean cup inclination measured 40.8° (SD, 5.0°; range, 26.1°-53.7°) in group I and 43.4° (SD, 5.6°; range, 31.3°-55.9°) in group II (P=.008). In group I, 96% of cups had inclination within 10° of the mean compared with 92% in group II (P=.24). Mean anteversion measured 35.3° (SD, 7.1°; range, 17.8°-60.7°) in group I and 25.9° (SD, 8.2°; range, 1.5°-44.8°) in group II (P=.0001). In group I, 87% of hips exhibited anteversion within 10° of the mean compared with 76% in group II (P=.045). Although the anterior approach with intraoperative fluoroscopy reduced mean limb length discrepancy, the clinical significance of this reduction is unclear. Fluoroscopy reduced the incidence of limb length discrepancy greater than 1 cm. However, the use of fluoroscopy did not help to improve the precision of cup positioning.

View details for DOI 10.3928/01477447-20150504-54

View details for Web of Science ID 000356148900005

View details for PubMedID 25970364