The Usefulness of Intraoperative Radiography for Prevention of Malalignment of the Cemented Femoral Stem

Ho Hyun Yun; Jung-Ro Yoon; Yong In Lee; Se Hyeok Yun; Kyoung Ho Kim

doi:10.5371/hp.2013.25.2.102

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Yun, Yoon, Lee, Yun, and Kim: The Usefulness of Intraoperative Radiography for Prevention of Malalignment of the Cemented Femoral Stem

Original Article

Hip & Pelvis 2013; 25(2): 102-109.

Published online: 30 June 2013

DOI: https://doi.org/10.5371/hp.2013.25.2.102

The Usefulness of Intraoperative Radiography for Prevention of Malalignment of the Cemented Femoral Stem

Ho Hyun Yun, MD, Jung-Ro Yoon, MD, Yong In Lee, MD, Se Hyeok Yun, MD, Kyoung Ho Kim, MD

Department of Orthopedic Surgery, Seoul Veterans Hospital, Seoul, Korea.

Address reprint request to Ho Hyun Yun, MD. Department of Orthopedic Surgery, Seoul Veterans Hospital, 6-2 Dunchon-dong, Gangdong-gu, Seoul 134-791, Korea. TEL: +82-2-2226-1114, FAX: +82-2-2226-1910, 3188yun@naver.com

Received 16 April 2013 Revised 14 June 2013 Accepted 14 June 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to evaluate the usefulness of our method, which estimated femoral stem alignment using a c-arm when the broach was inserted, for prevention of femoral stem malalignment.

Materials and Methods

A total of 103 hips were enrolled in this study. All patients underwentprimary hip arthroplasty from October 2011 to February 2013. The study was conductedretrospectively. Intraoperative estimated femoral stem alignments and final femoral stem alignments were classified into three groups. Multinomial logistic regression analysis was performed for analysis of factors (age, sex, diagnosis, body mass index, femoral stem size, osteoporosis, and proximal demur geometry) thatmight affect intraoperatively estimated femoral stem alignment.

Results

The distribution of intraoperative estimated femoral stem alignment was 80(78%) in the neutral group, 18(17%) in the varus group, and 5(5%) in the valgus group. The distribution of final femoral stem alignment was 100(97%) in the neutral group, 2(2%) in the varus group, and 1(1%) in the valgus group. There was no statistically significant factor affecting the intraoperatively estimated femoral stem alignment.

Conclusion

Intraoperative estimated femoral stem alignment using a c-arm is an effective method for prevention of femoral stem malalignment.

Keywords: Hip, Arthroplasty, Cemented femoral stem, Malalignment

Figures and Tables

Fig. 1

(A, B) The radiographs show estimated varus femoral stem malalignment is corrected to neutral femoral stem alignment. (C, D) The radiographs show estimated valgus femoral stem malalignment is corrected to neutral femoral stem alignment.

Fig. 2

(A, B) The radiographs show thin cement mantle thickness is expected in the lateral area of distal femoral stem and its corrected condition. (C, D) The radiographs show thin cement mantle thickness is expected in the medial area of distal femoral stem and its corrected condition.

Table 1

The Results of Multinomial Logistic Regression Analysis Associated with Intraoperative Estimated Femoral Stem Malalignment

Table 2

Established Results for Femoral Stem Alignment

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