Digital protractor as an intraoperative guide to cup anteversion in total hip arthroplasty

BMC Surg. 2024 Jan 18;24(1):27. doi: 10.1186/s12893-023-02297-9.

Abstract

Introduction: To explore if digital protractor could guide the anteversion of acetabular cup during primary THA and make it consistent with preoperative.

Methods: We retrospectively reviewed 172 cases of primary THA with direct anterior approach (DAA) over 2 years. The anteversion of acetabular cup were measured from computed tomography (CT) scan preoperative and de-identified plain radiographs postoperative by two blinded investigators who were not involved in the surgery. The effect of the digital protractor on the anteversion was determined using regression analysis.

Results: The mean anteversion for the THAs in digital protractor group was 15.5°and 21.4°in control group (P < 0.01). The mean anteversion bias for the THAs in digital protractor group was 1.59° and 6.63° in control group (P < 0.01).Regression analysis identified a 10.7% difference in anteversion due to the use of digital protractor (P < 0.01), and THAs performed without digital protractor were six times more likely to result in anteversion of > 25°. The correlation coefficient for the interobserver reliability of the measurement of the two investigators was 0.94.

Conclusion: The digital protractor is a practical tool in the DAA for THA to determine the anteversion of the acetabular prosthesis.

Keywords: Anteversion; Digital protractor; Direct anterior approach; Total hip arthroplasty.

MeSH terms

  • Acetabulum / diagnostic imaging
  • Acetabulum / surgery
  • Arthroplasty, Replacement, Hip* / methods
  • Hip Prosthesis*
  • Humans
  • Reproducibility of Results
  • Retrospective Studies