Abstract
Total hip arthroplasty restores lost mobility to patients suffering from osteoarthritis and acute trauma. In recent years, navigated surgery has been used to control prosthetic component placement. Furthermore, there has been increasing research on what constitutes correct placement. This has resulted in the definition of a safe-zone for acetabular cup orientation. However, there is less definition with regard to femoral anteversion and how it should be measured. This study assesses the validity of the femoral anteversion measurement method used in imageless navigation, with particular attention to how the neutral rotation of the femur is defined. CT and gait analysis methodologies are used to validate the reference which defines this neutral rotation, i.e., the ankle epicondyle piriformis (AEP) plane. The findings of this study indicate that the posterior condylar axis is a reliable reference for defining the neutral rotation of the femur. In imageless navigation, when these landmarks are not accessible, the AEP plane provides a useful surrogate to the condylar axis, providing a reliable baseline for femoral anteversion measurement.
Highlights
A successful total hip replacement normalizes the biomechanics of the hip joint, enabling a patient to regain mobility without pain or discomfort [1]
This study aimed to assess the reliability of the condylar axis for estimating the neutral rotation of the femur, and whether the normal to the ankle epicondyle piriformis (AEP) plane is coincident with the condylar axis
To assess whether the condylar axis accurately defines the neutral rotation of the femur, the angle between the pelvic medial-lateral axis and the femoral transepicondylar axis was measured in the transverse plane
Summary
A successful total hip replacement normalizes the biomechanics of the hip joint, enabling a patient to regain mobility without pain or discomfort [1]. Normalization of hip joint biomechanics is dependent upon achieving joint stability and the ideal range of motion for a patient to fulfil their daily activities [2]. The condylar axis is used to define the neutral rotation of the femur, and is coincident with the coronal plane of the hip joint [26]. This study aimed to assess the reliability of the condylar axis for estimating the neutral rotation of the femur, and whether the normal to the AEP plane is coincident with the condylar axis If both are true, the basis on which femoral anteversion is measured in imageless navigation can be considered valid and reliable
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