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Reliability of a simple fluoroscopic image to assess leg length discrepancy during direct anterior approach total hip arthroplasty

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World Journal of Orthopedics 2021年第11期12卷 850-858页

作者： Sandi Caus Hailee Reist Christopher Bernard michael blankstein Nathaniel J Nelms The Robert Larner College of Medicine University of VermontBurlingtonVT 05405United States Department of Orthopaedics and Rehabilitation Unviversity of VermontBurlingtonVT 05405United States

BACKGROUND Direct anterior approach(DAA)total hip arthroplasty(THA)in a supine position provides a unique opportunity to assess leg length discrepancy(LLD)intraoperatively with *** fluoroscopic techniques are useful but are generally complicated or *** the use of multiple techniques for leg length assessment,LLD continues to be a major post-operative source of patient dissatisfaction further emphasizing the importance of near-anatomic *** utility of an alternative direct measurement of LLD on an intra-operative fluoroscopic pelvic image during DAA THA has not been *** To determine the reliability of a novel simple intra-operative measurement of LLD using a parallel line technique on a single fluoroscopic digital image of the *** One hundred and seventy-one patients who underwent DAA THA were included for ***-operative fluoroscopic and post-operative anterior-posterior radiographs were imported to TraumaCad and calibrated for LLD *** was measured on each image using the right-left hip differences in lesser trochanter to pelvic reference line *** reference points included the teardrops and *** LLD was compared to the gold-standard measurement of LLD measured on a post-operative *** Mean absolute difference in teardrop referenced LLD between fluoroscopic and post-operative radiographs was 2.17 mm and based on the ischia mean absolute difference was 2.63 *** regression of fluoroscopic and post-operative radiograph LLD based on teardrop and ischia LLD found r2 values of 0.57 and 0.84,*** absolute difference between fluoroscopic and postoperative x-ray LLD was within 5 mm in 95%of cases regardless of pelvic *** This study demonstrates that a single fluoroscopic view obtained during DAA THA for leg length assessment is clinically useful.

关键词： Leg-length discrepancy Total hip arthroplasty Intra-operative fluoroscopy Direct anterior approach Limb asymmetry

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