Clin Orthop Surg.  2014 Jun;6(2):153-158. 10.4055/cios.2014.6.2.153.

Accurate Leg Length Measurement in Total Hip Arthroplasty: A Comparison of Computer Navigation and a Simple Manual Measurement Device

• Ogawa K
• Kabata T
• Maeda T
• Kajino Y
• Tsuchiya H

• KMID: 1784660
• DOI: http://doi.org/10.4055/cios.2014.6.2.153

Abstract

BACKGROUND
Several studies have shown that better placement of the acetabular cup and femoral stem can be achieved in total hip arthroplasty (THA) by using the computer navigation system rather than the free-hand alignment methods. However, there have been no comparisons of the relevant clinical advantages in using the computer navigation as opposed to the manual intraoperative measurement devices. The purpose of this study is to determine whether the use of computer navigation can improve postoperative leg length discrepancy (LLD) compared to the use of the measurement device.
METHODS
We performed a retrospective study comparing 30 computer-assisted THAs with 40 THAs performed using a simple manual measurement device.
RESULTS
The postoperative LLD was 3.0 mm (range, 0 to 8 mm) in the computer-assisted group and 2.9 mm (range, 0 to 10 mm) in the device group. Statistically significant difference was not seen between the two groups.
CONCLUSIONS
The results showed good equalization of the leg lengths using both computed tomography-based navigation and the simple manual measurement device.

Keyword

Total hip arthroplasty; Leg length discrepancy; Computed tomography-based navigation; Device

MeSH Terms

Acetabulum/surgery
Adult
Aged, 80 and over
Arthroplasty, Replacement, Hip/instrumentation/*methods
Body Weights and Measures
Female
Femur/surgery
Humans
Leg
Leg Length Inequality/*surgery
Male
Middle Aged
Retrospective Studies
Surgery, Computer-Assisted
Young Adult

Figure

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  Fig. 1 PCA limb lengthening gauge. The left pin goes into the acetabulum, and the right pin into the femur. A stopper and a thread cutting are added to the pin for the acetabulum.

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  Fig. 2 (A) Intraoperative photograph in the device group. The lengthening axis is marked and the device is placed. (B) A scheme showing the location of the device.

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  Fig. 3 (A) Computer-assisted group, p < 0.001, r = 0.88. (B) Device group, p < 0.001, r = 0.89.

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  Fig. 4 Postoperative leg length discrepancy (LLD). In the computer-assisted group, we had fewer cases with a residual discrepancy greater than 6 mm and a lower number of cases with postoperative over-lengthening.

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