The external obturator footprint as a landmark in total hip arthroplasty through a direct anterior approach: a CT-based analysis

Rüdiger, HA; Fritz, B; Impellizzeri, FM; Leunig, M; Pfirrmann, CW; Sutter, R

The external obturator footprint as a landmark in total hip arthroplasty through a direct anterior approach: a CT-based analysis

Rüdiger, HA Fritz, B Impellizzeri, FM

Leunig, M Pfirrmann, CW Sutter, R

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Publication Type:: Journal Article
Citation:: HIP International, 2019, 29 (1), pp. 96 - 101
Issue Date:: 2019-01-01

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Field	Value	Language
dc.contributor.author	Rüdiger, HA	en_US
dc.contributor.author	Fritz, B	en_US
dc.contributor.author	Impellizzeri, FM https://orcid.org/0000-0002-1703-2573	en_US
dc.contributor.author	Leunig, M	en_US
dc.contributor.author	Pfirrmann, CW	en_US
dc.contributor.author	Sutter, R	en_US
dc.date.issued	2019-01-01	en_US
dc.identifier.citation	HIP International, 2019, 29 (1), pp. 96 - 101	en_US
dc.identifier.issn	1120-7000	en_US
dc.identifier.uri	http://hdl.handle.net/10453/135725
dc.description.abstract	© The Author(s) 2018. Background: Anatomical landmarks for templating of total hip arthroplasty (THA) that are visible both during surgery and on radiographs are rare. If surgery is performed through a direct anterior approach the external obturator tendon (EO) is consistently visible. To use this point as a reference the exact position and dimensions of the footprint need to be known. Aim: To determine the location and dimension of the EO footprint on pelvic radiographs by correlating the EO anatomy in CT scans with conventional radiographs. Methods: CT scans and radiographs of 200 patients were analysed. The EO tendon was identified on CT scans; the height of its footprint, and its distance to the tip of the greater trochanter and to the anatomical axis of the femur was measured. The accuracy and inter-rater reliability in the identification of the EO footprint was determined. Results: The EO tendon was visible on all CT scans and it’s footprint was identifiable on all corresponding radiographs. It’s cranio-caudal dimension was 6.4 ± 1.4 mm. It’s distance to the tip of the greater trochanter was 16.0 ± 3.1 mm. The EO footprint was located 5.2 ± 3.7 mm lateral to the femoral anatomical axis. There was no significant difference regarding the accuracy of EO footprint localisation on radiographs among the 2 readers. Conclusion: The EO footprint on the greater trochanter is consistently visible on CT scans and radiographs. As the variability of the footprint dimension is small, this structure may serve as a useful landmark in THA, particularly when performed through a direct anterior approach.	en_US
dc.relation.ispartof	HIP International	en_US
dc.relation.isbasedon	10.1177/1120700018761320	en_US
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject.classification	Orthopedics	en_US
dc.subject.mesh	Pelvis	en_US
dc.subject.mesh	Femur	en_US
dc.subject.mesh	Tendons	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Tomography, X-Ray Computed	en_US
dc.subject.mesh	Radiography	en_US
dc.subject.mesh	Arthroplasty, Replacement, Hip	en_US
dc.subject.mesh	Retrospective Studies	en_US
dc.subject.mesh	Reproducibility of Results	en_US
dc.subject.mesh	Adolescent	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Young Adult	en_US
dc.title	The external obturator footprint as a landmark in total hip arthroplasty through a direct anterior approach: a CT-based analysis	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	29	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	0903 Biomedical Engineering	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Sports and Exercise Science
utslib.copyright.status	closed_access	*
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	29	en_US

Abstract:

© The Author(s) 2018. Background: Anatomical landmarks for templating of total hip arthroplasty (THA) that are visible both during surgery and on radiographs are rare. If surgery is performed through a direct anterior approach the external obturator tendon (EO) is consistently visible. To use this point as a reference the exact position and dimensions of the footprint need to be known. Aim: To determine the location and dimension of the EO footprint on pelvic radiographs by correlating the EO anatomy in CT scans with conventional radiographs. Methods: CT scans and radiographs of 200 patients were analysed. The EO tendon was identified on CT scans; the height of its footprint, and its distance to the tip of the greater trochanter and to the anatomical axis of the femur was measured. The accuracy and inter-rater reliability in the identification of the EO footprint was determined. Results: The EO tendon was visible on all CT scans and it’s footprint was identifiable on all corresponding radiographs. It’s cranio-caudal dimension was 6.4 ± 1.4 mm. It’s distance to the tip of the greater trochanter was 16.0 ± 3.1 mm. The EO footprint was located 5.2 ± 3.7 mm lateral to the femoral anatomical axis. There was no significant difference regarding the accuracy of EO footprint localisation on radiographs among the 2 readers. Conclusion: The EO footprint on the greater trochanter is consistently visible on CT scans and radiographs. As the variability of the footprint dimension is small, this structure may serve as a useful landmark in THA, particularly when performed through a direct anterior approach.

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http://hdl.handle.net/10453/135725