Keywords:
Musculoskeletal joint, Extremities, Musculoskeletal system, CT, Plain radiographic studies, MR, Normal variants, Complications, Prostheses, Outcomes
Authors:
V. Augustinavicius, E. Mockiene, J. Anuzis, A. Brazaitis, G. Kvederas; Vilnius/LT
DOI:
10.26044/essr2019/P-0179
Background
Total hip arthroplasty is the most successful method of treatment for patients with severe osteoarthritis,
femoral head avascular necrosis or proximal femur fractures.
Total hip arthroplasty systems are modular and allow better selection of components for every patient.
Malposition of prosthesis components results in impingement syndrome,
accelerated wear or unexplained pain.
The main role of imaging is to assess the position of the components and their relationship to surrounding structures.
Most radiological measurements can be assessed in standard pelvic x-ray.
It is nessesary to obtain correct pelvic AP X-ray to evaluate prothesis position. The main measurements that are used to evaluate hip prosthesis position are acetabular inclination and anteversion,
valgus/varus variation,
femur head rotation center,
leg length difference.
CT enables to measure the angles in 3D space,
making an assessment of femoral anteversion and femoral torsio possible.
We illustrate the main radiological techniques to obtain these measurements,
discuss common pitfalls and their impact on clinical management.