A Useful Anatomical Reference Guide for Stem Anteversion during Total Hip Arthroplasty in the Dysplastic Hip

Computed tomography scans of 50 dysplastic hips were obtained and reconstructed using preoperative planning software for total hip arthroplasty. The anteversion of the stem implanted parallel to the line connecting the trochanteric fossa and the middle of the medial cortex of the femoral neck (T line) was measured. The cutting heights of 5 mm and 10 mm above the lesser trochanter were simulated. The mean difference of the anteversion of the stem using the T line and the native femoral anteversion was 2.7° (95% CI: 1.0°-4.5°) and 3.5° (95% CI: 1.5°-5.5°) at cutting heights of 5 mm and 10 mm respectively. An anteversion using a T line is compatible with native femoral anteversion even in developmental dysplasia of the hip.