Radiographic Characteristics of the Femoral Nutrient Artery Canals in Total Hip Arthroplasty using Cementless Femoral Stem
https://doi.org/10.5704/MOJ.2303.015
- Author:
Roh YH
1
;
Yoo SJ
1
;
Choi TH
1
;
Nam KW
2
Author Information
1. Department of Orthopaedic Surgery, Jeju National University Hospital, Jeju City, South Korea
2. Department of Orthopaedic Surgery, Uijeongbu Eulji Medical Center, Uijeongbu, South Korea
- Publication Type:Journal Article
- Keywords:
hip arthroplasty, nutrient artery canal, periprosthetic femoral fracture, cementless stem, radiographic study
- From:Malaysian Orthopaedic Journal
2023;17(No.1):124-132
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Accurate diagnosis of undisplaced
periprosthetic femoral fracture (PFF) after hip arthroplasty is
crucial, as overlooked PFF may affect its treatment and
prognosis. The undisplaced PFF is often difficult to
distinguish from radiolucent lines of nutrient artery canal
(NAC) of the femur present on post-operative radiographs.
We aimed to identify the radiographic features of NAC to
distinguish them from PFFs.
Materials and methods: In this retrospective radiological
study, a total of 242 cases in 215 patients with hip
arthroplasty were analysed using pre-operative and postoperative anteroposterior (AP) and translateral (TL)
radiographs. Interobserver agreement of the measurements
was assessed by two independent experienced orthopaedic
surgeons. The kappa value ranged from 0.83 to 0.87,
indicating strong agreement according to the Landis and
Koch criteria.
Results: The NACs were found pre-operatively in 94
(39.8%) cases on AP views and in 122 cases (50.4%) on TL
views. The radiolucent lines were observed post-operatively
in 42 (17.4%) on AP views and 122 (50.4%) on the TL
views. three cases (1.2%) had a fracture around the stem that
were detected on radiographs. One case with PFF presented
simultaneously with NAC on the immediate post-operative
radiographs. All patients were treated by conservative
measures, and the radiolucent lines did not appear on followup radiographs.
Conclusion: It is not easy to differentiate undisplaced PFFs
that can occur after hip arthroplasty operation from NACs.
However, accurate diagnosis is possible through careful
observation and comparison of pre-operative and postoperative radiologic images
- Full text:16.2023my1302.pdf
