Stem torsion in total hip replacement

Figures & data

Figure 1. Stem antetorsion measurement. The mechanical axis was defined by 2 points: the center of the femoral head and the center of the caudal contact points of the femoral condyles. “Antetorsion plane” was defined by a third point on the prosthesis representing the direction of the neck. A caudal condylar plane was created orthogonal to the mechanical axis. The angle between the condylar axis projected on this plane and the normal to the “antetorsion plane” subtracted by 90° gave the torsion angle.

Figure 2. Range of stem torsion in 60 hips.

Figure 3. Distribution of stem torsion in 60 hips. The 10–15° of antetorsion shown in green is considered to be the normal stem antetorsion.

Femoral antetorsion measurements

Author	Patients	Range	Mean (SD)	Method	Gender
Maruyama et al. (2001)	100 pelvises, normal joints	–15° to 34°	10° (9)	craniometer, osteometric board	no significant difference in antetorsion
Anda et al. (1991)	33 dysplastic hips, CE < 20°	2° to 45°	20° (12)	2D CT scans
Husmann et al. (1997)	310 hips with osteoarthritis	0° to 45°	25° (9)	2D CT scans
Sugano et al. (1998)	30 patients without deformity	3° to 50°	20° (9)	3D reconstructed CT scans	M: 17° ± 7W: 23° ± 11 but not significant
Sariali et al. (2009)	223 patients with osteoarthritis	0° to 50°	22° (9)	3D reconstructed CT scans

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