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. 2020 Aug 3;21(1):516.
doi: 10.1186/s12891-020-03545-2.

A Surgeon's handedness in direct anterior approach-hip replacement

Xiangpeng Kong  1 , Minzhi Yang  1   2 , Alvin Ong  3 , Renwen Guo  1 , Jiying Chen  1 , Yan Wang  4 , Wei Chai  5
Affiliations

A Surgeon's handedness in direct anterior approach-hip replacement

Xiangpeng Kong et al. BMC Musculoskelet Disord. .

Abstract

Background: The impact of handedness on clinical outcomes was easily overlooked in hip replacement. This study aimed to find whether the component positioning and hip function were affected by the handedness in total hip arthroplasty (THA) through direct anterior approach (DAA).

Methods: Total 102 patients who underwent bilateral DAA-THAs simultaneously between May 2016 and November 2018 in our institute were reviewed. All surgeries were operated by one right-handed surgeon. Their demographic, cup positioning, stem alignment, femoral stem fit, Harris hip score (HHS), intraoperative and postoperative complications were used to evaluate the role of handedness in DAA.

Results: The inclination of left cups was significantly larger than that of right cups (42.61 ± 7.32 vs 39.42 ± 7.19, p = 0.000). The stem fit of left femur was significantly larger than that of right femur (84.34 ± 4.83 vs 82.81 ± 6.07, p = 0.043). No significant differences in safe zone ratio, HHS and complications between bilateral hips were found.

Conclusions: A surgeon's handedness had significant impact on cup's inclination and femoral stem fit in DAA-THA. However, there were no significant differences of cup malpositioning, stem alignment, hip function scores and complications between bilateral DAA-THAs.

Keywords: Cup positioning; Direct anterior approach; Femoral stem fit; Handedness; Total hip arthroplasty.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of patient enrollment in this study
Fig. 2
Fig. 2
The method of measuring anteversion and inclination of acetabular cups on plain radiograph of pelvic with Orthoview Software
Fig. 3
Fig. 3
Stem alignment was assessed by measuring the angle “α” between the axis of stem and femur in right hip. Femoral stem fit was assessed by calculating the ratio of stem width to cavity diameter at three level: proximal level (parallel to the upper border of the lesser trochanter); mid-stem and distal level (1 cm proximal to the distal end of stem). The three levels were perpendicular to the tangent line of lateral femoral cortex in left hip
Fig. 4
Fig. 4
A scatter plot of anteversion and inclination of acetabular cup refers to the Lewinnek safe zone. Left: blue plot; right: red plot
See this image and copyright information in PMC

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