Digital Radiography During Total Hip Arthroplasty: Early Results With a Combined Anteversion Technique

Ideal component positioning is critical to outcomes in total hip arthroplasty. We describe our early results using digital radiographs with a combined ante -version technique. We report the incidence of component adjustments made based on digital radiographs and show how this technology can be used dur-ing patient positioning to achieve appropriate starting pelvic alignment. We reviewed 176 cases of primary total hip arthroplasty performed by a single arthroplasty surgeon using a posterior approach. Mean follow-up was 1 year (range, 3 months to 2.7 years). Digital radiographs (Surgeon's Checklist Hip; Radlink) and a combined anteversion technique were used for component po-sitioning. For a subset of 100 patients, we recorded the incidence of pelvic mal-positioning found on digital radiographs obtained during initial positioning of the patient. For this same subset we also detail the component changes made as a result of intraoperative radiographs during trialing. Among 176 cases we have had 2 (1.1%) postoperative dislocations. Both underwent closed reduc-tion with no further dislocation. We have had no revisions and 1 intraoperative calcar fracture. For our 100-case subset, digital radiographs during patient po-sitioning identified pelvic malpositioning greater than 5?? (coronal or axial plane) among 17% of cases. During trialing, we made component adjustments 71% of the time because of findings on intraoperative imaging. Digital radiography can be a valuable tool for component positioning during total hip arthroplasty. We experienced favorable early outcomes and show the utility of digital radio-graphs for proper pelvic positioning and making intraoperative adjustments to achieve optimal component placement. [Orthopedics. 2022;45(4):221-226.]