A comparison of radiographic leg-length and offset discrepancies between 2 intraoperative measurement techniques in anterior total hip arthroplasty  Daniel.

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A comparison of radiographic leg-length and offset discrepancies between 2 intraoperative measurement techniques in anterior total hip arthroplasty  Daniel C. Austin, MD, MS, Brendan E. Dempsey, MS, Samuel T. Kunkel, MD, MS, Michael T. Torchia, MD, MS, David S. Jevsevar, MD, MBA  Arthroplasty Today  DOI: 10.1016/j.artd.2018.09.005 Copyright © 2018 The Authors Terms and Conditions

Figure 1 The transverse rod technique. An intraoperative radiograph is taken with the trial implants in place with a metal rod aligned across the ischial tuberosities. The apparent bend of the straight rod is an artifact due to parallax from using fluoroscopy. The relative position of the intersection between the metal rod and the lesser trochanters is judged on the operative and nonoperative sides to assess the relative leg lengths. The femoral offset is judged visually between the 2 sides. Arthroplasty Today DOI: (10.1016/j.artd.2018.09.005) Copyright © 2018 The Authors Terms and Conditions

Figure 2 The radiograph overlay technique. (a) The preoperative radiograph, taken after the patient was positioned on the operating table, with the reference landmarks appropriately marked in ink. (b) The second radiograph, taken after the trial implants were in place, overlaid on the preoperative image. The close proximity of the reference lines indicates successful recreation of both leg length and femoral offset. Arthroplasty Today DOI: (10.1016/j.artd.2018.09.005) Copyright © 2018 The Authors Terms and Conditions

Figure 3 Measurement technique used within the study. Line x was drawn to intersect the inferior portion of the teardrops and is used to anchor the limb-length measurements. Line z is a trans-teardrop line and is used to anchor the offset measurements as a medial reference. Line db is the radiographic limb length within the measurement algorithm. Line ae + af is the radiographic offset within the measurement algorithm. Arthroplasty Today DOI: (10.1016/j.artd.2018.09.005) Copyright © 2018 The Authors Terms and Conditions

Figure 4 Flowchart of the included and excluded procedures. Arthroplasty Today DOI: (10.1016/j.artd.2018.09.005) Copyright © 2018 The Authors Terms and Conditions