Intraoperative Radiography of Pelvis Position, Femoral-Acetabular Bone Preparation and Implant Size-Orientation During Canine Total Hip Arthroplasty

Introduction: Intraoperative imaging of canine total hip arthroplasty allows for assessment of pelvis positioning, acetabular cup placement and femoral bone preparation with optimized implant sizing, orientation and insertion depth. This clinical series consisted of 34 consecutive patients undergoing 40 primary, BFX cementless (78%) or hybrid cementless cup-cemented CFX stem (22%) THA during an 8-month period.

Materials and Methods: Outcomes evaluated included (1) number of images, X-ray exposure and time for patient positioning, cup assessment and evaluation of the femoral bone preparation-implant position, (2) changes to acetabular cup position and femoral reamer-broach orientation, (3) femoral stem size, canal fit and fill, (4) intraoperative complications, (5) major postoperative complications within 90 days of surgery, and (6) absolute and relative increases in total surgery and anaesthesia times.

Results: Initial preoperative patient positioning was acceptable in 37.5% and required an average of 3.4 images. Evaluation and adjustments to acetabular cup position required 5.8 images with changes made to BFX cup orientation in 60%. Evaluation of femoral reaming and broach orientation required 6.3 images with changes made in 87% of BFX stems. Intraoperative imaging added a mean of 8.7 and 11.2 minutes, respectively, to total surgery and anaesthesia times. There were no intraoperative or short-term 90-day postoperative complications.

Discussion/Conclusion: Intraoperative THA radiography is associated with a brief learning curve, is simple to perform, has a low procedural cost and may be a method for optimizing both acetabular cup and femoral stem implant size-position and avoidance of intra- and short-term postoperative complications.

Acknowledgment

Two of the authors are consultants and course instructors for BioMedtrix/Movora.

 

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Publication History

Article published online:
15 July 2025