Reliability of a New Method for Evaluating Femoral Stem Positioning After Total Hip Arthroplasty Based on Stereoradiographic 3D Reconstruction

The goal of this study was to validate a new method for determining femoral stem positioning based on 3D models derived from the EOS biplanar system. Independents observers measured stem anteversion and femoral offset using CT scan and EOS system of 28 femoral stems implanted in composite femurs. In parallel, the same parameters were measured on biplanar lower limb radiographs acquired from 30 patients who had undergone total hip arthroplasty. CT scanner and biplanar X-ray measurements on composite femurs were highly correlated: 0.94 for femoral offset (P < 0.01), 0.98 for stem anteversion (P < 0.01). The inter and intra-observer reproducibility when measuring composite bones was excellent with both imaging modalities as when measuring femoral stem positioning in patients with the biplanar X-ray system.