Comparison of acetabular and femoral component positioning with and without fluoroscopy in direct anterior approach total hip arthroplasty
Bibliographic record
Abstract
Background: The direct anterior approach (DAA) for total hip arthroplasty (THA) continues to increase. Accurate component placement can be guided by intra-operative fluoroscopy, but there is a lack of comprehensive comparative data on final implants guided or not guided by intra-operative fluoroscopy in DAA THA. This study aims to compare acetabular and femoral component positioning along with surgical time in DAA THA with and without intra-operative fluoroscopy. Methods: All patients with DAA THA for osteoarthritis by an arthroplasty surgeon at a university teaching hospital from March 2021 to March 2024 were evaluated. Demographic, implant data, post-operative radiographic measurements and surgical times were compared between fluoroscopy and non-fluoroscopy groups. Results: Overall, 354 patients who had DAA THA were included. In 200 patients, fluoroscopy was not used and in 154 patients, fluoroscopy was used. Groups were compared using 2825 radiographic measurements. There was no significant difference between groups for safe acetabular inclination (p = 0.792) or anteversion (p = 0.906), satisfactory femoral component coronal alignment (p = 0.071), femoral component undersizing (p = 0.476) and leg length discrepancy (p = 0.726). More patients in the fluoroscopy group had femoral offset restored (65.6 %; fluoroscopy vs 54.3 %; non-fluoroscopy, p = 0.038). The surgical time was longer in the fluoroscopy group (60 min; fluoroscopy vs 42 min; non-fluoroscopy, p < 0.001). Conclusion: In DAA THA for osteoarthritis most parameters regarding implant positioning with or without fluoroscopy are not significantly different except for femoral offset. Additionally, surgical time is significantly shorter without the use of fluoroscopy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".