A technique for accurate reproduction of the femoral anteversion during primary total hip arthroplasty

Accurate reproduction of the femoral anteversion is important in achieving stability of the prosthetic joint in total hip arthroplasty (THA), while placement of the femoral stem in excessive anteversion or retroversion results in an increased incidence of dislocation. Due to a number of factors, the current surgical technique results in significant variation between the anatomical and the surgically reconstructed femoral anteversion. This technical note describes a method to reproduce the normal anatomical femoral anteversion accurately in any case of primary THA. The method is based on the idea that the initial stages of femoral canal preparation can be completed before the femoral neck is osteotomised and therefore at a stage when the femoral head and neck are still accessible and can be used as landmarks for accurate reconstruction of the femoral anteversion. The described technique for accurate reconstruction of the anatomical version of the femoral head is indicated for all cases of primary THA where reproduction of the normal anatomical centre of rotation of the hip joint is a principal aim.