Evaluation of Native Femoral Neck Version and Final Stem Version Variability in Patients With Osteoarthritis Undergoing Robotically Implanted Total Hip Arthroplasty

Abstract Background Combined anteversion in total hip arthroplasty influences both dislocation risk and range of motion. One of its components, stem version (SV), could be dictated by many factors, from native femoral anatomy to stem geometry and surgeon’s choice. In the present multicenter study, robotic technology was used to assess the influence of native femoral version on final SV and combined anteversion using a straight, uncemented stem. Methods Three hundred sixty-two patients undergoing total hip arthroplasty were enrolled from 3 different orthopedic centers from 2012 and 2016. All patients underwent computed tomography planning with measurement of femoral neck version (FNV) and intraoperative measurement of stem version (SV), acetabular component version (AV), and combined version (CV) with robotic instrumentation. Results Mean FNV was 5.0° ± 9.6°, and SV was 6.4° ± 9.7°. The average difference between FNV and SV was 1.6° ± 9.8°. A moderate correlation was found between FNV and SV (R = 0.48, P P P P Conclusion With the use of an uncemented, single-wedge, straight stem, SV is highly variable. Despite being moderately correlated with native FNV, SV can be partially influenced by the surgeon. A low SV could be hardly corrected, bringing high risk of low CV.