title: Comparison of femoral stem alignment in primary total hip replacement by transtrochanteric and posterior approach.
abstract: BACKGROUND
  In this study we have compared the femoral component alignment in primary cemented THR performed by a single surgeon using the same implant by trochanteric osteotomy and posterior approach in 50 consecutive cases.
  
  
  METHODS
  The femoral component was compared in sagital and coronal planes on plane X-rays. The femoral stem position was classified as neutral, varus or valgus in the sagital plane. In the coronal plane the femoral stem was graded as neutral, stem pointing anteriorly or stems pointing posteriorly. Chi square test was used for the statistical significance of the findings.
  
  
  RESULTS
  The number of stems in neutral position in AP radiograph (coronal plane) was 36 and 42 respectively in osteotomy and posterior approach. 6 stems were in varus/valgus angle of ≥5° in osteotomy group and 1 stem in the posterior approach group had a varus/valgus angle of ≥5° (p value 0.05). In the lateral radiograph (sagital plane) 45 and 43 stems respectively in osteotomy and posterior approach were in neutral position (p value 0.37).
  
  
  CONCLUSIONS
  There is no statistically significant difference in the positioning of the femoral stem in the sagital plane by either trochanteric osteotomy or posterior approach to the hip. The positioning of the femoral stem in the coronal plane is better with the posterior approach as compared to trochanteric osteotomy
authors.affiliation: Wrightington Hospital, Wigan, Lancashire, UK. kowshikjain@gmail.com
authors.forename: Kowshik
authors.initials: K
authors.lastname: Jain
authors.forename: Siva
authors.initials: S
authors.lastname: Subramanian
authors.forename: John
authors.initials: J
authors.lastname: Hodgkinson
authors.forename: Mukesh
authors.initials: M
authors.lastname: Hemmady
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D005272:Femur Neck / Q000000981:diagnostic imaging; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods; D017755:Prosthesis Fitting / Q000379:methods*; D014057:Tomography, X-Ray Computed