The Utility of Lesser Trochanter Version to Estimate Femoral Anteversion in Total Hip Arthroplasty: A Three-Dimensional Computed Tomography Study

Objective: Femoral anteversion is an important parameter that can prevent complication following total hip arthroplasty (THA) caused by improper positioning of the implant. However, assessing the femoral anteversion can be challenging in situations with significant defect of the femoral neck. In this study, the lesser trochanter version was nominated as alternative parameter to femoral anteversion. So, the main objective of this study is to determine whether the femoral anteversion correlates with the lesser trochanter version. Design: Retrospective study. Methods: Three-dimensional images of 100 femora were generated and their femoral anteversion and lesser trochanter version was measured. Correlation between the parameters were calculated. Results: The mean lesser trochanter version was 38.54 degrees +/- 7.86 degrees (mean +/- SD), while the mean femoral anteversion was 11.84 degrees +/- 10.06 degrees. The lesser trochanter version was inversely correlated with the femoral anteversion with a correlation coefficient of -0.72. Conclusions: The lesser trochanter should be considered as an additional bony landmark to assess proper implant positioning in THA.