Abstract
The recent introduction of digital radiography has enabled a paradigm shift in intra-operative imaging technology. Rather than deal with the cumbersome process of chemical image processing we can now acquire a high quality digital image in a matter of seconds. The functionality approaches that of fluoroscopy, or even a C-arm, however, a digital system can operate with lower radiation, higher resolution, and perhaps most importantly a larger field of view. These features and the greater ability for post-acquisition, digital image enhancement make it very suitable for use during surgery.
The purpose of this presentation is to illustrate the intra-operative technique and share the overwhelmingly positive experience gathered over the past few years.
The current paradigm in total hip arthroplasty (THA) employs use of post-operative radiography for “outcome assessment.” This unfortunately does not allow the surgeon to evaluate the relevant parameters and make necessary adjustments without returning to the operating room. The new paradigm, however, permits intra-operative guidance and “outcome control.” We now have an opportunity to add a “trial radiograph” to our practice of performing a trial reduction. This provides an immediate and complete preview of what the post-operative film will show. There is now an opportunity, during the course of any hip arthroplasty, to optimise component orientation, sizing, apposition, screw position, limb length, and offset, before leaving the operating room. This can be done with minimal intrusion on normal workflow, adding only a few minutes of operating time.
