Computed Tomographic Measurement of Cementless Total Hip Replacement Implant Orientation.

CT-based multiplanar measurement of BFX total hip implant orientation is highly repeatable and surpasses radiographic assessment.

This retrospective study evaluated a computed tomography (CT)-based technique for measuring implant orientation following cementless total hip replacement (THR) using the BioMedtrix Biologic Fixation (BFX) system in dogs. Postoperative CT studies from 15 dogs that received a 24 mm BFX acetabular cup and BFX stem were analyzed. Multiplanar reconstructed CT images were standardized to generate consistent pelvic and femoral reference positions, enabling sequential measurement of cup open face version, angle of lateral opening (ALO), cup inclination, and stem anteversion. Two independent observers each performed three measurements per case on anonymized, randomized studies. Intraclass correlation coefficients (ICCs) for intraobserver repeatability were excellent across all parameters, ranging from 0.97 to 1.0 for both observers. Interobserver ICCs were equally high (0.99–1.0), demonstrating outstanding reproducibility between evaluators. The technique offers a significant advantage over conventional radiography by enabling quantification of three-dimensional implant orientation parameters—particularly stem anteversion and cup version—that cannot be reliably assessed on standard radiographic projections. Accurate implant orientation measurement is clinically relevant because malpositioning of the acetabular cup or femoral stem may contribute to complications such as implant luxation, impingement, and accelerated wear. This CT-based methodology provides an objective, highly reproducible tool for postoperative assessment of BFX THR implant positioning in dogs, which may support outcome analysis, complication investigation, and surgical technique refinement in veterinary orthopedic practice.

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