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Purpose: Optimal positioning of acetabular components is crucial for maintaining stability of THA. Postoperative assessment of acetabular anteversion is a vital but difficult task. Various methods have been devised with good results for measuring anteversion on plain radiographs but these methods are either too complicated or require special objects like scientific calculators, special protectors, tables, etc. A new simplified method of measuring anteversion on plain radiographs was created based on basic geometry., Methods: Anteversion of acetabular components was estimated on computer generated images of the acetabular cup by our method and compared with two previously established methods of Liaw and Pradhan. Measurement was done at 400 different positions of acetabular cup and compared with actual values. Another analysis was done after adding the femoral head to the acetabular component, thus obscuring some of the acetabular rim., Results: Mean and standard deviation of error for our method was 0.77° ± 0.75° as compared to 0.93° ± 0.86° and 0.72° ± 0.68° for the methods of Liaw and Pardhan, respectively, with no significant differences from actual values. Maximal errors for our method, Liaw's and Pradhan's method were 3°, 4°, and 2.91°, respectively. On analysis, after the adding femoral head, there was a significant error of measurement with Liaw's method, while our method as well as Pardhan's remained accurate. All methods showed high inter- and intraobserver reliability., Conclusion: Our new simplified method of measuring acetabular anteversion on plain radiographs is acceptable in comparision to other established methods and requires only routinely used goniometer and calliper.

Although accurate measurement of cup anteversion in hip replacement requires CT scans, however, its routine application, especially during follow-up, remains economically and ethically unreasonable. Thus, several methods have been devised for making this measurement on plain radiographs. In recent years, several ways have been adopted using software on digital radiographs. We present one such method which uses open access mathematical software GeoGebra. Anteversion was measured on 72 radiographs (36 cemented; 36 uncemented) by three different observers using this software. One observer repeated measurements at three weeks interval. The intraclass correlation coefficient for interobserver variability and intraobserver variability was 0.982 (0.973–0.989) and 0.986 (0.978–0.991) respectively. There was a significant difference in the reliability of the method for cemented and uncemented cups with higher reliability for cemented cups (p < 0.001). GeoGebra software can be used as a reliable alternative for measuring acetabular cup anteversion on good quality well centred digital radiographs of the pelvis. [ABSTRACT FROM AUTHOR]

Introduction: Open reduction and internal fixation of acetabular fracture is associated with significant blood loss. Although Tranexamic acid (TXA) infusion effectively reduces perioperative blood loss and transfusion requirements in elective orthopedic surgery, its efficacy in major orthopedic trauma surgery is controversial.Material and Methods: Sixty-three patients undergoing open reduction and internal fixation of acetabular fracture were randomized into either TXA (n = 36) or placebo (n = 27) group. TXA group received a bolus dose of TXA (10 mg/kg) 15 min prior to incision, followed by another similar dose after 3 h of surgery. The placebo group received the same volume of normal saline similarly. All patients were operated on by a single pelviacetabular surgeon with a uniform perioperative protocol. The intraoperative blood loss, drain output, the number of blood transfusions, postoperative hemoglobin (Hb) drop, and hematocrit (Hct) drop were calculated.Results: Both groups were similar in relation to age, sex, BMI, preoperative Hb, the timing of surgery, fracture pattern, operative time, and surgical approaches. The mean postoperative Hb was 10.35 ± 1.36 gm% in TXA group and 9.74 ± 1.98 gm% in placebo group (p-value 0.158). There were no differences in intraoperative blood loss (438.11 ml vs. 442.81, p=.947), drain output (131.94 ml vs. 129.63, p=.870), and blood transfusion (8 patients vs. five patients, p=.719) between the groups. The drop in Hb and Hct in the postoperative period was also statistically not significant between the groups.Conclusion: There is no significant reduction in blood loss and blood transfusion with the use of intravenous Tranexamic acid in open reduction and internal fixation of acetabular fractures. [ABSTRACT FROM AUTHOR]