scholarly journals Kinematic pelvic tilt during gait alters functional cup position in total hip arthroplasty

2021 ◽  
Author(s):  
Markus Weber ◽  
Franz SuessEng ◽  
Seth A. Jerabek ◽  
Matthias Meyer ◽  
Joachim Grifka ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Total Hip ◽  
Cup Position

scholarly journals Accuracy of cup position following robot-assisted total hip arthroplasty may be associated with surgical approach and pelvic tilt

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shinya Hayashi ◽  
Shingo Hashimoto ◽  
Yuichi Kuroda ◽  
Naoki Nakano ◽  
Tomoyuki Matsumoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Surgical Approach ◽  
Pelvic Tilt ◽  
Robot Assisted ◽  
Total Hip ◽  
Predictive Risk ◽  
Cup Positioning ◽  
Cup Position

AbstractThis study aimed to investigate the accuracy of cup placement and determine the predictive risk factors for inaccurate cup positioning in robot-assisted total hip arthroplasty (THA). We retrospectively analyzed 115 patients who underwent robot-assisted THA between August 2018 and November 2019. Acetabular cup alignment and three-dimensional (3D) position were measured using pre- or postoperative computed tomography (CT) data. Absolute differences in cup inclination, anteversion, and 3D position were assessed, and their relation to preoperative factors was evaluated. The average measurement of the absolute differences was 1.8° ± 2.0° (inclination) and 1.9° ± 2.3° (anteversion). The average absolute difference in the 3D cup position was 1.1 ± 1.2 mm (coronal plane) and 0.9 ± 1.0 mm (axial plane). Multivariate analysis revealed that a posterior pelvic tilt [odds ratio (OR, 1.1; 95% confidence interval (CI), 1.00–1.23] and anterior surgical approach (OR, 5.1; 95% CI, 1.69–15.38) were predictive factors for inaccurate cup positioning with robot-assisted THA. This is the first study to demonstrate the predictive risk factors (posterior pelvic tilt and anterior surgical approach) for inaccurate cup position in robot-assisted THA.

scholarly journals Pelvic Tilt in Patients Undergoing Total Hip Arthroplasty: When Does it Matter?

2015 ◽  
Vol 30 (3) ◽  
pp. 387-391 ◽  
Author(s):  
Joseph D. Maratt ◽  
Christina I. Esposito ◽  
Alexander S. McLawhorn ◽  
Seth A. Jerabek ◽  
Douglas E. Padgett ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Total Hip

Effects of posterior pelvic tilt on anterior instability in total hip arthroplasty: A parametric experimental modeling evaluation

2013 ◽  
Vol 28 (2) ◽  
pp. 178-181 ◽  
Author(s):  
Taishi Sato ◽  
Yasuharu Nakashima ◽  
Akinobu Matsushita ◽  
Masanori Fujii ◽  
Yukihide Iwamoto
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Experimental Modeling ◽  
Anterior Instability ◽  
Total Hip

Influence of pelvic sagittal tilt on 3-dimensional bone coverage in total hip arthroplasty: a simulation analysis

2019 ◽  
Vol 30 (3) ◽  
pp. 288-295
Author(s):  
Takuro Ueno ◽  
Tamon Kabata ◽  
Yoshitomo Kajino ◽  
Tomoharu Takagi ◽  
Takaaki Ohmori ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Orientation Angle ◽  
Acetabular Coverage ◽  
3 Dimensional ◽  
Total Hip ◽  
Sagittal Tilt ◽  
Posterior Tilt ◽  
3D Coverage

Background: In total hip arthroplasty with computer navigation assistance, cup orientation is generally determined according to the coordinate system relative to the functional pelvic plane (FPP). However, there is a large difference in the cup anteversion between a posterior pelvic tilt relative to the computed tomography (CT) table in the sagittal plane and anterior pelvic tilt, even when the cup is set at the same orientation angle according to each FPP. The present study analysed this difference from the viewpoint of 3-dimensional (3D) coverage of the acetabular component (3D coverage) to determine how the 3D acetabular coverage is altered with changes in pelvic sagittal tilt. Methods: We analysed 3D-simulated acetabular coverage measured in 3D pelvic models reconstructed from the preoperative CT data of 50 patients. In each patient, we created 5 pelvic models with a sagittal tilt of 10° increments between 20° anterior tilt and 20° posterior tilt relative to the CT table. Results: We found that 3D coverage decreased as the pelvis tilted posteriorly. Particularly, there were significant differences between the pelvis with 20° anterior tilt and that with neutral tilt ( p < 0.001). There was also a difference between the pelvis with neutral tilt and that with a 20° posterior tilt ( p < 0.01). The mean decrease in 3D coverage between the pelvis with neutral tilt and that with 20° posterior tilt was 7.2 ± 1.6%. Conclusions: We found that 3D coverage differed among pelvis with different sagittal tilts when the cup orientation angle was determined according to FPP.

Trends in cup position utilizing computer-assisted navigation during total hip arthroplasty

2020 ◽  
Vol 31 (3) ◽  
pp. 211-217
Author(s):  
Rachel R. Mays ◽  
Jessica R. Benson ◽  
Jeffrey M. Muir ◽  
Morteza Meftah
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Total Hip ◽  
Cup Position

Dislocation after total hip arthroplasty: does head size really matter?

2020 ◽  
pp. 112070001989840
Author(s):  
Erkan S Ertaş ◽  
A Mazhar Tokgözoğlu
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Large Diameter ◽  
Safe Zone ◽  
Head Size ◽  
Dislocation Rate ◽  
Head Group ◽  
Total Hip ◽  
Large Head ◽  
Cup Position

Introduction: Recent advances in polyethylene and ceramic technologies has allowed us to use larger sized heads without compromising the wear properties of a total hip arthroplasty (THA). 1 benefit of this change has been proposed to be a lower incidence of dislocation. Methods: We retrospectively evaluated the dislocation rate in 913 THAs performed using the same standardised surgical technique employed by a single team of surgeons at our institution between 1995 and 2015. Patients were assigned to 2 groups: small (⩽28 mm), large diameter heads (⩾36 mm and larger). The cup position was measured and plotted to determine its status according to the Lewinnek’s safe zone (15° ± 10° for anteversion, 40° ± 10° for inclination). Results: 16 of the 472 small heads dislocated (3.4%) while 5 of the 441 in large head group (1.1%) ( p = 0.04). In all of the large head patients that dislocated the cup position was in the safe range of Lewinnek. However, in the large head group only 64.5% of the cups were in the safe zone. Conclusions: By changing the head size to 36 mm, we were able to decrease the dislocation rate significantly. Errors of cup positioning according to Lewinnek became oblivious when using large heads. In our opinion, using large heads in THA makes a difference in terms of dislocation.

Predictability of Pelvic Tilt During Total Hip Arthroplasty Using a Traction Table

2018 ◽  
Vol 33 (8) ◽  
pp. 2556-2559
Author(s):  
Paul S. Roettges ◽  
Jack R. Hannallah ◽  
Jordan L. Smith ◽  
John T. Ruth
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Total Hip

scholarly journals Identification of risk factors for treatment failure of closed reduction and abduction bracing after first-time total hip arthroplasty dislocation

2021 ◽  
Author(s):  
Viktor Janz ◽  
Georgi Wassilew ◽  
Michael Putzier ◽  
Geraldine Kath ◽  
Carsten Perka
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Conservative Treatment ◽  
Hip Arthroplasty ◽  
Closed Reduction ◽  
Conservative Therapy ◽  
Statistical Significance ◽  
Total Hip ◽  
First Time ◽  
Cup Position

IntroductionAfter a first-time total hip arthroplasty (THA) dislocation, a closed reduction followed by partial immobilization in an abduction brace is the recommended therapy. Despite modern abduction braces the success rate of conservative therapy is limited and evidence is scarce. The aim of this study was to identify risk factors for failure of conservative treatment after THA dislocation.Material and methodsEighty-seven patients, with conservative treatment of a first-time dislocation of a primary or revision THA, were included in this retrospective cohort study. Success was defined as a stable THA for a minimum of six months. Re-dislocation, open reduction or revision was defined as failure. The following risk factors were analyzed: gender, age, body mass index (BMI), ASA (American Society of Anesthesiologists) score, time of dislocation, head size, cup orientation, leg length, center of rotation and offset.ResultsSixty-seven percent of all patients experienced a re-dislocation, despite standardized conservative therapy. A BMI ≥ 25, early THA dislocation, and low cup anteversion were associated with a statistically significantly higher risk for re-dislocation. None of the other risk-factors achieved statistical significance. A multifactorial risk-factor analysis was performed to assess whether a cup position outside of Lewinnek’s safe zone in combination with gender, BMI and time to dislocation showed statistical significance for re-dislocation. Both BMI ≥ 25 and early dislocation showed a statistically higher failure rate. Cup position and gender were not significant.ConclusionsBMI ≥ 25, early THA dislocation and low cup anteversion were identified as significant risk factors for failure of conservative treatment with an abduction brace for first-time THA dislocation.

scholarly journals Axial pelvic tilt in direct anterior Total hip Arthroplasty using a traction table

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
A. Aichmair ◽  
M. Dominkus ◽  
J. G. Hofstaetter
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Pelvic Tilt ◽  
Patient Positioning ◽  
Direct Anterior Approach ◽  
Operating Table ◽  
Inclusion Criteria ◽  
Single Institution ◽  
Total Hip

Abstract Background Direct anterior approach total hip arthroplasty may be undertaken on a traction table, but the effects that patient positioning can have on axial pelvic tilt (aPT) are unknown. The aim of this study was to assess the degree of error from patient positioning on the traction table during anterior minimally-invasive surgery (AMIS) THA. Methods Patients were included who underwent direct anterior THA via the AMIS technique at a single institution between 11/2018 and 03/2019. Axial pelvic tilt was measured (a) in the supine position on the operating table, and (b) after positioning on the traction table, by the same consultant surgeon in all cases. Results In the above-mentioned study period, 50 patients (F: 32; M: 18) with an average age of 60.6 ± 13.6 (range: 26.5 to 88.3) years, and an average BMI of 27.2 ± 5.0 (range: 17.9 to 41.5) kg/m2 met the inclusion criteria. When measured in supine position, the average aPT was − 0.2 ± 1.7 (range: − 5.6 to 3.8) degrees. After positioning on the traction table, the average aPT was − 3.5 ± 2.1 (− 8.5 to 1.6) degrees (p < 0.001). In patients with an aPT of more than 5 degrees, the caput-collum-diaphyseal (CCD) angle was significantly lower (125 ± 11° vs. 134 ± 8°, p = 0.007). Conclusion This study raises awareness for the potential risk of aPT during positioning of the patient on the traction table, commonly used during direct anterior THA via the AMIS technique.

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