scholarly journals Validation of use of transverse acetabular ligament and mechanical angle guide device to orient the acetabular cup

2020 ◽  
Vol 11 ◽  
pp. S766-S771
Author(s):  
Archit Agarwal ◽  
Inder Pawar ◽  
Sandeep Singh ◽  
Deepti Randev ◽  
Hem Chandra Sati
2008 ◽  
Vol 18 (1) ◽  
pp. 7-10 ◽  
Author(s):  
C.J. Pearce ◽  
Shaun A. Sexton ◽  
D.C. Davies ◽  
A. Khaleel

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
B Murphy ◽  
R Pollock ◽  
S Ramchurn ◽  
C Hurson

Abstract Introduction The transverse acetabular ligament (TAL) is an anatomical landmark that is of particular use during primary total hip replacements (THR). Visualisation is important to aid the orientation of the acetabular cup and it is a structure that can be identified in virtually every primary hip replacement surgery. We introduce a simple technique to facilitate this. Method A thoracic suction catheter is taped to the distal end of a blunt Hohmann’s retractor with two steristrips wrapping around the catheter and retractor leaving approximately 1-1.5cm of retractor exposed. Our preference is for a thoracic suction catheter with side holes and a proximal end which allows direct connection with the tip of the Yankauer suction. The blunt Hohmann’s retractor is used as the inferior acetabular retractor in the usual way, placed inferior to the transverse acetabular ligament, resting on the posterior ischial surface. The catheter suction tip should lie just under the TAL, in the most dependant point of the wound. Results The TAL suction catheter can be used continuously or intermittently to facilitate visualisation of the TAL during reaming, trialling, and acetabular cup placement. The TAL suction retractor provides suction in the most dependant point of the surgical wound, preventing unnecessary movement and facilitates a clutter-free surgical field leading to more streamlined and efficient surgery with potential reduced operative times. Conclusions The transverse acetabular ligament (TAL) suction retractor is a simple improvised surgical tool that makes it easier to visualise the TAL during acetabular preparation in total hip replacements.


Author(s):  
W Macdonald ◽  
L V Carlsson ◽  
G J Charnley ◽  
C M Jacobsson

2016 ◽  
Vol 11 (12) ◽  
pp. 2253-2271 ◽  
Author(s):  
Yoshiyuki Kagiyama ◽  
Itaru Otomaru ◽  
Masaki Takao ◽  
Nobuhiko Sugano ◽  
Masahiko Nakamoto ◽  
...  

2020 ◽  
Vol 4 (04) ◽  
pp. 155-157
Author(s):  
Michael Newman ◽  
David Hartwright

AbstractThe aim of this study was to assess a large, single-surgeon dataset of uncemented total hip arthroplasties that had been templated using software. This assessment compared preoperative templated predictions with what was implanted with regard to (1) femoral prosthesis size and (2) acetabular cup size. The operation notes for two types of uncemented total hip arthroplasty performed by a single surgeon between January 9, 2008, and March 21, 2019, were assessed. The data were refined so that only those that were fully templated on a correctly calibrated pelvic radiograph were included. This provided a total of 153 cases. The predicted software template was compared with actual implanted component sizes. With regard to the femoral stems, the templating software was exactly correct in 45.75% of cases and was accurate to within one size in 87.59% of cases. With regard to the acetabular component, the templating software was exactly correct in 52.94% of cases and was accurate to within one size (2 mm) in 86.94% of cases. Templating software offers an accurate prediction of the size of uncemented femoral and acetabular components. In addition, the benefits of templating include cognitive rehearsal, insight into potentially challenging aspects of surgery, and highlighting intraoperative issues where there is a large intraoperative deviation from what is templated. This study demonstrates the congruence and reproducibility of templating software when compared with other smaller studies performed in the literature.


2019 ◽  
pp. 112070001987482
Author(s):  
Arthur J Kievit ◽  
Johannes G G Dobbe ◽  
Wouter H Mallee ◽  
Leendert Blankevoort ◽  
Geert J Streekstra ◽  
...  

Introduction: We tested whether a mechanical device (such as Hipsecure) to pinpoint the anterior pelvic plane (APP) as a guide can improve acetabular cup placement. To assess accuracy we asked: (1) is the APP an effective guide to position acetabular cup placement within acceptable ° of divergence from the optimal 40° inclination and 15° anteversion; (2) could a mechanical device increase the number of acetabular cup placements within Lewinnek’s safe zone (i.e. inclination 30° to 50°; anteversion 5° to 25°)? Methods: 16 cadaveric specimens were used to assess the 3D surgical success of using a mechanical device APP to guide acetabular cup placement along the APP. We used the Hipsecure mechanical device to implant acetabular cups at 40° inclination and 15° anteversion. Subequently, all cadaveric specimens with implants were scanned with a CT and 3D models were created of the pelvis and acetabular cups to assess the outcome in terms of Lewinnek’s safe zones. Results: The mean inclination of the 16 implants was 40.6° (95% CI, 37.7–43.4) and the mean anteversion angle was 13.4° (95% CI, 10.7–16.1). All 16 cup placements were within Lewinnek’s safe zone for inclination (between 30° and 50°) and all but 2 were within Lewinnek’s safe zone for anteversion (between 5° and 25°). Conclusion: In cadaveric specimens, the use of a mechanical device and the APP as a guide for acetabular cup placement resulted in good positioning with respect to both of Lewinnek’s safe zones.


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